You also have discussed the concept of inflammaging in several of your papers. What is inflammaging? Inflammaging is a state with lots of inflammation in the human body. And the aging part in inflammaging means that inflammation increases with chronological age. So what does it mean? Inflammation is not bad because we know that if there is a bacteria or virus in our body, we need that inflammatory reaction to reduce the number of bacteria. Dr. Andrea B. Maier, MD. Dr. Anton Titov, MD. After all, it's a stimulus for our immune system to fight that infection, which is very important. But this is acute inflammation. And what happens with the aging process, that there is chronic inflammation, and that's not good. So we need acute inflammation because we have to attack bacteria or other things coming in from our environment. But we have to reduce to a low level chronic inflammation. Chronic inflammation means that there is no homeostasis of cells. Dr. Andrea B. Maier, MD. Dr. Anton Titov, MD. I will come back to the senescent cells. So these cells do not replicate anymore, but they secrete inflammatory factors. They say, 'hey, I'm senescent. I'm not sure what I have to do'. Cells are secreting these inflammatory reactants, they provide the status of chronic inflammation. And if something is chronic, but it's not needed, that's damaging the surroundings of cells. And this is what we see in age-related diseases. There's a high state of chronic inflammation, where the immune system is up and running without the need to be up and running. So that is inflammaging. In very strenuous exercise, there's been data that there is some negative remodeling that's going on. And that has to do with the concept of hormesis. What is hormesis? Can you briefly define it? Yeah, hormesis is a status where cells and the cellular system are communicating well. So you need homeostasis, where the function of organ systems and of the tissue systems, and the cells in between is communicating well. So you need that homeostasis to function optimally. There could be extensive stressors from the outside, such as doing far too much exercise or doing very low amounts of exercise, which is sedentary behavior. Then the homeostasis is being dysregulated. Dr. Andrea B. Maier, MD. Dr. Anton Titov, MD. And we see that we need a good frequency of exercise. And we don't need too much exercise, which is damaging our system too much. So I wouldn't say that running a marathon is bad. For some, it's fine. But especially for the untrained people, there will be so much damage in the muscle and myofibrils, which are the cells of the muscle being damaged. That is always leading to so much inflammation that it's too much for the system because the system is not prepared for that. It's not in homeostasis. On the other hand, if somebody has to do bed rest because of a fracture, or some other medical reasons, or because of extreme sedentary behavior, it's the same. It's like too much is very bad for you, because the homeostasis is destroyed and is disturbed, etc. Dr. Andrea B. Maier, MD. Dr. Anton Titov, MD. So exercise needs to be based on an individual level, a very personalized level. We need to find the optimal exercise level for individuals for the greatest benefit. It is for increasing muscle mass or muscle strength and cardiovascular fitness, versus not damaging the system too much with too much inflammation. That is the reason why there's a U shape in how much exercise is being provided versus the benefits of it. So this is very important. We discussed exercise. A lot is being said about dietary interventions. Dr. Andrea B. Maier, MD. Dr. Anton Titov, MD.
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