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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. Perceptions of Aging. Decline of cognition Physical decline Loss of libido Aches and pains Serious illness Death. Outline.

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healthy aging what you need to know

HEALTHY AGING: WHAT YOU NEED TO KNOW

Paul Richard Saunders, PhD, ND, DAHNP

Canadian College of Naturopathic Medicine

North York, Ontario

perceptions of aging
Perceptions of Aging
  • Decline of cognition
  • Physical decline
  • Loss of libido
  • Aches and pains
  • Serious illness
  • Death
outline
Outline
  • Review the aging literature
    • Genetics
    • Dietary/Caloric Restriction
    • Disease/Physical Factors
    • Mental/Emotional factors
    • Dietary Factors
  • Recommendations for Healthy Aging
a genetics
A. Genetics
  • Gene pool of negative genes vs. positive genes
    • Cardio-cerebral-vascular dz
    • Alzheimer’s Dz
    • Cancer: breast, colon, prostate
    • Fracture risk
    • Diabetes Ann NY Acad Sci. 2005;1057:50-63.
  •  genes play some role
b dietary restrictions
B. Dietary Restrictions
  • Caloric restriction  longevity: female outlives males- all species, all food levels Exp Gerontol.2005:40(10):784-792.
  • Reduces age-dependent tissue deterioration
    • CV Dz
    • Diabetes
    • Cancer
  • Reduce calories by > 30% J Gerontol A Biol Sci Med Sci. 2005;60(12):1494-1509.
slide6
Calorie restriction
    •  insulin
    •  body temperature
    • Must maintain DHEA (dehydroepiandrosterone) Ann NY Acad Sci. 2005;1057:365-371.
slide7
Diet restriction
    • 60% of calories induced neurogenesis, improved cognition
    • 40% of calories  cognition and catecholamine;  neural apoptosis and mortality J Biol Chem. 2005:280(51):42142-8.
c disease physical factors
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.2005;2005(23):17.
  • Male: testosterone  estrogen w/ age (andropause)
slide9
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.2003:165(13):1353-8.
slide10
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.2001;163(19):2633-2635.
slide11
Ostebro:
  • Acute cerebrovascular disease (stroke)
    • Women and Men similar
    •  HDL
    •  total cholesterol
    •  triglycerides Ugeskr Laeger.1995;157(19):2720-2723.
slide12
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.1991;153(9):660-662.
slide13
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.2001;56(Suppl 1):55-58.
d mental emotional factors
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.2006:54(2):199-209.
slide15
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.2005:17(5):419-425.
slide16
Italy: N=38, 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 Ageing:1998;27(2):207-216.
slide17
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.2005;42(6):677-683.
slide18
Japan: rural N=1544 vs. urban N=1003; > 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.2003;40(4):390-396.
slide19
US Terman Life Cycle Study: 1921-2000, study of parental divorce and  mortality risk in subgroup of N=1183
    • 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.2005;61(10):2177-2189.
slide20
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.2003;58(2):S74-S82.
e dietary factors
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.1994;344(8939-8940):1719-1723.
slide22
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.2004;13(5):453-456.
slide23
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 traitsCurr Biol.2006;16(3):296-300.
slide24
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.2003;pp1117-1118.
slide25
Olive oil: effects
    •  total cholesterol,  HDL,  LDL oxidation
    •  BP over 6 mo
    • 54 g/d  first MI 82% vs < 7 g/d
    •  breast cancer risk
    •  colon polyps, colon cancer risk
    •  RA risk, migraine HA risk @ 1382 mg/d
  •  consume ad libitum Pharm Lett.2003;pp.976-978.
slide26
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.2006;9(1):2-7.
healthy aging recommendations
Healthy Aging Recommendations
  • Know family history
  • Control calorie intake
    • Control glucose-insulin-  diabetes risk factors
    • Maintain DHEA
  • Control known risks
    • Hypertension
    • Smoking
    • Physical inactivity
slide28
Address psychological issues as they arise
    • Anxiety
    • Depression
  • Maintain positive social relationships
  • Avoid hospitalization
  • Maintain neurological functions
    • Sight
    • Hearing
    • Mentation
slide29
Diet
    • Red wine
    • Plant foods
    • Extra virgin olive oil
  • Positive outlook- we began aging the moment we were born, look where you are now!
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