Vitality, Spring 2019

VITALITY MAGAZINE

USC LEONARD DAVIS SCHOOL OF GERONTOLOGY

VOL. 09 A Magazine for All Ages SPRING 2019

14

Fast Times

FALL 2018

Can this popular diet trend prevent disease and promote healthy aging?

“Our research funding success underscores our leadership of a global field that has grown more essential than ever.”

In this year’s State of the University Address, USC Interim President Wanda Austin shared the amazing fact that in 2017, USC received more Alzheimer’s disease research funding than any other American research university. I am proud to report that much of that research is taking place here at the USC Leonard Davis School of Gerontology, where we currently have 20 active National Institutes of Health research project grants for exploring Alzheimer’s disease, cancer, diabetes, the genetics of aging and more age-related issues.

Our research funding success underscores our leadership of a global field that has grown more essential than ever, as people age 65 or older will soon outnumber children younger than 5 across the world. In the 21st century, the challenge for our researchers is to focus not just on lifespans — how long we live — but also on healthspans, or how well we live.

In the quest to maximize our healthy years, researchers here at the USC Leonard Davis School explore novel methods of disease prevention and intervention, including that of lifestyle factors. This issue’s cover story features the remarkable work of Professor Valter Longo, who researches how fasting and fasting-mimicking diets can reduce risk factors for chronic diseases and lessen their impact.

Another feature story focuses on Professor Jennifer Ailshire’s recent findings that more Americans are getting fewer hours of sleep. Shorter sleep duration is associated with poorer health outcomes, and this work is an important step in understanding who is most at risk and how they can be helped.

We are also moving into the precision longevity era — one where we can leverage DNA and other biomarkers to better understand aging on an individual basis. Readers can learn more about USC Leonard Davis alumna Morgan Levine, now a faculty member at Yale, who explores the power of biomarkers to measure “biological age” and discern what factors are most likely to influence aging trajectories.

You will also read about some of our students who are making a difference both in and out of the classroom.

Our commitment to remaining on the forefront of aging investigation and educating the next generation of gerontology leaders is reflected in the extraordinary stories of innovation and impact in this issue of Vitality. It’s also reflected in the sustained growth of both our faculty and our student body. Decades ago, we anticipated this age of aging, and we continually lead the way in advancing science and scholarship to improve how long and how well we all live.

Pinchas Cohen, Dean

Photo by Stephanie Kleinman

DEAN’S MESSAGE

VITALITY MAGAZINE — Chief Communications Officer Orli Belman Editor in Chief Beth Newcomb Managing Editor Natalie Avunjian Design Golden Design Studio Contributors Joanna Clay Alicia Di Rado Diane Krieger Jenesse Miller Fiona Pestana Constance Sommer Cover Illustration Chris Gash

USC LEONARD DAVIS SCHOOL OF GERONTOLOGY — Dean Pinchas Cohen Executive Vice Dean Kelvin J. A. Davies Senior Associate Dean Maria L. Henke Senior Associate Dean for Advancement David Eshaghpour Associate Dean of Research Sean Curran Assistant Dean of Diversity and Inclusion Susan Enguídanos Assistant Dean of Education John Walsh Assistant Dean of Faculty and Academic Affairs Mara Mather Senior Business Officer Lali Acuna Senior Human Resources Business Partner Wendy Snaer

INSIDE

3

By the Numbers California caregivers miss out on paid family leave

5

New Directions The African turquoise killifish offers a unique aging model

FEATURED —

7

Onscreen When caregiving is a laughing matter

9

Q&A Reginald TuckerSeeley discusses his D.C. policy fellowship

28

14

Fast Times A look at the science behind this popular diet trend

A New Age Alumna Morgan Levine works to quantify the aging process

12

Vital Signs Is the keto diet safe?

38

Drawing Connections Kids create art from older adults’ stories

40

Half Century Trojan Shari Thorell named to Hall of Fame

20 24 32 From Neighbor to Advocate A tap on the door led Jon Pynoos to a career in helping older adults

Losing Sleep More Americans are getting less rest, increasing risks for poor health outcomes

Making an Impact Gerontology students are a force for change in their communities and professions

SPRING 2019 | 1

NEWS BITES HONORS & AWARDS —

Kelvin J.A. Davies Distinguished Professor, USC; Fellow, American Aging Association; Distinguished Scholar Award, Fulbright Scholar Program Jyung Mean Son Postdoctoral Fellowship in Aging Research, Glenn Foundation for Medical Research John Lew Diversity Scholarships, California Academy of Nutrition and Dietetics Foundation; Commission on Dietetic Registration, Academy of Nutrition and Dietetics Foundation QUOTABLE —

“The Minimum Data Set, when merged with data from Medicare and Medicaid, has greatly improved our understanding of nursing homes.”

— Vincent Mor, Florence Pirce Grant Professor of Community Health at Brown University, who delivered the 2018 Esther and Isadore Kesten Memorial Lecture at the USC Leonard Davis School. He is a creator of the Minimum Data Set, a standardized clinical assessment used for nursing homes.

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LAB SPOTLIGHT —

New Alzheimer’s Insights New research from USC Leonard Davis School Professor Andrei Irimia aims to use detailed brain scans to help determine why traumatic brain injuries (TBIs), such as concussions, can put certain patients at higher risk for Alzheimer’s disease (AD) and related dementias (ADRD) than others.

An estimated 5.6 million Americans suffer from AD. Head injuries are a big problem, too. Falls are the cause of two of every three cases of TBI in older adults, and injuries sustained at any age are suspected of putting people at increased risk for ADRD, according to Irimia.

One of only four investigators nationwide to recently receive a New Investigator Award from the DoD’s Congressionally Directed Medical Research Programs’ Peer Reviewed Alzheimer’s Program, Irimia is comparing anatomic properties of TBI-affected brains and looking at how factors like injury severity, number and age at occurrence make their mark in the brain — something that used to be viewable only during autopsies.

The results of his research could help scientists predict who is most likely to develop AD after a head injury, and why. “By establishing who is at highest risk, we can help prioritize care and monitoring of head injuries and hopefully decrease the incidence of AD,” said Irimia.

Photo: courtesy of Andrei Irimia. Opposite page: illustration by Natalie Avunjian

Andrei Irimia New Investigator Research Award, Congressionally Directed Medical Research Programs, Department of Defense

GLOSSARY — Epigenetics How an organism’s traits vary with changes to levels of gene expression — turning genes “off” or “on” — instead of changes to the DNA sequence itself - Dictionary.com Chronological vs. biological age Comparison of actual age in number of years lived to the age at which one’s body functions per average fitness or health levels - Levine et al., 2018 Mitochondrialderived peptides Small signaling proteins coded from DNA within the mitchondria of a cell - Lee, Yen and Cohen, 2013

Best of 2019 The USC online Master of Science in Gerontology program was named a top gerontology program and the best program overall for policy careers by OnlineMasters.com.

1 in 5

working caregivers in California who know about Paid Family Leave incorrectly think that they aren’t eligible for it Source: Understanding Working and Caregiving, 2018

BY THE NUMBERS —

Many Caregivers Miss Out on State Benefits Caregivers in California aren’t taking full advantage of the state’s Paid Family Leave benefit as they fulfill care duties for loved ones, according to a new report by the California Work and Family Commission and Human Impact Partners.

Donna Benton, director of the USC Family Caregiver Support Center at the USC Leonard Davis School of Gerontology, served on the advisory committee for the project. The team found that eligible caregivers didn’t use the Paid Family Leave benefit for several reasons, including insufficient wage replacement or job protection, confusion during the application process or lack of knowledge of the program’s existence. The benefit provides partial pay for six weeks to eligible individuals caring for a new child or ill family member and is funded by payroll taxes to the State Disability Insurance program. — B.N.

$7,000

average yearly caregiving costs of U.S. family caregivers Source: Family Caregiving and Outof-Pocket Costs: 2016 Report, AARP

18.1 million

Californians are covered by the Paid Family Leave program Source: Understanding Working and Caregiving, 2018

SPRING 2019 | 3

NEWS BITES FINDINGS —

Mitochondrial Gene May Protect Against Dementia

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U.S. Overdose Death Rates Highest of Wealthy Nations

In the most comprehensive international comparison of its kind, a USC study found that the United States has the highest drug overdose death rates among a set of highincome countries.

“The United States is experiencing a drug overdose epidemic of unprecedented magnitude, not only judging by its own history, but also compared to the experiences of other high-income countries,” said study author Jessica Ho, assistant professor at the USC Leonard Davis School of Gerontology.

The study, published in the journal Population and Development Review, found that drug overdose death rates in the U.S. are 3.5 times higher, on average, compared to 17 other high-income countries. The study is also the first to demonstrate that the drug overdose epidemic is contributing to the widening gap in life expectancy between the U.S. and other high-income countries.

“On average, Americans are living 2.6 fewer years than people in other highincome countries. This puts the U.S. more than a decade behind the life expectancy levels achieved by other high-income countries. American drug overdose deaths are widening this already significant gap and causing us to fall even further behind our peer countries,” said Ho. ­­­— J.M.

Photo: Shutterstock/Scotyard. Opposite page: photo courtesy of Itamar Harel

USC Leonard Davis School research uncovered a previously unknown genetic risk factor for Alzheimer’s disease and related dementias, providing insights into how diseases of aging might one day be treated and prevented.

The study, which appeared in the journal Scientific Reports, sheds light on the mitochondrial peptide humanin. Amounts of the peptide decrease with age, leading researchers to believe that humanin levels play an important function in aging and age-related diseases.

“Because of the beneficial effects of humanin, a decrease in circulating “Because of the levels could lead to an increase in beneficial effects of humanin, a decrease in several different diseases of aging,” circulating levels could said senior author Pinchas Cohen, USC Leonard Davis School dean and one lead to an increase of three researchers to independently in several different discover humanin in 2003. diseases of aging.”

Because humanin is encoded within the mitochondrial genome, the team examined the mitochondrial DNA for genetic variations known as single-nucleotide polymorphisms, or SNPs, that could explain differences between humanin levels. One SNP they identified was associated with a 14 percent decrease in circulating humanin levels; this SNP is also associated with accelerated cognitive aging, the first correlation of a humanin SNP in mitochondria to cognitive decline in people. The paper also shows that in mice, injections of humanin delay cognitive decline, suggesting a possible therapeutic role for humanin-related drugs. — O.B.

NEW DIRECTIONS

FUSSY FISH

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It takes special attention to raise Nothobranchius furzeri in the lab:

Go Fish!

Back in its native habitat, the African turquoise killifish wiggles from its egg, eats, spawns and dies — all within a few months.

Life goes by fast when your home is a quickly evaporating pond of rainwater. But even when raised as pets in a home aquarium, these killifish still live for less than a year.

For researchers studying aging, that’s a good thing. It turns out that the fish mature much like humans do — but far more rapidly. That makes them helpful for efficiently studying the aging process, and it’s why research labs focusing on the fish are growing exponentially.

Now Bérénice Benayoun, who was on the first team to sequence the fish’s genome, has joined the USC Leonard Davis School of Gerontology from Stanford University. She is bringing Nothobranchius furzeri to USC for the first time, so insights on aging are sure to follow. ­ CONNECTIONS TO AGING The fish go through many of the same aging processes that human beings do. As they get older, their injured tail fins regenerate more slowly, just as humans find it harder to heal wounds. They’re also prone to cancer — 30 percent of them die with liver cancer — making them a good model for studying the disease. Male fish even lose their bright colors as they age. — A.D.

They’re fed baby brine shrimp in their early weeks, before moving on to food pellets formulated by researchers.

Aquarium water must flow slowly to mimic the creature’s near-stagnant native waters.

It takes only 40 days for the fish to grow to its full size of 2.5 inches long.

KILLIFISH CLAIMS TO FAME

Their surrounding room temperature must be 26 degrees Celsius — nearly 79 degrees Fahrenheit.

Fertilized eggs are removed from the water and placed on moss beds to simulate the dry seasons of Zimbabwe and Mozambique.

African turquoise killifish have the shortest lifespan of any vertebrate bred in captivity.

Embryos go into suspended animation during the dry season, emerging from dry mud at first rain.

Fish can breed within two weeks of hatching.

SPRING 2019 | 5

NEWS BITES

Los Angeles Times

—

Time

50 Most Influential People In Health Care of 2018 USC Leonard Davis School Professor Valter Longo, director of the USC Longevity Institute, was named one of Time magazine’s 50 Most Influential People in Health Care for his research on fasting-mimicking diets as a way to improve health and prevent disease.

CNN

EXPERT INTERVIEW

How can we keep ourselves healthier for longer?

“If we can strive to eat a plantbased diet as much as possible, we’re going to be better off.”

— Cary Kreutzer, appearing on Larry King Now.

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Is air pollution tied to higher dementia risk?

CNN noted that a recent study co-led by University Professor Caleb Finch of the USC Leonard Davis School adds to a growing body of research investigating the potential link between air pollution and dementia.

Reuters

One-floor living helps seniors “age in place” A Reuters article quoted Professor Jon Pynoos of the USC Leonard Davis School on what features can help older adults age comfortably in their own homes. “In a home with two or more stories, stacking closets that could later be replaced with a small elevator might be a good investment,” Pynoos said. “Basically, plan ahead.”

Smithsonian Magazine

The U.S. has the highest overdose death rate of any wealthy nation Smithsonian featured research by USC Leonard Davis School Assistant Professor Jessica Ho about global drug overdose death rates and how the United States compares to other high-income countries. “While the United States is not alone in experiencing increases in drug overdose mortality, the magnitude of the differences in levels of drug overdose mortality is staggering,” Ho said.

Harvard Business Review

The longevity opportunity/When no one retires Harvard Business Review published two columns by Paul Irving, Distinguished Scholar in Residence at the USC Leonard Davis School, on the buying power of older consumers and what an aging population will mean for employers and the workforce.

Health Affairs

Let’s not muddle the message about home- and community-based palliative care USC Leonard Davis School Research Assistant Professor Anna Rahman authored a blog post for Health Affairs about how the distinction between palliative care and end-of-life care needs to be made clearer.

“Consistently conflating palliative care and hospice care threatens to undermine our field’s credibility and our ability to help patients who could benefit from the extra layer of support palliative care provides,” Rahman wrote.

This page: photo courtesy of Cary Kreutzer. Opposite page: illustration by iStock/Mykyta Dolmatov; photo by Shawn Corrigan

IN THE MEDIA

California’s senior population is growing faster than any other age group. How the next governor responds is crucial The Los Angeles Times quoted Donna Benton, director of the USC Family Caregiver Support Center, on how the strain that aging can cause for seniors and their families has long been seen as a private affair. “This is a public health issue now,” Benton said.

SOLUTIONS —

Untapped App Potential One moment, you’re liking posts and sharing your avocado toast on Instagram. The next, you’re managing the medications and doctor appointments of your loved one.

Recognizing the power of our devices, USC Leonard Davis School of Gerontology Professor Elizabeth Zelinski, PhD candidate Mollie Grossman and project specialist Deanah Zak wanted to assess the ability of mobile apps to assist caregivers.

The team recently published a study in JMIR mHealth and uHealth on the availability of apps serving caregivers. After searching on iTunes and Google Play for apps targeting caregivers, the researchers identified their functions, which ranged from providing practical problem-solving strategies for older adults to allowing coordination between multiple caregivers. They aimed to learn about what apps already existed on the market and which ones exhibited best practices for caregiving assistance on the go.

Apps for caregivers can help ease the difficulties of caring for older adults. However, the study found that the apps largely lack tools for emotional support for caregivers. Functions such as stress-reduction exercises could improve both the caregiving process and the care older adults receive, the authors said. — F.P.

ONSCREEN —

Humor and Heart Stand-up comedian Jesus Trejo often starts his late-night sets explaining that he’s got two little ones at home: his father and mother, 73-year-old Antonio and 72-year-old Adelaida.

The trio are the subjects of Care to Laugh, a documentary that follows the younger Trejo as he strives to establish himself in the L.A. comedy scene while serving as the sole caregiver for his parents. He monitors his diabetic mom’s blood glucose levels before stepping onstage, mows lawns for his dad’s gardening business between auditions, and brings his parents along to out-of-town shows when they can’t stay home alone. “My parents took care of me, and now I’m doing it for them,” said Trejo.

There are currently 40 million caregivers in the U.S., and 10 million of them are millennials like Trejo, according to Jeffrey Eagle, vice president of AARP Studios, which produced the film to shine a light on caregivers’ stories.

“We are trying to effect change,” Eagle said at a recent screening hosted by the USC Leonard Davis School of Gerontology and the USC School of Cinematic Arts. The event was part of the USC Age-Friendly University initiative.

In a post-screening discussion moderated by USC Leonard Davis School Instructional Associate Professor Caroline Cicero, Trejo and Eagle touched on the challenges of caregiving, the importance of family, and the healing powers of laughter.

“I’m very lucky that I’m able to bring it onstage, so it almost seems like therapy,” Trejo said. Through his humor and his honesty, he aims to help others as well. “I hope people watch this and know they are not alone.” — O.B.

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NEWS BITES

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The Human Impact of Health Policy “From early results, it seems like many older people experience an extraordinary sense of relief when they transition onto Medicare.”

Mireille Jacobson, Associate Professor of Gerontology at the USC Leonard Davis School

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Health care policy isn’t just a numbers game for economist Mireille Jacobson. Besides affecting costs, it can have significant impacts on patient outcomes and well-being, including for older adults, she says.

Jacobson, who came to the USC Leonard Davis School of Gerontology as an associate professor from UC Irvine, trained as a labor economist during her PhD program at Harvard. Wanting to further explore health care issues led her to a postdoctoral fellowship at Harvard Medical School in the Department of Health Care Policy, and to her first time working on issues facing older adults in particular.

“That was my introduction to health care, and I was hooked,” Jacobson says. “The health care market is just so fascinating and frustrating and has endless sets of questions.”

Currently of special interest to Jacobson is the transition of U.S. adults onto Medicare at age 65. Beyond the effects on personal health care spending, she wants to know more about how enrolling in Medicare affects well-being, including self-reported physical health and mental health.

“From early results, it seems like many older people experience an extraordinary sense of relief when they transition onto Medicare,” she says.

Along with her primary appointment at the USC Leonard Davis School, Jacobson is also co-director of the program on aging at the USC Schaeffer Center for Health Economics and Policy and a research associate in the Health Care Program at the National Bureau of Economic Research. — B.N.

This page: photo by Leb Orloff; illustration by iStock/Irina Strelnikova. Opposite page: photo by John Skalicky

POLICY

in my course. Understanding the many challenges that are present in the process — from problem identification to solution identification and implementation — will be useful for students interested in health and social policy in an aging society, and learning and practicing these skills in the classroom will prepare them for engaging in the policy process at the local, state and federal levels.

Reginald Tucker-Seeley, the Edward L. Schneider Assistant Professor of Gerontology, spent a year in Washington, D.C., as a Robert Wood Johnson Foundation Health Policy Fellow. This prestigious program places health professionals in policymaking residencies so they can get handson experience working on legislative and regulatory issues. Tucker-Seeley, an expert on health disparities who focuses on the financial well-being of families as they navigate health care, served in Senator Dianne Feinstein’s (CA-D) office.

Q: What were the most valuable aspects of your experience in D.C.?

A: Having the opportunity to see the policy process happen, to see how funding decisions get made in the U.S. Senate, and to see how hard folks are working to solve big problems was an amazing opportunity.

One of the things that was really instructive was to see the policy prioritization process —how an issue goes from an idea to actual legislation. … The fellowship experience and working in Senator Feinstein’s office with her really talented health policy staff showed me some strategies that worked, and some strategies that could be improved.

Q: Will you incorporate anything you learned into your teaching?

A: I definitely plan to incorporate what I learned about federal policymaking in my teaching. In Senator Feinstein’s office, student interns can work on a project where they go through the process to actually identify a problem, evaluate solutions and prepare a presentation for a potential policymaker. I plan to use that model

Q: Did being in Washington impact any aspects of your current research on the financial well-being of families as they navigate health care?

A: As I was immersed in the Washington, D.C., health policy landscape, I was constantly thinking about ways to include in all health policy discussions the impact on household financial well-being as families navigate health care, and the substantial problem this will become as the U.S. population ages. … This fellowship gave me an opportunity to see the federal policymaking process from the inside, and I look forward to bringing that invaluable real-world experience to my teaching and research here at USC. Q: Will this experience influence your future research?

A: There were several issues related to health disparities that were raised through the many meetings I had with healthrelated organizations during my fellowship, especially through the many constituent meetings in Senator Feinstein’s office. One of those health issues is end-stage renal disease, or kidney failure. The U.S. spends close to $35 billion on end-stage renal disease care, which is almost as much as the budget for the entire National Institutes of Health. I learned that African Americans are more likely to have end-stage renal disease and progress to end-stage faster than other groups. These disparities-related issues raised my interest in this area, and understanding these issues in the context of aging and household financial well-being is something I’d like to explore further.

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NEWS BITES 2018 GSA SCIENTIFIC MEETING — Faculty, postdoctoral and student researchers shared their work during the Gerontological Society of America Annual Scientific Meeting in Boston in November 2018.

From the biological processes underlying aging to the social factors influencing well-being in older adults, USC Leonard Davis School experts shared work on a wide variety of topics:

Social Media & Loneliness

24%

of survey respondents from 57 nations have a “highly ageist” disposition.

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“Compared to older adults who do not have any frequent contact with their networks, those who only use one mode (i.e., only in-person meetings or phone calls) have the same odds of being lonely. Those who use multiple modes of contact — either with or without social media — have lower odds of being lonely. Those who added social media to these multiple modes did not have reduced odds of being lonely over and above their peers who used multiple modes without social media, however.”

— Haley Gallo, PhD in Gerontology student, USC Leonard Davis School

Potential Treatments from Mitochondrial Peptides

“Mitochondrial-derived peptides (MDPs) are novel peptides encoded within the mtDNA that serve as signals for cell and organismal protection and energy expenditure. ...

MDPs have been administered to various disease models and delay the progression of atherosclerosis, Alzheimer’s and chemotherapy-induced side effects.”

— Pinchas Cohen, dean, USC Leonard Davis School

Ageism Across the World

“From 2000 to 2050, the global population over 60 is expected to double. Whether or not countries benefit from population aging will depend on their attitudes toward aging and older persons. The pervasive nature of ageism presents older people negatively, globally representing them as burdensome for health and economies.”

— Paul Nash, research assistant professor, USC Leonard Davis School Among 57 countries, 24 percent of respondents were classified as having “highly ageist” dispositions, and 32 percent were classified as “moderately ageist.”

Source: World Values Survey

Undiagnosed Diabetes in Older U.S. Hispanics

“Diabetes is a major disease that affects a growing number of aging Hispanics in the U.S. and contributes to poor quality of life, increased health care costs and premature death. However, Hispanics are less likely to receive preventive and screening services than non-Hispanic whites due to the challenges they face in accessing and interacting with the health care systems. ... Results show that diabetes was underestimated for all older Hispanic subgroups, but greater rates of underestimation were observed for Puerto Ricans, non-white Hispanics, and Hispanic immigrants who migrated to the U.S. after age 60.”

— Catherine Pérez, PhD in Gerontology candidate, USC Leonard Davis School

Differences in Death Sites

“Stays in nursing homes [prior to death] were more common in the U.S. compared to Europe. There is, however, significant variation across European countries. ... Having a spouse or coresident child was a particularly important determinant for remaining in the home prior to death.”

— Jennifer Ailshire, assistant professor, USC Leonard Davis School 52 percent of European deaths occurred in hospitals, versus 37 percent of American deaths. Fewer Europeans (20 percent) than Americans (34 percent) died in nursing homes or other locations such as hospice.

Source: Health and Retirement Study; Survey of Health, Ageing and Retirement in Europe

34%

of American deaths take place in nursing homes, hospice or other locations.

52%

Adapting to Stress

Navigating Nursing Home Reviews

“Adaptive Homeostasis is the mechanism by which we adapt to changing environmental and metabolic conditions throughout the day. Unfortunately, Adaptive Homeostasis declines with age, increasing our susceptibility to frailty, senescence, and disease.”

“Correlations between the Yelp and Nursing Home Compare ratings [of 675 California nursing homes] were relatively weak. The Yelp rating was significantly lower than the 5-star NHC rating and the NHC ratings for staffing and quality measures, and it was significantly higher than the NHC inspection rating.”

— Kelvin Davies, executive vice dean and James E. Birren Chair, USC Leonard Davis School

— Anna Rahman, research assistant professor, and Susan Enguídanos, associate professor, USC Leonard Davis School

of deaths in Europe occur in hospitals, versus 37 percent of U.S. deaths.

SPRING 2019 | 11

VITAL SIGNS

Is the Keto Diet Safe?

“Ninety percent of Americans have dieted, and when asked whether they’re dieting for health or to lose weight, the predominant answer is ‘to lose weight.’”

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The ketogenic diet — a high fat, moderate protein, very low carbohydrate plan — may eclipse paleo and Whole30 as the hot diet trend of 2019.

The keto diet excludes major groups of foods, such as grains, legumes and dairy, and cuts back on certain nutrient-rich vegetables. The idea is to get your body to switch from burning carbs to burning fat for fuel, in turn producing ketones, leading to ketosis.

Maybe you’ve seen #keto on your Instagram feed alongside plates heaped with steaks, bacon and avocado. Meal delivery companies are accommodating keto eaters as they do for vegetarians or vegans, even offering strip tests to test ketone levels. But USC experts say to exercise caution when trying out the trend.

Ninety percent of Americans have dieted, and when asked whether they’re dieting for health or to lose weight, “the predominant answer is ‘to lose weight,’” according

to Dean Pinchas Cohen of the USC Leonard Davis School.

So it’s no surprise that keto — essentially a new take on the Atkins diet — is popular, since it results in weight loss, he said. But long term, the keto diet could be detrimental, since cutting out carbs increases health risks and mortality over time, Cohen said.

The keto diet is usually something that’s prescribed by a dietitian. Jessica Lowe, a Keck School of Medicine of USC ketogenic dietitian and a preceptor for the Master of Science in Nutrition, Healthspan and Longevity program, said she might prescribe it to a patient with epilepsy, since there’s research showing it can help control seizures. There’s also interest in whether high-fat diets could help with brain injuries or neurodegenerative diseases, Lowe said.

But she added that for the everyday dieter, it’s important to consult with a registered dietitian before trying the keto diet.

Photo: Shutterstock/Maglara

by Joanna Clay

JOIN A STUDY —

Experience Calmness Through Heart Rate Biofeedback

CLASSROOM —

Making Data Digestible At the USC Leonard Davis School, students learn how to make data less daunting.

Associate Professor Cary Kreutzer teaches “Communicating Nutrition and Health,” a class offered to students in the Master of Science in Nutrition, Healthspan and Longevity (MSNHL) program.

Learning how to create effective devices such as infographics can help these students communicate scientific data in a reliable, digestible way. This way, their findings can impact anyone, regardless of educational background. With understanding, the public can actively make changes to benefit their health.

“I think tools such as infographics are fantastic learning tools,” said Jillian Chaney MSNHL ’20. “They provide an ability to communicate information quickly, in an easily digestible format that can be easily understood by consumers. Particularly in today’s fast-paced environment, where people don’t have time to read even magazine articles, infographics are quick and to the point.” — F.P. Pictured above: a section from an infographic on salt created

by John Lew and Laura Nolting, Master of Science in Nutrition, Healthspan and Longevity graduate students

Meditation is known to have remarkable effects on emotional health outcomes: it can calm you down and reduce stress and anxiety.

People also experience feelings of peace, calm and happiness.

Many types of meditation also influence heart rate, but not much is understood about how these heart rate changes relate to the effects of meditation.

USC Leonard Davis researchers are investigating how controlling your heart rate over the course of seven weeks could influence emotional health and the function of brain regions involved in emotion regulation. Through heart rate biofeedback training, researchers hope to see improved functioning of cardiovascular control systems in the brain that help regulate emotions, improve well-being and reduce feelings of depression, stress and anxiety.

If you’d like to participate and are between the ages of 55 and 75, please visit healthyminds.usc.edu/ biofeedback to learn more, or call (213) 740-9543.

SPRING 2019 | 13

1 | VITALITY

When it comes to what, when and how we eat, fasting — voluntarily abstaining from food for varying periods of time — is having a moment. It was the most popular diet of 2018, according to a survey from the International Food Information Council Foundation (IFICF), and forms of fasting rank among Google’s top-trending diet searches. Seemingly ageless celebrities like Halle Berry and Hugh Jackman praise the practice for helping them to look, feel and even sleep better.

Yet fasting is far from a fad. It was a part of life in ancient civilizations, and many religions today retain some form of the rite, often as a way to achieve focus and clarity. In scientific circles, no less than Hippocrates, known as the father of modern medicine, is said to have prescribed it to spur healing.

by Orli Belman Illustration by Chris Gash

SPRING 2019 | 2

When Time magazine named Valter Longo to its first-ever list of the 50 Most Influential People in Health Care, they called him “the fasting evangelist.” Evangelism captures the passion that Longo, director of the USC Longevity Institute and the Edna M. Jones Professor of Gerontology at the USC Leonard Davis School, brings to his research exploring the life-extending benefits of fasting-like diets. It also connects to the many faith traditions that make fasting an age-old practice. And it’s a techie term used in Silicon Valley circles for spurring mainstream adoption of an innovation.

The word works. One in 10 people today are following a fasting diet, according to the IFICF survey.

Today, health and renewal remain key reasons for fasting’s enduring popularity, and they are at the heart of a thriving field of scientific inquiry that aims to leverage fasting-like diets as a way to extend life and help treat and prevent disease.

“I want to optimize the chance for people to make it to 110 healthy,” said Longo.

Findings from the Field In a landmark 2008 study, Longo found that fasting for two days protected healthy cells against the toxicity of chemotherapy, while the cancer cells stayed sensitive. These results opened the door to a new way of thinking about cancer treatments — one that shields healthy cells to allow for a more powerful assault on cancerous ones. They also led to the creation of the first fasting-mimicking diet, which Longo developed as a way to put patients with cancer, or mice in the lab, in a fasting state while still allowing them to eat.

“The oncologists did not want to fast the patients, and the patients did not want to fast,” Longo said. “We went to the National Cancer Institute, and they came up with a call for a fasting-mimicking diet, essentially saying: ‘Let’s develop something that people can

16 | VITALITY

Photo by Stephanie Kleinman

Professor Valter Longo

Starving for Answers Longo, who earned his PhD in biochemistry, has been at the forefront of the modern fasting movement for more than 20 years. His work grew out of earlier food-related findings showing that reducing calories without malnutrition extended healthy life spans and reduced cancer and other diseases in animal models. But these studies, as well as some later ones in humans, also revealed harmful consequences of severe caloric restriction and proved to be very difficult for people to maintain.

“Those experiments told us that there is no doubt there is this secret to many diseases in those calorie-restriction studies, but calorie restriction is not the answer,” Longo said. “So, the goal was always to come up with something that was as good as calorie restriction, if not better, but take away the burden and take away the side effects.”

Longo’s search led him to study the genetics of aging, where his early experiments showed that yeast cells starved of nutrients lived longer and were more resistant to stress. “If you starve them, they become very protected,” he said. “So I started thinking, what would this be useful for? And the first idea was chemotherapy.”

eat but [that], to the body — whether it’s a mouse or a person — is going to be like water-only fasting, meaning that it will cause very similar changes, as if they were not eating at all.’”

Longo answered the call, and in the past decade, he and other researchers have clinically demonstrated that brief cycles of periodic fasting-mimicking diets (FMD) have a range of beneficial effects on aging and on risk factors for cancer, diabetes, heart disease and other age-related diseases in mice and humans. More recent studies have also shown promise for treating multiple sclerosis and Crohn’s disease.

“If the results remain positive, I believe this FMD will represent the first safe and effective intervention to promote positive changes associated with longevity and health span, which can be recommended by a physician to almost any adult,” Longo said.

Based on his USC research, Longo founded L-Nutra, a nutritechnology company that offers packaged versions of the FMD. Longo says the company is gathering clinical data related to efficacy and side effects, and it aims to one day gain FDA approval for use of the diet as a way to treat disease. Longo also says that he will donate 100 percent of his shares in the company to research and charity.

Renewal Longo’s USC lab is currently delving further into how the FMD dietary intervention affects regeneration and disease resistance. He has coined the term “juventology” to explore the question of how to stay young and not just healthy.

“That’s really what this fasting movement is about. How do you change the system, how do you trick and reset cells so that you’re going back, maybe not to 18 years old, but certainly to that state where everything was in place?” he said.

Longo, who hopes to live to 120, thinks that an L-Nutra fastingmimicking diet called Prolon, made for relatively healthy people and providing an average of 900 calories a day, can help with this resetting, even if it is done an average of only three times a year. “I think it’s got little to do with everyday food, in general, [and] more to do with the ability of a system to reset,” he said. “That’s the power of understanding the fundamental ability of organisms to repair themselves.”

However, this is not to say that Longo does not have recommendations about what, and how much, to eat when not fasting.

In his recent book The Longevity Diet, he advocates following a diet supported by science and seen in most long-lived populations around the world that is mostly plant-based, low in protein and rich in unsaturated fats and complex carbohydrates. “It just has to be the right foods in the right amounts,” Longo said.

Types of Intermittent Fasting In addition to Longo’s fasting-mimicking diet, here are some other popular forms of fasting.

TIME-RESTRICTED FEEDING Restrict your eating to 10 hours a day.

THE 16/8 PLAN Eat during an eight-hour window, and fast for the rest of the day.

THE 12-6 PLAN Eat only between noon and 6 p.m.

WARRIOR DIET To mimic the eating habits of warriors in history, fast for 20 hours during the day, and consume any foods in a four-hour window.

ONE MEAL A DAY (OMAD) DIET Eat a large meal in a one-hour window, and fast for the rest of the day. You can drink calorie-free drinks (e.g., black coffee, water) the other 23 hours.

THE 5-2 PLAN Fast two nonconsecutive days of the week, and eat healthy on the other five days.

ALTERNATE-DAY FASTING Fast every other day, and eat healthy on the in-between days. — F.P.

Fast Talk In light of the focus on fasting, the USC Leonard Davis School hosted the First International Conference on Fasting, Dietary Restriction, Longevity and Disease. Top researchers from Harvard, MIT, the Salk Institute, the National Institutes of Aging and other institutions gath-

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Interested in fasting? Here’s what you need to know.

Registered dietician Cary Kreutzer, director of the USC Leonard Davis School’s Master of Science in Nutrition, Healthspan and Longevity program, gives advice for those considering forgoing food, even for a short time.

GET MEDICAL SUPERVISION.

BE WARY IF YOU HAVE A PREEXISTING MEDICAL CONDITION.

DO NOT FAST CONTINUALLY OR TO LOSE WEIGHT.

“You should speak with your physician before trying any type of fasting program,” said Kreutzer.

Everyone has a different genome, with different needs. Supervision by a doctor will help an individual try intermittent fasting safely, with patient-specific medical advice and care, while consuming fewer calories.

The physician will also let you know if fasting is right for you.

“Some may benefit more [from such a fasting program] than others,” said Kreutzer.

Kreutzer says that people with conditions like diabetes or autoimmune disorders should be especially careful when considering fasting. Asking a physician about fasting could prevent an individual from aggravating the medical conditions they already have. Fasting unhealthily would take away from the potential benefits of fasting entirely.

Kreutzer emphasizes that the fasting program should not be a permanent diet. Pursuing the program for a long period of time would deprive the body of the energy it needs, counteracting fasting’s goal to strengthen it.

“People need to be clear on why they’re doing this diet,” said Kreutzer.

Fasting is for living longer, not for losing weight. Fasting gets rid of weak cells in the body, letting them die off by briefly not giving them energy. This gives room for stronger cells to grow and thrive after the process, possibly improving the chances of living a longer life.

Fasting is not intended for weight loss. Having this intention might lead to unhealthy forms of fasting, such as pursuing the program for too long.

— F.P.

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ered for a two-day conference that offered education for doctors and the lay public, and that also provided an opportunity for participants to dialogue with other field leaders in an attempt to set standards — and reality checks — for the increasingly popular, and often improvised, practice.

“If you go out there and you pick the people that are fasting, I would say 95 percent of them are doing it wrong. Conferences like this are really important to make sure that we keep getting it right,” Longo said. “You really need to have lots of universities, lots of leaders, lots of clinical trials and lots of basic research. And I think that for the first time, this is happening.”

What’s Next Indeed, several large clinical trials are now underway. One trial funded by the National Institutes of Health is looking at whether intermittent fasting is a safe and effective alternative to more standard methods of weight control, such as caloric restriction. Another National Institute on Aging (NIA) study is testing an intermittent fasting diet in obese people ages 55 to 70 with insulin resistance. According to the NIA, researchers will continue to explore many unresolved questions around determining the long-term benefits and risks of various eating patterns, including looking at which diets are feasible as a long-term practice, what specific biological effects on aging and disease are triggered by a particular eating pattern, what ways of eating are best for different age groups, and whether an eating pattern that’s found to help one person might not have the same effect on another.

“Other than genes, it is hard to think of something that can be more powerful than food in determining whether someone is going to make it to 100 or die before 50 years old,” Longo said.

The challenge for researchers and for society in general, he says, is to translate what works in the lab into real people’s lives. He says a new approach is needed, one that does not call for an across-theboard reduction in the amounts and types of foods people eat — which, studies show, most people cannot sustain.

“So, if you went to somebody and said, ‘You can do everything you did before, but I just ask you one thing: Reduce your animal protein intake by 40 percent, or undergo a vegan fasting-mimicking diet for 15 days a year.’ Now we start to become reasonable,” Longo said.

“Let’s come up with something that doesn’t require people to change their habits, but it does require them to maybe once in a while make smaller changes.”

In other words… not so fast.

“Other than genes, it is hard to think of something that can be more powerful than food in determining whether someone is going to make it to 100 or die before 50 years old.”

Longo is the founder of and has an ownership interest in L-Nutra; the company’s food products are used in studies of the fasting-mimicking diet. Longo’s interest in L-Nutra was disclosed and managed per USC’s conflict-of-interest policies. USC has an ownership interest in L-Nutra and the potential to receive royalty payments from L-Nutra. USC’s financial interest in the company has been disclosed and managed under USC’s institutional conflict-of-interest policies.

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Neighbor It began in 1966 with a tap on Jon Pynoos’ door.

Dorothy Benton, a spry 73-year-old neighbor dressed in silk brocade, asked Pynoos, then a Harvard grad student studying urban planning, to join her for tea. Pretty soon, they were close friends.

by Diane Krieger Illustration by Lorindo Feliciano

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Connecting with “Mrs. B.” — as Pynoos fondly calls her — created an unlikely intergenerational bond. It also diverted Pynoos’ career path.

Today, he is the UPS Foundation Professor of Gerontology, Policy and Planning in the USC Leonard Davis School of Gerontology. He has written six books and hundreds of articles on housing and the elderly, and he advocates for “aging in place,” or seniors living independently as long as possible.

“Were it not for Mrs. B., I probably wouldn’t have been in the field of aging,” says Pynoos, who joined USC’s faculty in 1979. “I wouldn’t have met my wife, and I wouldn’t have ended up at USC.” It was Mrs. B. who encouraged Pynoos to apply for a job running a Boston-area home care agency tasked with keeping seniors out of institutions. That led to his meeting fellow gerontologist Elyse Salend. Mrs. B. attended their wedding. The couple’s daughters — Jessica Pynoos MSW ’09, MSG ’09 and Rebecca Pynoos MSW ’10 — also work in the field of aging; son Josh Pynoos MPP ’14 focuses on criminal justice.

The stately brick apartment building in Cambridge, Massachusetts, had been home to Mrs. B. for more than 30 years when Pynoos moved in. She was unlike anyone he had ever met: a refined, articulate, intensely independent woman; a divorcée who’d raised a daughter alone; and a retired teacher who checked in on elderly shut-ins for the Red Cross. Above all, she was a social butterfly. Her afternoon teas brought together an eclectic cross-section of Boston society, young and old.

As their friendship deepened, Pynoos saw their apartment building through her eyes: how three flights of stairs took their toll and how removal of the dumbwaiter had made grocery shopping harder. At age

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94, Mrs. B. fell in her apartment. She waited 14 hours for help to arrive, her telephone inches out of reach.

Deemed too frail to return there, she was consigned to a nursing home. “Hard as it is to believe, I am no longer mistress of all that I survey,” she wrote Pynoos from the facility.

When Pynoos visited, he didn’t like what he saw. He intensified his advocacy for “universal design,” a movement to create environments accessible to everyone, including the elderly and people with disabilities.

Today, he directs the USC Leonard Davis–based National Resource Center on Supportive Housing and Home Modification, and he co-directs the USC-affiliated Fall Prevention Center of Excellence. An online executive certificate program he co-founded in 2004 has trained hundreds of building contractors, social workers, occupational therapists and other professionals to create safe living environments for seniors.

In addition, a recent $750,000 grant that Pynoos’ team received from the Administration for Community Living will fund programs to improve access and services for various older adult populations, including tribal, rural and low-income communities. “One size does not fit all when it comes to home modification,” Pynoos says.

“With this funding, we aim to meet specific needs and concerns of populations that have long been underserved.”

Jon Pynoos is now older than Mrs. B. was when they first met. Over their decades-long friendship, he recorded 40 hours of interviews with her and is planning to publish them as an oral history. That project is finally coming into focus.

Old friends don’t forget.

Photo courtesy of Jon Pynoos

Dorothy Benton, aka “Mrs. B,” and future professor Jon Pynoos

Transforming Homes and Communities for Healthy Aging

by Fiona Pestana

The 2018 Morton Kesten Summit brought together experts in the field of gerontology to discuss making environments more age-friendly. The keynote panel focused specifically on how to transform homes and communities to support healthy aging.

“Housing and communities matter for older adults,” said Jon Pynoos, UPS Foundation Professor of Gerontology, Policy and Planning at the USC Leonard Davis School, who organized the event.

The Morton Kesten Summit addresses the needs of individuals aging in place. The biannual summit and associated Universal Design Competition are endowed by a family member in memory of the late Morton Kesten, an executive of Colonial Penn Life Insurance Company at the time it was servicing AARP.

Fall Prevention Programs Make a Difference Kathleen Cameron, director of the National Falls Prevention Resource Center within the National Council on Aging, highlighted programs and resources for preventing falls or their potential causes in a holistic way.

“Falls are largely preventable,” Cameron said. The National Falls Prevention Resource Center has information for consumers and professionals on how to reduce fall risks.

Emily Nabors, program manager for the USC Fall Prevention Center of Excellence, discussed home modification to prevent falls. “Home modification can make daily activities easier, reduce accidents and support independent living,” Nabors said.

Nabors mentioned the importance of upskilling a workforce for home modification and suggested

that professionals from the aging, disability, housing and health care sectors get trained on the importance and benefits of home modification for aging in place through programs such as USC’s Executive Certificate in Home Modification Program.

Housing Needs for Older Adults in Los Angeles Caroline Cicero, instructional associate professor of gerontology at the USC Leonard Davis School, said that Los Angeles is lacking in its amount of intergenerational housing and dementia-friendly housing, making it difficult for families to live together and care for each other and for individuals hoping to live and take care of themselves alone.

“More than 20 percent of L.A.’s homeless population is comprised of older adults,” she added.

Housing help could come in the form of 10,000 accessory dwelling units — secondary housing units that share the building lot of a primary house — that the city hopes to add by 2021, she said.

When it comes to new construction, Rosemarie Rossetti from the Universal Design Living Laboratory encouraged architects and planners to consider including universal design before construction starts so that buildings can be as supportive as possible.

“Doing it right from the beginning, with small differences like wider doorways and varied vanity heights, can add big value,” she said.

Lo s i n g —

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ore Americans are getting fewer hours

of sleep, according to a new study published in the journal Sleep. Researchers from USC, Arizona State University and the University of South Carolina found more Americans reporting inadequate sleep over time, with the sharpest increases among AfricanAmerican and Hispanic adults.

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The percentage of Americans reporting inadequate, or “short,” sleep — defined as six hours or less — increased from 29 percent to 33 percent of adults from 2013 to 2017.

“Poor sleep is a canary in the coal mine,” said Jennifer Ailshire, USC assistant professor of gerontology and sociology and a lead author of the study. “We will see worse health outcomes as a result, and we may be seeing that already.”

Study authors include Ailshire and Stephen E. Frochen of USC, Connor Sheehan of Arizona State University and Katrina Walsemann of the University of South Carolina.

DEFINING SHORT-SLEEP DURATION Researchers examined data from the National Health Interview Survey for nearly 400,000 U.S. adults ages 18 to 84 from 2004 to 2017. Respondents were asked how much they slept in a 24-hour period, on average. Those responses were divided into three categories: short sleep (six hours or less), adequate sleep (seven to eight hours) and long sleep (nine or more hours).

The study’s authors found that the prevalence of short-sleep duration was relatively stable from 2004 to 2012. But then, there was a notable shift: Researchers found an increasing trend toward short sleep beginning in 2013 that continued through 2017.

PROBLEMS RELATED TO GETTING LESS SLEEP Ailshire and her colleagues observed that increasing reports of shorter sleep corresponds with a period of economic instability, a rise in societal stress and the greater use of smartphones, among other technology, all of which been shown to negatively impact sleep.

“Population health researchers pay attention to health inequities, and when we see those gaps are increasing, we ask why — and how we can prevent any greater divergence in the population,” Ailshire said.

“We need to give our minds a break to let ourselves float peacefully into sleep,” says Jennifer Ailshire. See opposite page for her healthier sleep hints:

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Night sky illustration by iStock/kdshutterman

LARGE RACIAL AND ETHNIC DIFFERENCES IN SLEEP The trend was most significant among African-Americans and Hispanics. Reports of short-sleep duration among African-Americans climbed from 35 percent in 2004 to 42 percent in 2016, then went down slightly. Hispanics experienced a particularly large increase in short sleep, from 26 percent in 2004 to 33 percent in 2017.

In contrast, the percentage of whites reporting short sleep increased from 29 percent to 31 percent during the same time period. By 2017, there was a 10-point percentage difference between African-Americans and whites who reported getting inadequate sleep.

Short-sleep duration is associated with obesity, decreased cognitive functioning, dementia, heart disease and diabetes, along with increased numbers of motor vehicle accidents and conflicts in social relationships. The increasing numbers of Americans reporting poorer sleep is a concern for public health experts, who believe disparities in sleep duration may worsen existing racial and ethnic health inequities.

“The results of this study that are most surprising and alarming are not only that African-Americans and Hispanics are more likely to get inadequate sleep, but [that it’s] at a faster rate over time,” Ailshire said. “Life has gotten harder and more hectic in a lot of ways, and this finding may be a sign of our troubled times.”

Tips for Better Sleep

1

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Yoga, meditation and puzzles like sudoku can relax the mind.

Don’t use or read social media right before bedtime.

Don’t use devices (e.g., smartphones and tablets) in bed.

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Evaluate your environment: Is your bedroom the right temperature? Are there any lights or distracting sounds?

Experiment with bedtimes. Try going to bed a little earlier, and see if you can find the ideal time when you’re most primed to fall asleep.

For people who have more serious sleep issues, it’s important to consult a physician.

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A NEW AGE

By Constance Sommer Photography by Kate Henderson

Morgan Levine wants to know why some people live longer than others.

“How do people move from health to disability to diseases and mortality?” said Levine, a 2015 USC Leonard Davis School of Gerontology alumna.

Thanks to the research she began as a USC doctoral student and is continuing as an assistant professor of pathology at Yale University, Levine is starting to close in on some answers. In the process, she’s changing our understanding of what aging is and how it’s connected to a range of diseases.

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“On a biological level, what things change with age, and can we then map or track where an individual is in that process, aside from [his or her] chronological age?”

Levine’s work attempts to separate chronological age from the body’s biological age. Her research has developed a biomarker — one single, calculated value — that correlates with age in every tissue of the body and is predictive of many, if not most, causes of mortality. In other words, if aging is a continuum, someone far enough along that continuum will be likely to struggle with cancer or heart disease or Alzheimer’s, or any number of other diseases associated with mortality — no matter how young or old that person is.

“I think of what I do as really trying to quantify the aging process,” she said. “On a biological level, what things change with age, and can we then map or track where an individual is in that process, aside from [his or her] chronological age?”

At the moment, this is purely information for scientists, but Levine imagines that one day it can be part of a regular physical exam. “That’s hopefully where we’re headed,” she said.

Levine said she is also working with a few companies — including L-Nutra, founded by Valter Longo, the Edna M. Jones Professor of Gerontology at USC — to develop websites where people can type in test results from a physician’s visit and be given a prediction of a median life expectancy. The sites would also tell them how much longer they could expect to live if they reduced one or more of their problematic test results. “So it’s kind of a fun, interactive thing,” she said.

Levine could be said to have geronotology in her own genes — her mother is Kathleen Wilber, the Mary Pickford Foundation Professor of Gerontology at the USC Leonard Davis School of Gerontology. But when Levine first enrolled at USC as an undergraduate, she was

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determined to set her own course, planning to major in premed. Soon, though, she switched to psychology, because she wanted to do research.

After graduating in 2008, she spent a year working with horses, training them for professional jumpers. She quickly found she itched for more intellectual fulfillment and enrolled in a master’s program at the USC Leonard Davis School of Gerontology, thinking it would be an entry into the health care field that had long attracted her. But she realized that, like her mother, she enjoyed academic research, and soon she was pursuing her PhD. “What I loved about research is you can think up any interesting question and have the tools to go out and answer it,” she said.

It was while she worked toward her degree that Levine started down the path she’s currently on, studying the biomarkers of aging. Her mentor at the time was Eileen Crimmins, the AARP Chair of Gerontology at USC. The two scientists continue to collaborate on research today.

“Morgan’s a star,” Crimmins said. “She’s smart, she works hard, she writes well, she gets it.”

Where other students might wander off into research tangents or agonize over the wording of a thesis or paper, “[Morgan is] very fast at grasping things and very direct at writing them,” Crimmins said. “She doesn’t get lost in the weeds.”

As she dived deeper into the world of gerontology and science, Levine found her passion at the nexus of computers and biology. Her lab at Yale is what’s called a “dry lab” — it contracts with “wet labs” to get data they collect, then analyzes the data using computers. Levine’s research also uses data gathered by health surveys that

Yale University Assistant Professor Morgan Levine

stretch over years, or even decades, returning to the same patient population to ask questions and gather information.

“I’ve always been very interested in statistics and research methods and the power that gives you for answering questions,” she said.

Since her days as a doctoral student, Levine has been trying to find a way to chart and predict aging in individuals. What she didn’t think she would discover, as she did in her lab in 2016, was one single marker for the entire process. “That was the biggest ‘whoa’ moment,” she said. “Statistically, the results I was getting were so strong, I was just amazed that it happened.”

Currently, Crimmins and Levine are part of a team analyzing results from a multi-decade study of 20,000 adults ages 50 and over across the United States. That the study itself exists is due to the doggedness of Crimmins and others like her, who believed 15 years ago that future scientists would find uses for the data.

They began “first by convincing people that it could be done, and that it should be done, then getting the money to do it, then doing it — it’s been a long, long road,” Crimmins said.

And just as Crimmins predicted a decade and a half ago, here, among others, is Levine, an eager recipient of the data. “She will be a beneficiary,” Crimmins said, “but we’re a beneficiary of her working on it.”

Describing what’s in the data, Levine sounds like a child listing the goodies she got for her birthday. Not only did researchers collect socioeconomic and behavior data, she said, but “for me, the exciting thing is we have their genetic data, their epigenetic data, their gene

expression and a bunch of other biological data, such as mitochondrial functioning and a whole inflammatory panel as well.”

With this information, Levine wants to learn why one individual ages faster than another, and why some people are at higher risk for disease and mortality at younger ages.

She’s also hoping to one day be able to break down aging organ by organ. “Something we’re interested in is what if, say, you have an old heart, but a younger liver, and old lungs?” she said. “What does that mean for your risk of different outcomes?”

In the meantime, she keeps busy not only overseeing her lab, but riding horses, running even in the New England winters, and chasing after her three-year-old daughter. Her husband, Zachary Levine, is a scientist who works in physics research at Yale.

Although Levine initially resisted following her mother’s academic path, she now cherishes the extra bond they share. “I thought I wanted to be distinct from her,” she said. “But then, having that sounding board was really nice. And I felt there was a whole other level I could relate to her on.”

Wilber’s research focuses on improving health outcomes and quality of life for vulnerable elders; Levine hopes her own discoveries will keep elderly people active and vital for longer. It’s the quest that gets her up in the morning and that rivets her to her computer, numbers and scientific terms scrolling by.

“My favorite thing about studying aging is that there are so many questions,” she said. “It’s constantly evolving. We will never run out of questions.”

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KAYEE LIU Program: Program: Master Master of of Science Science in in Nutrition, Nutrition, Healthspan Healthspan and and Longevity Longevity

BEYOND THEIR CLASSWORK, USC LEONARD DAVIS SCHOOL OF GERONTOLOGY STUDENTS ARE A FORCE FOR CHANGE IN THEIR COMMUNITIES AND THEIR PROFESSIONS.

BY BETH NEWCOMB • PHOTOGRAPHY BY STEPHANIE KLEINMAN

IN HIS DIETETICS rotation at Keck Hospital of USC, Master of Science in Nutrition, Healthspan and Longevity (MSNHL) student Kayee Liu enjoys sitting down with patients and helping them develop healthy eating plans.

“It’s fun talking to patients,” he says. “I just like talking to people.”

After graduation this May, he looks forward to continuing that work, both one-to-one as a dietitian and also expanding those conversations to a wider audience through education and filmmaking.

“I want to do something mediarelated as well as something clinical — a little bit of everything,” he says.

“I want to get a message out.”

Liu, who studied human biology and society at UCLA before coming to the USC Leonard Davis School, first became interested in using media to share information about food and nutrition during his senior year.

He took a class on making documentary films for social change, and his final project for the course examined food access and marketing to children in South Pasadena.

“I followed a family as they navigated their community,” Liu explains. “Unhealthy foods are marketed toward kids in a very in-yourface way.”

Liu has also taken photos and made a video chronicling L.A. Kitchen, a nonprofit providing culinary job training and affordable meals while fighting food waste. In addition, he’s provided in-person nutrition education both for older adults and for children from first to seventh grade through the organization API Forward Movement, which addresses community health and environmental justice issues affecting people of Asian and Pacific Islander descent. While his classes grew from just three attendees in

the beginning to packed rooms now, Liu still aims to have his presentation be less lecture-like and more of a conversation, asking participants to share recipes and experiences from their own lives.

“It’s a two-way conversation. It’s not just, ‘Here’s what your nutrition should be.’ It’s a happy exchange,” he explains. “I admire the work that is more grassroots. You don’t see the impact immediately; lasting change takes time to develop.”

In the USC Leonard Davis MSNHL program, Liu has been able to connect with other people who are also passionate about sharing nutritional knowledge, even if they have different specific interests within the field.

“The students in my cohort and I have a nice exchange of information; they’re some of my closest friends now,” he says.

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STEPHANIE BOLTON Program: Bachelor of Science in Human Development and Aging, Master of Science in Gerontology

“THE MORE I GET OUT AND IMMERSE MYSELF, THE MORE GRATIFYING EXPERIENCES I HAVE AND THE MORE PASSIONATE I BECOME ABOUT THE ISSUES THAT MATTER TO ME.”

AS A STUDENT in the USC Leonard Davis School’s progressive Master of Science in Gerontology degree program, Stephanie Bolton will receive her Bachelor of Science in Human Development and Aging, along with a minor in French, this May, and will finish her master’s degree in just one additional year. Even with her busy academic schedule, she has taken on several extraordinary roles both within and outside of USC. “I love being involved and meeting and interacting with new people, and I find that the more I get out and immerse myself, the more gratifying experiences I have and the more passionate I become about the issues that matter to me,” Bolton says.

Serving as the President of the Student Gerontology Association (SGA), she oversees all programming, events and service activities for the USC Leonard Davis School student group. From recruiting students to participate in the AlzLA’s annual Walk4Alz, organizing food drives for the Los Angeles Regional Food Bank, and gathering holiday gifts for local senior centers, to planning guest lectures and an annual alumni dinner, Bolton serves as the main point of contact for her fellow gerontology students looking

to get involved in SGA’s vast array of professional and extracurricular events.

She also works to recruit students for community service work, including for YouthCare, a caregiver respite program of the Youth Movement Against Alzheimer’s, as well as for respite care services at the Aging into the Future Conference on technology and aging taking place in downtown Los Angeles this April.

Bolton also kept caregivers in mind with her recent internship with The Memory Kit, LLC, in Atlanta, Georgia, where she assisted with the launch of Care Card, an app designed for coordinating care among different caregivers.

“Caregiving is an extremely taxing job, so I think that any way we can give back to those in need or develop new products and systems to help the current population affected by debilitating diseases is essential to our future,” she says.

Bolton’s service work doesn’t just involve older adults. As a member of the Gamma Phi Beta sorority, she developed and implemented the USC chapter’s risk management plan for member safety and health. She has also developed mentoring relationships with girls at local middle schools through the Women and

Youth Supporting Each Other program, which encourages college-age women to serve as role models and sources of support for young girls.

Bolton also supports research and other scholarly activities within the USC Leonard Davis School. As a research assistant in the laboratory of Professor Valter Longo, she’s completing a senior thesis on the effects of a short-term fasting-mimicking diet on brain changes in Alzheimer’s-predisposed mice, and has presented her findings during the USC Undergraduate Research Symposium. She also provides administrative support for the USC Fall Prevention Center of Excellence and assists prospective and current students of the center’s Executive Certificate in Home Modification courses.

“Being able to study and learn from some of the top experts in gerontology at USC has been a beyond enriching and enlightening experience,” Bolton says. “One thing that has been consistent throughout my time in the USC Leonard Davis School is the enthusiasm that professors have when teaching.

It’s clear that they are in this field because this is their passion.”

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ELIZABETH AVENT Program: Doctor of Philosophy in Gerontology

“WE HAVE A LOT OF WORK TO DO. I WANT TO SEE WHERE WE COULD INTERVENE FOR PEOPLE AT RISK OF ABUSE AND PROVIDE TRAUMA-INFORMED CARE.”

PHD IN GERONTOLOGY student Elizabeth Avent first encountered a glaring gap in violence research when she was an undergraduate student at Georgia State majoring in sociology. She was trying to write a paper on intimate partner violence in older adults — but she couldn’t find much research on it.

Now, as a research assistant at the USC Secure Old Age Lab and USC Center on Elder Mistreatment, she’s devoting her doctoral program to investigating the important but overlooked topic.

“Elder abuse and late-life intimate partner violence are two distinct things,” Avent explains.

“Intimate partner violence tends to go down as age increases, but it doesn’t go away.”

In her quest to understand more about domestic violence in older adults, Avent, who is now in the second year of her PhD program, investigated connections between people who have experienced adverse childhood experiences, or ACEs, and victims of intimate part-

ner violence over age 60. She has uncovered that people who experience more than one ACE, especially falling victim to sexual abuse or witnessing domestic violence, face higher odds of being victims of intimate partner violence after age 60.

The next step is to figure out how to use these risk factors to identify people in danger of becoming victims of domestic violence and ultimately make shelters and other resources for victims more inclusive for people of all ages, Avent says.

“We have a lot of work to do. I want to see where we could intervene for people at risk of abuse and provide trauma-informed care,” she says.

Avent first encountered research on violence and older adults by USC Leonard Davis faculty members during her undergraduate and master’s in gerontology programs at Georgia State. After learning more about USC at a Gerontological Society of America conference, she enrolled in the USC PhD in Gerontology program. Her mentor is one of the authors whose work she read years

ago: Kathleen Wilber, Mary Pickford Foundation Professor of Gerontology at the USC Leonard Davis School.

“I saw that USC faculty were doing a lot of exciting research, and I wanted to be a part of that,” Avent says. “I like that the school is very collaborative. It pushes you out of your comfort zone, and that’s what I really needed.”

Avent says she ultimately wants to go into policy research, conduct and encourage more multidisciplinary investigation into late-life intimate partner violence, and apply the science in the real world to make violence prevention and intervention services more age-inclusive.

“I really want to convince people in other disciplines that this is an important subject and something we need to talk about,” she says.

“We can do something about it. I want my work to reach the people doing the work on the front lines.”

SPRING 2019 | 37

Drawing Connections

by Constance Sommer

One afternoon, a couple dozen fifth-graders piled into an activity room at Valley Beth Shalom synagogue in Encino. At their teacher’s direction, they flicked on their iPads and fitted headphones on their ears. It was time for an unusual lesson about the lives of their elders.

At a table in the corner, Avital, 11, watched Selma Patent, 86, talk about moving from her Jewish neighborhood in Brooklyn, New York, to mostly Christian Kansas City, Kansas, at age 6. One of the highlights of her time there became her Friday night trips with her grandfather to synagogue, she said.

“I felt such a sense of belonging to something exciting,” she recalled in a video made for the USC Leonard Davis School. “The gentlemen carrying the Torahs, and the children with their flags following after them. ... Even after all these many years, I still remember it with such fondness.”

Selma and Avital are two of the 160 volunteers and students in “Dor Vador: Sharing the Wisdom of Elders,” a program of the Rongxiang Xu Regenerative Life Science Lab at the USC Leonard Davis School. The program is funded by the Jewish Community Foundation of Los Angeles and encourages understanding and communication between children and the elderly in L.A.’s Jewish community.

After the children watch the videos, they’re invited to draw a

38 | VITALITY

picture inspired by the talk. Avital used crayons to draw a smiling yellow sun shining down upon a lipstick- red rectangle rising out of green grass, with two white doors on the front and blue letters across the top that read “Synagogue.”

“L’dor vador” is a Hebrew phrase meaning “from generation to generation.” The Dor Vador project is headed by Kevin Xu Professor of Gerontology George Shannon. The program involves adult volunteers from 55 to 88 years old and children from kindergarten to seventh grade at Valley Beth Shalom and three other Jewish institutions: Temple Emanuel and Nagel Jewish Academy, both in Beverly Hills, and Temple Isaiah in West Los Angeles.

“The kids get so involved and are so willing to dive in and partake in this experiment without reservation,” Shannon said.

The children at Valley Beth Shalom learned after they finished their artwork that the adults they had watched on their tablets were actually waiting in another room. There were seven adults in all, including a Holocaust survivor and a woman who recalled celebrating Shabbat with her family in a Japanese concentration camp in China during World War II. Avital and her classmates listened wideeyed as Selma answered from a list of questions they had hastily scribbled. Selma read the first one aloud: “What was it like, being the only Jew in Kansas?”

“Well,” she told the children, “I didn’t want to stand out too much. And I didn’t want to not do well, either, because I didn’t want them to think, ‘Oh, Jewish kids are stupid.’ I always wanted to be in the middle.”

Then Avital and classmates Brandan and Noah showed her their drawings, now posted on a board alongside the table. “Oh!” Selma said. “Look at my synagogue!”

See the full gallery at dorvador.usc.edu

Photo: Student’s drawing from Dor Vador. Opposite page: SLEC speakers and sponsors with Dean Emeritus Ed Schneider

NOTES

2019 SENIOR LIVING EXECUTIVE COURSE

Housing Design for an Increasingly Older Population: Redefining Assisted Living for the Mentally and Physically Frail (John Wiley & Sons) offers relevant aging research and examples of more than 20 settings that are getting it right.

—

Calls for Change

Each year, senior living industry leaders gather at USC to provide perspective and give advice to young executives in the industry.

Now in its fifth year, the two-day Senior Living Executive Course (SLEC) from the USC Leonard Davis School of Gerontology, in partnership with the USC Marshall School of Business, draws professionals from across the United States and abroad for education on a range of key issues. USC Leonard Davis Dean Pinchas Cohen and Dean Emeritus and Professor Ed Schneider provided insights into the science of aging, and USC Marshall School Professor Greg Patton led leadership exercises.

Among the industry experts was Paul Klaussen, co-founder and former CEO of Sunrise Senior Living, who said that changes to improve affordability, combat ageism and provide better end-oflife care are long overdue. “I know the best senior living is yet to be invented,” he said.

Mercedes Kerr, executive vice president at Welltower, stressed the important role managers play in driving innovation, building culture and stemming turnover. “We have to be aware of all the new trends and evolve the model,” she said.

Bill Thomas, MD, founder of The Eden Alternative and The Green House Project, said that a changing customer base will demand that communities cater to people of all ages and cognitive abilities. “The era of age segregation is drawing to a close,” he said.

Senior living leaders must embrace new ways of doing business, according to Bob Kramer, NIC founder and strategic advisor, who noted that health care providers should come to residents, not the other way around. “We have to think differently,” he said. — O.B. SLEC was sponsored by Welltower, American Seniors Housing Association (ASHA), Argentum, Belmont Village, Greystone, National Investment Center for Seniors Housing & Care (NIC), Sabra Health Care REIT, and Silverado.

RECENTLY PUBLISHED —

Model Homes

When USC Architecture Professor Victor Regnier FAIA set out to write a textbook for people who build and manage housing projects for the elderly, it turned into something more. Regnier, also a professor of gerontology at the USC Leonard Davis School, combined his areas of expertise to create a road map for how to design the kinds of living environments that can help sustain, and even improve, quality of life for older adults, especially those who are frail or have cognitive impairments.

“As our aging population has grown in size and longevity, it is clear that we need to carefully and quickly find better solutions to help everyone stay independent,” says Regnier.

Regnier writes about the Apartment for Life model in Northern Europe, which houses people from ages 60 to over 100 in a residential setting that encourages independence, supports community and provides health and personal care services when they are needed. In the U.S., he cites the growing sharing economy, with cohousing and on-demand service providers, such as Uber and Lyft, as providing potential ways for people to stay in their communities longer.

Beyond buildings, the professor provides lessons for a better future. “We need to commit more resources, demand better affordable accommodations and raise our expectations for providing care in humanistic ways,” says Regnier. — O.B.

SPRING 2019 | 39

NOTES RECOGNITION —

Shari Thorell Receives Half Century Trojans Hall of Fame Award

Top photo: Shari Thorell ’65 accepts the Hall of Fame award.

Middle: Three generations of Thorells: Shari, her son, daughter-in-law and grandchildren.

Bottom, left to right: USC Leonard Davis School Executive Vice Dean Kelvin Davies; Shari Thorell ’65; and Alli Solum ’59, President of the Half Century Trojans Board of Directors.

40 | VITALITY

This page: photos by Will Chiang. Opposite page: photo by Steve Cohn

Shari Thorell, USC Leonard Davis School of Gerontology Board of Councilors chair and president of ST Enterprises, was honored during the Half Century Trojans Hall of Fame Luncheon on October 23, 2018.

Congratulations and Fight On, Shari!

USC Leonard Davis School Scholarship Recipient Shares Her Journey to Gerontology

SUPPORT —

Benefactor Luncheon Brings Students, Faculty and Donors Together

USC Leonard Davis School students, faculty and supporters gathered together on October 17 for the 2018 Scholars and Benefactors Luncheon, an annual event recognizing the donor support that makes achieving strides in gerontology a reality.

“As gerontologists, the entire lifespan is our work. Not very many people in professions can claim that,” said USC Leonard Davis School of Gerontology Dean Pinchas Cohen.

The USC Leonard Davis School’s student body tripled over the last six years, Cohen said. He added that more than half of the school’s students receive scholarships to support their studies, and he listed scholarships that make the school’s programs accessible to more students.

“These students are some of the most remarkable, wonderful individuals at USC,” Cohen said. “They’re compassionate, they’re extraordinary, and they come here to apply their interests and passions and goals to create unique careers — the careers of the future — and lead in service, leadership and scientific discovery.”

Shari Thorell, chair of the USC Leonard Davis School Board of Councilors, told stories about her love for the school and the field of study. “Every student I have ever met who has been in gerontology is passionate about it, and that pleases me because of my own passion as well,” she said. — F.P.

Her grandmother changed her life.

Elizabeth Rojas was exposed to caregiving after her grandmother was diagnosed with vascular dementia.

Her family’s unwavering care and attention for her grandmother inspired Rojas to follow the same path of compassion and eldercare.

“I saw firsthand the patience, and the love, and the effort and determination it really takes to care for somebody aging and to care for somebody facing cognitive decline,” Rojas said. “I decided I wanted to make it my mission to do the same thing in my life. … It was the greatest honor of my life being able to reverse those roles and care for someone who cared so deeply for me.”

This moved Rojas to attend the USC Leonard Davis School. She received her Bachelor of Science in Lifespan Health and is currently finishing her graduate studies.

While at USC, Rojas was a member of the Student Gerontology Association, where she was able to bond with members within the USC Leonard Davis School and deepen her passion for the subject. She also studied abroad in Tel Aviv with Professor Mara Mather and worked at L.A. hospitals. During her speech, Rojas thanked the benefactors in the crowd for making these stages of her journey possible.

“The Leonard Davis School is my home away from home, and it is my safe haven on this campus. I always know I am welcome there,” she said.

— F.P.

SPRING 2019 | 41

A CLOSER LOOK

13 | VITALITY

“That’s one of the great pleasures in science. As you put your best thoughts together and let them be challenged... it turns up that there are things that seem paradoxical that give deeper insights into basic mechanisms of aging.”

— Caleb “Tuck” Finch, University Professor and ARCO/William F. Kieschnick Professor of the Neurobiology of Aging

The Dean’s Circle When you donate to the USC Leonard Davis School, you partner with us in the pursuit of excellence. Your support allows students to explore and engage further in their studies, advances our work to provide outreach and advocacy for older adults, and helps provide faculty scientists the best resources to conduct groundbreaking research. Please show your commitment to our students and mission by making a gift of $500 or

more to the USC Leonard Davis School, and join the Dean’s Circle today.

Photo by Stephanie Kleinman

THANK YOU AND FIGHT ON!

SPRING 2019 | 4

3715 McClintock Avenue Los Angeles, CA 90089 gero.usc.edu

APR 11, 2019

OCT 19, 2019

1 2 :00 P.M. – 1 :00 P.M.

Kesten Memorial Lecture

USC Homecoming

— Gary Ruvkun, PhD, Professor of Molecular Biology at Harvard Medical School, will deliver the 2019 Kesten Memorial Lecture. To learn more, please visit gero.usc.edu/event/speaker-gary-ruvkun-phd.

— Cheer on the Trojans as they take on the Arizona Wildcats in the 2019 USC Homecoming football game! For tickets, call (213) 740-GOSC or visit usctrojans.com.

USC Campus

USC Leonard Davis School of Gerontology

APR 12, 2019

6:00 P.M.

SGA Alumni Dinner: Viva la Vida USC Leonard Davis School of Gerontology

— Students and alumni enjoy a night of food, drinks and friendship hosted by the USC Student Gerontology Association. To learn more and to RSVP, visit bit.ly/gero2019.

MAY 10, 2019

136th USC Commencement

uscleonarddavis

USC Campus

— Trojan Family Weekend offers visiting families a snapshot into the life of their USC student and provides an up-close look at how the campus community achieves excellence in teaching, research and public service. Learn more and register at tfw.usc.edu.

9 : 00 A. M. – 2: 00 P. M.

19th CALM Conference

— Congratulations to this year’s outstanding graduates! The USC Leonard Davis School of Gerontology Ceremony will take place at 11:00 a.m. in the Ronald Tutor Campus Center. For more information, please contact Linda Broder at lbroder@usc.edu or (213) 740-5156.

STAY IN TOUCH

Trojan Family Weekend

NOV 9, 2019

8:30 A.M. – 1 2 :30 P.M .

USC Campus

OCT 31 – NOV 3, 2019

USC Leonard Davis School of Gerontology

— The Caregivers Are Learning More (CALM) Conference offers education and resources for families who provide care for older loved ones. To learn more, visit the USC Family Caregiver Support Center website at fcsc.usc.edu.

@USCLeonardDavis

/USCLeonardDavis

/company/usc-leonard-davis