HEALTHY AGING: WHAT YOU NEED TO KNOW

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HEALTHY AGING WHAT YOU NEED TO KNOW

• Paul Richard Saunders, PhD, ND, DAHNP
• Canadian College of Naturopathic Medicine
• North York, Ontario

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Perceptions of Aging

• Decline of cognition
• Physical decline
• Loss of libido
• Aches and pains
• Serious illness
• Death

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Outline

• Review the aging literature
• Genetics
• Dietary/Caloric Restriction
• Disease/Physical Factors
• Mental/Emotional factors
• Dietary Factors
• Recommendations for Healthy Aging

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A. Genetics

• Gene pool of negative genes vs. positive genes
• Cardio-cerebral-vascular dz
• Alzheimers Dz
• Cancer breast, colon, prostate
• Fracture risk
• Diabetes Ann NY Acad Sci. 2005105750-63.
• ? genes play some role

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B. Dietary Restrictions

• Caloric restriction ? longevity female outlives
  males- all species, all food levels Exp
  Gerontol.200540(10)784-792.
• Reduces age-dependent tissue deterioration
• CV Dz
• Diabetes
• Cancer
• Reduce calories by 30 J Gerontol A Biol Sci
  Med Sci. 200560(12)1494-1509.

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• Calorie restriction
• ? insulin
• ? body temperature
• Must maintain DHEA (dehydroepiandrosterone) Ann
  NY Acad Sci. 20051057365-371.

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• Diet restriction
• 60 of calories induced neurogenesis, improved
  cognition
• 40 of calories ? cognition and catecholamine ?
  neural apoptosis and mortality J Biol Chem.
  2005280(51)42142-8.

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C. Disease/Physical Factors

• Females out live Males Homo sapiens benefits of
  estrogen
• Estrogen ? longevity associated genes
• Estrogen ? encoding for superoxide dismutase
  (SOD), glutathione peroxidase (GSH) (antioxidant
  enzymes)
• ? Female mitochondria produce fewer reactive
  oxygen species (free radicals) Sci Aging
  Knowledge Environ.20052005(23)17.
• Male testosterone ? estrogen w/ age (andropause)

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• Osterbro Copenhagen City Heart Study
• 5600 Men, 6500 women, 2 decades 30-79 yo at
  baseline
• Risk factors coronary heart disease
• Men diabetes, hypertension, smoker, physically
  inactive
• Women diabetes, smoker, hypertension, physically
  inactive Ugeskr Laeger.2003165(13)1353-8.

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• Osterbro
• Jogging 1976-8, 1981-3, mortality follow-up
  1998 Men
• 4.7 jogged 1976-8
• 2.1 jogged 1981-3
• Regular jogging Sig lowered mortality Ugeskr
  Laeger.2001163(19)2633-2635.

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• Ostebro
• Acute cerebrovascular disease (stroke)
• Women and Men similar
• ? HDL
• ? total cholesterol
• ? triglycerides Ugeskr Laeger.1995157(19)2720-27
  23.

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• Ostebro
• Wrinkles, Age and Smoking
• Wrinkles- w/ ? income, ? age, NS BMI
• Men ? wrinkles w/ ? smoking
• Women NS wrinkles and smoking
• ? sunlight?
• ? face cream use? Ugeskr Laeger.1991153(9)660-66
  2.

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• Growth Hormone Deficiency (GHD)- short adult
  stature
• GH ? normal adult height
• GHD adults
• 38 social phobia vs 13 general population
  anxiety, depression, panic disorder,
  obsessive-compulsive disorder
• Underemployed, unmarried, unhappy
• Issue over protection in childhood? Horm
  Res.200156(Suppl 1)55-58.

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D. Mental/Emotional Factors

• Cache County, Utah among highest life expectancy
  at 65 yo
• Health rate
• 80 at 65-75 yo healthy
• 60 at 80 yo healthy
• Primary Factors- age, sex, cognitive function
• Secondary Factors- vision, hearing, mood J Am
  Geriatr Soc.200654(2)199-209.

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• Switzerland 295 80 yo w/ social contacts
  followed for 5 yr
• Social survival factors
• Spouse- NS
• Siblings- Sig
• Close friends- Sig
• ? Social Relationships- quality more important
  than frequency of contacts Aging Clin Exp
  Res.200517(5)419-425.

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• Italy N38, 75-85 yo, 86-99 yo, 100 yo
• Centenarians-
• complained less re health, but had less physical
  function
• Cognition good
• ? anxiety, ? depression
• Religious
• Okay w/ their finances
• No interest sex, recreation
• ? Centenarians more positive outlook Age
  Ageing199827(2)207-216.

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• Tokyo Metropolitan Institute of Gerontology
  Longitudinal Interdisciplinary Study on Aging
  1034 men, 1413 women, 52-77 yo, urban Japanese
• Men- age ? education ? well-being
• Men/Women- hospitalization, illness , living
  alone ? ? well-being
• ? subjective well being ? ? mortality risk
• ? Satisfaction w/ life ? well-being, ? longevity
  Nippon Ronen Igakkai Zashi.200542(6)677-683.

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• Japan rural N1544 vs. urban N1003 65 yo
  ikigai
• Ikigai feeling of being alive, motivation to
  live
• Rural vs. urban ikigai- NS
• Ikigai, rural and urban Sig related to- health,
  intellectual activity, social role
• Rural- family structure Sig
• Urban- hospitalization experience Sig men Nippon
  Ronen Igakkai Zasshi.200340(4)390-396.

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• US Terman Life Cycle Study 1921-2000, study of
  parental divorce and ? mortality risk in subgroup
  of N1183
• Divorce ? socioeconomic status, family
  psychosocial environment
• Higher mortality- ? risk (esp. men) who achieved
  sense of personal satisfaction by mid-life
• Smoking strongest factor in divorce-mortality
  link
• ? Stress of parental divorce in childhood not
  always lead to negative morality outcome Soc Sci
  Med.200561(10)2177-2189.

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• Aging in Manitoba Study activity in 1990,
  outcome assessment in 1996
• Greater activity related to greater happiness,
  better function, reduced mortality
• Solitary activities (e.g. work, hobbies) related
  only to happiness
• ? Social and Productive activities provide
  physical benefits, ? mortality
• ? Solitary activities (reading) have more
  psychological benefits J Gerontol B Psychol Sci
  Soc Sci.200358(2)S74-S82.

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E. Dietary Factors

• French Paradox coronary heart disease (CHD)
• 21 developed countries 1965, 1970, 1980, 1988
• France highest wine intake, highest total EtOH
  intake
• France second lowest coronary heart disease
• France Animal fat correlated to CHD risk
• France Fruit consumption neg correlated to CHD
• ? Wine EtOH neg correlated to CHD, but not to
  mortality unless light to moderate EtOH
  consumption Lancet.1994344(8939-8940)1719-1723.

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• Mediterranean Diet (MD) meta-analysis of 5
  cohort studies
• Diet influences longevity
• Optimal diet overlaps w/ MD
• MD ? risk coronary heart disease, cancer
• ? MD factors olive oil, plant foods, moderate
  wine intake Eur J Cancer Prev.200413(5)453-456.

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• Resveratrol phenolic stilbene in grapes, red
  wine short-lived vertebrate longevity fish
• Protects from ischemia
• Protects from neurotoxicity
• Delays age-dependent loss of locomotor activity
• Delays loss of cognitive performance
• Reduces neurofibrillary degeneration of brain
• ? Slows expression of age-dependent traits Curr
  Biol.200616(3)296-300.

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• Resveratrol mechanism
• Decrease inflammatory cytokines
• Weakly binds ?- and ?-estrogen receptors
• Antioxidant
• Antimutagenic
• Inhibits COX-1, COX -2 5-lipoxygenase, platelet
  aggregation
• Inhibits colon cancer cell function
• Prevents liver cancer invasion
• Inhibits CYP450 isoenzymes 3A4, 1A, 2E1
• 640 mcg/glass red wine (pinot noir, cabernet
  sauvignon Pharm Lett.2003pp1117-1118.

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• Olive oil effects
• ? total cholesterol, ? HDL, ? LDL oxidation
• ? BP over 6 mo
• 54 g/d ? first MI 82 vs
• ? breast cancer risk
• ? colon polyps, colon cancer risk
• ? RA risk, migraine HA risk _at_ 1382 mg/d
• ? consume ad libitum Pharm Lett.2003pp.976-978.

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• Plant Foods polyphenols
• Antiinflammatory- Curcuma longa, turmeric
  (curcumin)
• Liver protective- Cynara scolymus, artichoke
  (cynarin)
• Blood vessel wall integrity- Vaccinium myrtillus,
  blueberry (proanthocyanidins), Citrus paradisi,
  grapefruit (rutin)
• Antiallergy- Allium cepa, onion A. sativum,
  garlic (quercetin)
• Many polyphenols are tissue/organ specific Curr
  Opin Clin Nutr Metab Care.20069(1)2-7.

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Healthy Aging Recommendations

• Know family history
• Control calorie intake
• Control glucose-insulin- ? diabetes risk factors
• Maintain DHEA
• Control known risks
• Hypertension
• Smoking
• Physical inactivity

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• Address psychological issues as they arise
• Anxiety
• Depression
• Maintain positive social relationships
• Avoid hospitalization
• Maintain neurological functions
• Sight
• Hearing
• Mentation

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• Diet
• Red wine
• Plant foods
• Extra virgin olive oil
• Positive outlook- we began aging the moment we
  were born, look where you are now!