Entries in longevity (4)

Thursday
Jul212011

Keeping Your Marbles

The quick answer: Hippocrates first observed that what's good for the heart is good for the brain.  Living the Healthy Changes helps to protect your brain from the twin threats of dementia and stroke.  

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Preventing dementia, including Alzheimer’s disease

We went to a funeral the other day for one of the loveliest people you could hope to know.  Her name was Nancy and she left us at a relatively young age.  Nancy was in her mid ‘60s, just entering what should have been her golden years.  But in truth, Nancy had left us some time before, for she died of Alzheimer’s disease.  Alzheimer’s, the most common form of dementia, is growing at a frightening rate.  This post is dedicated to the memory of Nancy, and the proposition that the Word of Wisdom Living lifestyle can reduce the risk of dementia, as well as stroke.

A 2005 Columbia University study found four risk factors that were highly predictive of Alzheimer’s disease (AD).  Per the study, your risk of AD is 240% greater if you have three of these four conditions:

  • Smoking,
  • Diabetes,
  • Hypertension,
  • Heart disease.

A 2010 study, also at Columbia, found a strong link between HDL cholesterol—known fondly as the “good” cholesterol, though in fact we need all the forms of cholesterol, just in the right ratio—and the risk for AD.  Those with higher HDL levels (>55 mg/dL) had 60% less risk of AD than those with lower levels.  How do we improve our level of HDL?  Here is a summary:

  • Get regular aerobic exercise (more is better).
  • Lose excess weight.
  • If you smoke, stop.  (Is there no end to the ways tobacco harms the body?)
  • Eliminate manmade trans fats (eat nothing hydrogenated).
  • Eat whole foods (lower glycemic index plus more fiber and nutrients).  A diet high in sugar is a special risk for AD—those who consume the most sugar have a six-fold greater risk vs. those who eat the least.
  • Eat fish (rich in the essential fat, omega-3).
  • Get adequate B-complex vitamins (including niacin).

The last protective action—getting adequate B-complex vitamins—brought to mind a study of AD among Catholic nuns reported in the book, Amazing Grace.  In a prior post we discussed the link between the B vitamin folic acid and spinal cord birth defects, particularly spina bifida.

Amazing Grace found a similar protection for folic acid against AD.  It’s most interesting to learn how vitamins that are protective at birth also protect our brain at the end of our lives.

There was also a link between AD and homocysteine, a normal chemical which can be harmfully high when folic acid and other B vitamins are deficient.  In the post on heart disease, elevated homocysteine was an important risk factor.  In fact, if you look over the lifestyle habits that protect from heart disease, you find the same constellation that is protective of dementia.  Because tradition is one of the three sources of wisdom for this blog, we should now honor the ancient physician Hippocrates who said: 

“Food that is good for the heart is likely to be good for the brain.”

A Personal Story

May I tell a story?  In 1991 I took a position with a new medical device company called Target Therapeutics.  With the help of leading doctors, this company founded a new field of medicine called interventional neuroradiology.  Basically we provided doctors with miniature catheters and other tools to treat structural brain disorders by working from inside the blood vessels.  (This was much less invasive than surgery by cracking open the cranium.)  At first we provided catheters for diagnosis but our fame came from an innovative treatment for treating aneurysms.  Yet all the time our big goal—a task still unfulfilled—was better treatment of strokes. 

My work here brought an unexpected moment of closure.  When I was just three years old—this is the short version of the story—I fell out of a moving car and suffered a brain injury that might have proved fatal.  The concussion caused a slow-developing hemorrhage that put increasing pressure on my brain.  As the clot grew over weeks, I became less active, sleeping more and more.  Because the progress was slow, the doctor involved was not concerned.  My parents were frightened, however, and through a serendipitous chain of events my Mom got into the office of a neurosurgeon in San Francisco.  This was during the early years of neurosurgery but the doctor immediately saw the problem and arranged a life-saving surgery not available where I lived.  (Yes, that's me in the picture above, wearing a protective cap during recuperation.)  Years later, while working at Target Therapeutics and observing the use of our products I visited that same hospital where my life had been saved as a child.  I think it was this moment of closure that sparked a continuing interest in promoting brain health.  For this reason, I call your attention to stroke prevention and treatment.

Treating Stroke

Stroke is the 3rd leading cause of death in the US, causing 160,000 deaths each year.  Because breast cancer has been so well advertised we should note that more women die of stroke than breast cancer.  In fact, strokes are much more easily avoided—up to 80% of strokes are preventable.  It’s a tragedy that our society is not more effective at preventing, or quickly treating, strokes. 

Most strokes are ischemic, meaning a clot blocks an artery in the brain, cutting off the flow of blood and life-giving oxygen to brain cells.  A minority of strokes is hemorrhagic, meaning a blood vessel bursts, usually due to an aneurysm, and leaks into the brain cells.  Avoiding high blood pressure is the first protection against stroke. 

It’s important to remember that when a stroke occurs, it takes 4-8 hours for brain cells to die—a much longer treatment window than in heart attacks.  Therefore, recognizing the signs of a stroke and quickly getting to a major hospital—one with a certified stroke center and interventional neuroradiologists trained in methods of treatment—is essential to survival.  I repeat: essential! (If you don't know the best hospital, get to the biggest one and inquire.)

Borrowing from the success our society had in alerting people to the signs of heart attacks, it’s helpful to see strokes as brain attacks, and be aware of the signs.  Because the brain is separated into two halves, stroke symptoms usually affects one side of the body.  As a public service, the American Stroke Association posts these stroke signs to watch for:

  • Sudden numbness or weakness of the face, arm, or leg, especially on one side,
  • Sudden confusion, trouble speaking or understanding,
  • Sudden difficulty speaking,
  • Sudden trouble seeing in one or both eyes,
  • Sudden trouble walking, dizziness, loss of balance or coordination,
  • Sudden, severe headache, with no apparent cause. 

If someone you know shows these symptoms, respond quickly. 

One other  fact about strokes—strokes can be “tiny”, and these are called “transient ischemic attacks” or TIAs.  With TIAs the above symptoms may pass, but there can be loss of brain cells and the accumulation of TIAs is one cause of dementia.  It’s equally important to see a doctor about TIAs because treatment can prevent a more devastating stroke, as well as progressive dementia.

Preventing Stroke

We should follow Hippocrates’ advice; the following protect both the heart and the brain:  Manage your blood pressure, avoid the use of tobacco and alcohol, eat a healthy diet, get plenty of exercise, avoid or control diabetes, and watch out for TIAs.  One more thing (I hope this isn't too much information): be aware that the heart problem of atrial fibrillation can increase your stroke risk by 500%!  For more information, visit the website of the National Stroke Association.  

Please comment:  We’re not used to thinking of the brain when we discuss diet and other lifestyle improvements.  Have the posts this week helped you to know how to hang on to your marbles?

Thursday
Jun162011

Last Person Standing

Graph from The Los Angeles Times

The Quick AnswerChronic inflammation is a big risk factor for chronic disease, but is hard to measure.  Metabolic syndrome—often the next step—is easier to measure.  The goal of wordofwisdomliving.com: help you reform your lifestyle, avoid these conditions, and live to a healthy old age. 

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Learning to Live Longer

A deep thought:  People will argue about what diet is best but due to the near-infinite complexity of nutrition, the correct answer will remain unknowable.  There is however one indisputable fact—who lives the longest.  For nutrition and lifestyle, longevity is the proof of the pudding.  Unfortunately for the last guy standing, your detractors won’t be around to see you do your victory lap.

So I was interested in a recent report (see it here) that reveals two contrasting longevity trends in America.  The report looked at 3000 counties in the US to compare longevity progress since 1987 and 2000 (vs. 2007).  The report also estimated how many years each county lags behind (or leads) the standard set by the ten best nations.  (No, America is not a leader in longevity, we rank #34 despite the fact we spend lots more on health care, 16.2% of our GNP.)  

In some counties of America longevity is nicely improving (the green zones in the chart above), while in others it is actually in decline (red zones), especially for women.  Because life expectancy around the world has steadily increased over the last century, it’s distressing to see areas—about ¼ of our counties—moving in the wrong direction.  It's even more disturbing to see that women bear the brunt of this decline.  Children born here will have a lower life expectancy than their parents—a disturbing trend that is rare among the modern nations. 

The red zones are mainly in Appalachia, the Deep South, and to the west in Oklahoma and Texas.  In these areas smoking, untreated high blood pressure, and overweight are common but they reflect a deeper failing—a culture turning self-destructive. 

The green zones where longevity is making the best improvement are located along the coasts, and in progressive areas like Marin County, California, the ski country of Colorado, and Seattle, Washington.  So why does Yuma, Arizona and Los Angeles come up green?  It’s the immigrants; the people who come from afar are healthy and vigorous and actually improve our longevity metrics.

The bottom line:  Although longevity has steadily increased in the US for a century, there are now two opposing trends: some counties are improving while others are regressing.  These contrasting movements—one showing progress, the other decline—are disturbing and should not happen in the greatest democracy the world has seen.  The solution?  I believe it lies in the power of the Internet to connect, inform, and influence.  Blogs like Word of Wisdom Living can save the world, meal by meal.  Please spread the word.

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Chronic Inflammation

The prior post introduced the subject of chronic inflammation, the chemical fire that burns within us.  Inflammation is the body’s healing response to injury, infection, and other threats, even stress.  If you live a healthy lifestyle, inflammation is occasional; if you live an unhealthy lifestyle it is chronic and eventually leads to chronic disease.  Like the frog cooked in the open pot when the temperature is slowly raised, we tend to be unaware of our inflammatory status.

Habits that drive inflammation:  Smoking, long-term infection (gingivitis, etc.), protracted stress and anxiety, the standard American diet (high in sugar and other stimulants, processed foods, fast food, hydrogenated vegetable oils, and meat), overweight, lack of sleep, social isolation, anger, a disorderly life of rushing about, frustration and loss of control. 

Habits that reduce inflammation:  A healthy diet (rich in vegetables, fruits, nuts, and whole grains, with a little meat), regular exercise, sunshine (but not sunburns), good friends, loving and being loved, achievement, service, the ability to solve problems, rest, meditation and church-going.

Chronic inflammation is not likely due to one thing though nutrition is critical—it’s the sum total of a lifestyle.  The important thing is we can change our lifestyle.

Metabolic Syndrome

The path from chronic inflammation to chronic disease typically passes through another condition—metabolic syndrome (MS).  While we may be unaware of chronic inflammation (unless a test like hsCRP is done), MS is easier to measure.  If you have three of these five easily tested conditions, you have MS:

1.     Abdominal obesity (waist >40” for men, >35” for women).

2.     High blood triglycerides (>150 mg/mL).

3.     Low HDL cholesterol (under 40 mg/dL for men, 50 mg/dL for women).  Note:  HDL cholesterol is sometimes called “good” cholesterol, though all forms are needed.

4.     High blood pressure (>130/85 mm Hg).

5.     High blood sugar (fasting glucose >110 mg/dL).

A physical exam with your doctor (an important health practice) can determine MS (metabolic syndrome, not multiple sclerosis) but I once tested myself by measuring my waist, getting a blood test at the local health food store, and buying a blood pressure tester. Different factors contribute to MS—because you need just 3 of the 5 factors, two people can have MS but only have one factor in common.  Consequently, MS is a syndrome without established clinical use, but it is an early warning to either improve your life style or prepare a will. 

High blood pressure (one indicator of MS) is a serious but silent health problem.  Keep an eye on your blood pressure by using the testers available at some pharmacies, or buying a tester of your own.  I added a new exercise, stretching, as a Healthy Change this week, but learning your blood pressure would be a good change also. 

 Warning:  While the diagnosis of MS requires 3 of 5 possible conditions, any of these conditions is a health concern and a clue to consult your doctor.  Hopefully, he’ll talk about lifestyle improvement and not just reach for the prescription pad.

An important finding from longevity studies is that it is a community affair.  The conditons that reduce the risk of chronic inflammation and metabolic syndrome and optimize life have a strong social content.  We do what our friends do.  To make a difference we must bond with others who actively seek a healthier and longer life.  Encourage your family and friends by inviting them to this blog.

Please share one thing or influence that helped you adopt a healthier lifestyle.

Monday
Mar072011

Aging With Grace

If the body’s old cells are constantly being replaced with new cells, why do people get old?  In 1956 a brilliant scientist proposed an answer—the Free Radical Theory of AgingFree radicals are byproducts created when fuel and oxygen are burned within our cells to make energy.  Basically, the free radical is a molecule that lost an electron in the process and is aggressively seeking to replace it.  (This is referred to as oxidative stress.)  If the electron is not replaced within a certain time, damage is done to the cell and its DNA.  The accumulation of this damage ages the cell, as well as the replacement cell created with the damaged DNA.  Besides aging, free radical harm is linked to chronic illness like heart disease and cancer.

Nature offers a solution to the free radical problem:  Antioxidants in food supply the missing electron.  Therefore, the theory posits, a diet rich in antioxidants will slow down the aging process.  The ultimate expression of this is the girl who goes to her 50th high school reunion and looks young enough to be the daughter of the other people.  They’ll hate you, but what could be more fun?

Natural foods are loaded with antioxidants.  There are thousands of types of antioxidants, which suggests they each may have a unique function.  The vitamins A (beta-carotene), C, and E are antioxidants.  Minerals like selenium are potent antioxidants.  Antioxidants have a function in plants also—they protect the plant from sunlight, a little like sunscreen.  It is important, therefore, to eat the edible skins of plants.  Because much of the mass is skin, the small, colorful berries are packed with antioxidants. 

Research indicates that different food groups provide different kinds of antioxidants.  Fruits, vegetables and whole grains each help, but in different ways.  There also seems to be a synergistic effect: eating a variety of foods gives a greater protection than just the sum of the ingredients.  There was unforeseen wisdom in the W of W guidance to eat from the varied herbs, fruits, and grains.

Besides the antioxidants in food, the body also produces antioxidants.  Melatonin is a powerful antioxidant and is produced when we sleep in the dark.  If you don’t sleep in a dark room, you reduce the production of protective melatonin.  Sometimes we think it a sign of our dedication if we get insufficient sleep—bad idea.  Prolong your youthfulness with adequate sleep.

The allure of eternal youthfulness is behind the recent fad of taking vitamin E supplements.  Scientists who encouraged this should have known better.  Because there are so many thousands of different antioxidants, it was highly unlikely that taking a concentrated dose of one would be healthful.  In fact, studies searching for a benefit from taking the antioxidant vitamins A, or C, or E in pill form, have each failed and some have found harm in this practice.  (See, for example, “The Antioxidant Myth: a medical fairy tale”, by L. Melton, 2006.)

The Breakfast Compote recipe provides a fabulous mix of antioxidants from berries, apples, orange juice, dried cranberries, whole grains, ground flaxseed, and pecans.  Salads, thanks to the synergy of variety, are also a good antioxidant source.  Meals that are rich in natural foods of different colors and varied food groups, slow aging, protect health, and comply with our next healthy change:


In closing, a word about cancer:  we noted above that free radical generation was linked to oxidative stress, which the body resolves with antioxidants.  Studies have linked low levels of antioxidants to a greater risk for cancer, including breast cancer.  For example a low blood level of vitamin A doubled the risk of breast cancer.  Women with low vitamin E had triple the risk.  In addition, elevated markers of oxidative stress are an independent risk factor for breast cancer.  In our next post on Thursday, we will address the tragedy of breast cancer. 

Please share what you do to provide adequate antioxidants in your diet.

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

Sunday
Jan302011

Not Quite Jack LaLanne

Got a healthy exercise program that makes you sweat?  Great!  You can skip down to the comment section and tell what you do.  Don’t have a program?  You have two choices: start one now, or plan on a shorter life, maybe seven years shorter.  Another fact:  exercise will do as much to prevent breast cancer as good diet. 

Jack LaLanne, founder of the physical fitness movement, famously stated, “I can’t die, it would ruin my image”.  It was a good line but he died the other day, at the ripe old age of 96.  Both his life and his death model the benefits of exercise: he had a long vigorous life, followed by a brief illness (pneumonia).  Jack made a good exit.  The benefits of exercise are too numerous to mention, but in sum if you exercise you not only look better, you feel better, live longer, avoid a long list of diseases, ward off dementia and depression, and have better . . . well, better everything.

More than we realize, we are the shark that dies if it stops moving.  Yet the form of our society frees us from the need to move.  The more we prosper, the more moving is an option.  Several years ago I became busy and stopped regular exercise.  There were health consequences: I gained weight and my blood pressure went up.  Concerned, I got a physical and made a plan to restore my health by natural means. 

To avoid injuries I started slowly—walking.  We live near a beach so I would walk down to the beach, then hike to the top of a nearby hill.  In the beginning it was hard.  Months passed.  One day a neighbor jogged past as I walked.  Later, when no one could see, I tried jogging up the hill.  In less than 100 yards I was out of breath, my legs turning to rubber.  Over the course of a year I jogged a little farther each time, with the goal to reach the hilltop.  A gazelle I’m not, but I’m getting better.  Later, I saw someone doing push-ups on a flat rock.  When the coast was clear I did as many as I could, just ten.  So I added push-ups to my routine, inspired by a friend who daily did his age in push-ups. 

As time passed, I expanded my workout, covering the triad of aerobic, strength, and stretching exercises.  Later I added bicycle riding on alternate days.  I lost weight.  My blood pressure came down.  There were other improvements.  After reading about the importance of sunshine as a natural source of vitamin D, I moved my workout from the morning to midday.  Some days it’s hard to get out, but it always feels good when I’m done.  And when I exercise, I want to eat better.

My wife walks with her friends for an hour each morning.  They’re very faithful in their exercise, even walking with umbrellas in inclement weather.  Her goal is 10,000 steps each day.  She wants us to add yoga next.  A son prefers to get his exercise at a gym, with a little help from a trainer.  A daughter goes to a rigorous early morning workout called “boot camp”.  Our son-in-law rides his bike 30 minutes to the train station, as part of his work commute.  Another friend prefers to do laps at the community swimming pool.  Wouldn’t ballroom dancing lessons be fun?  Jack LaLanne celebrated his 70th birthday by swimming a mile and a half—with his hands handcuffed and towing 70 boats carrying 70 people.  Yeah.  There are a lot of ways to exercise; each should find their own kind of fun. 

Please comment and share your experience with exercise.  What works for you? 

Need a reminder? Download our Healthy Change reminder card. Print and fold, then place in your kitchen or on your bathroom mirror to help you remember the Healthy Change of the week.

(photo from The NY Times, you can read more about Jack LaLanne here)