Nowadays, we can all greatly increase our likelihood of enjoying 100 or more fully functional, vibrant and robust years of health. But just like increasing our chances of a robust and healthy bank account in our "golden years," investing in our health takes proper planning, diversification, and sound strategies, and of course, the sooner you start the better!
Five Steps to the 100-Year Health Span
I wish to underscore the term "health span" to indicate that we are not talking about merely continuing to breathe (perhaps with the assistance of oxygen canisters) as we begin slow decades of decline into a more or less vegetative state in a nursing home, bereft of mind, memory and mobility and/or blind, crippled, hunched over and dependant.No, the goal here, to quote a famous anti-aging doctor, is to "die young...at a ripe old age!"
Five Steps for Your Patients to Follow
One: Cultivate and inculcate "Ha-Ha-Hah!": healthy attitudes, healthy activities and healthy alimentary habits!
Two: Keeping moderation in mind, endeavor to minimize exposure to oxidants and toxicants, while optimizing antioxidant and detoxicant intake.
Three: Keep the "hormones of age," insulin and cortisol, under control.
Four: Maintain the "hormones of youth" at optimum levels. These include human growth hormone; melatonin; thymosins; thyroid (and perhaps parathyroid) hormone; and the steroid hormones: pregnenolone; DHEA; progesterone; testosterone; and the estrogens.
Five: Review as best you can your patients' historical lifestyles and genetic risk factors, and "shore up" likely weak points with a specific strategy. For example, do lifetime habits and exposures or genetic tendencies subject them to heart disease, diabetes, dementia, or cancer? Have they perhaps already shown themselves in one form or another? Then preventative action should be taken specific to said threat in addition to the four steps above.
These steps might be visualized as steps along a pyramid. By this I mean that each step is best built upon the foundation of the previous more basic and foundational step. The best way to build your own "pyramid of health" is to build the foundation first, then proceed one step at a time, in order.
Step One: Ha-Ha-Hah!
"The more you cover the basics, the less you need of anything else." These are the words of Rick Armstrong, heavyweight kickboxing champion, oft repeated to his students. They are just as applicable here.
The primacy of healthy attitude is perhaps best argued by Lynn Peters Adler,JD, author of Centenarians: The Bonus Years:
"I have found after interviewing thousands of centenarians and their families, and in my 14 years of working with centenarians in public and private celebrations, media events, travel and leisure that centenarians who are successful in active, engaged living at 100 years have the following five traits, attitudes, behaviors or as some would say, personalities:
- a love of life;
- a positive, yet realistic attitude;
- the courage and willingness to use modern medical interventions when needed;
- a spiritual or religious belief; and
- a remarkable ability to renegotiate life at every turn adjusting to and accepting the inevitable losses that come with longevity."
Healthy activity encompasses not only physical activity, but mental activity (left- and right-brain), social activity and spiritual activity.
Physical activities should be varied and promote strength, flexibility, endurance and balance.
Mental activities should include the new, different and challenging. These may range from a new avocation, taking a new class, taking up chess and crossword puzzles, and staying active in those fields about which you are still passionate, to writing/playing music, engaging in works of art, or writing prose or poetry.
Social activity is always essential to robust health, particularly as you begin to outlive your family and friends. We must commit ourselves to constantly building and rebuilding close meaningful relationships.
"Spiritual activities" refers to any activity that gets us in touch with what we feel as our deepest selves. No matter how one tries, with age, the ability to engage in physical activities diminishes. The "gold" of the golden years is really the enjoyment of the fruits of wisdom and awareness that comes from a life of reflection, a life based on sound values, and of knowing for one's self what really matters.
"Healthy alimentary habits" refers to what we eat and drink, the alimentary canal being that tube that runs throughout our bodies. Whether it be a Seventh-Day Adventist, Mediterranean or Okinawan diet, the core essentials are more or less the same; eating smaller, frequent, and varied amounts of minimally-processed and mostly plant-based meals, with lots of pure fresh water!
It is of interest to note that the latest "diet" of interest is the Okinawan diet. The Okinawan islands have the highest proportion of centenarians in the world: 33.6 per 100,000 people. A low-calorie diet abundant in soy, vegetables and fish is being credited for the fact. But also note that a study of 600 Okinawan residents who are 100 years old or older found that they share the same lifestyle factors: regular exercise, moderate alcohol intake, and strong belief systems and social networks.
It has been said that "laughter is the best medicine." So let me encourage you to take the first step and start, "ha-ha-hah-ing" your way to a 100-year health-span today!
Step Two: Minimize Exposure to Oxidants and Toxicants, Optimize Antioxidant and Detoxicant Intake
There are many theories of aging. Two of the more popular are the free radical theory and the waste accumulation theory.
Free radical describes any molecule that differs from conventional molecules in that it possesses a free electron, a property that makes it react with other molecules in highly volatile and destructive ways. That destruction is known as oxidation. Oxidation is that process that when slow, causes iron to rust; when moderate, causes a cut apple exposed to air to turn brown; and when rapid, causes paper to burn!
Oxidation reactions occur inside of us when we turn food into energy. That is why we need to breathe in oxygen all the time.
Free radicals are not only produced inside us, but we take them in through smoking; food, air and water pollution; x-rays; sun exposure; household chemicals; and environmental poisons, to name the most common.
E.R. Stadtman, researcher on aging at the NIH notes: "Aging is a disease. The human lifespan simply reflects the level of free radical oxidative damage that accumulates in cells. When enough damage accumulates, cells can't survive properly anymore and they just give up."
The waste accumulation theory states that eventually our cells produce or imbibe more waste than they can properly eliminate. These accumulate, eventually interfering with normal function, ultimately killing the cell. The age spots we older folks might find appearing in our skins is just such an accumulation (lipofuscin)!
Our bodies have built-in antioxidant and detoxication mechanisms, but these mechanisms depend highly on proper nutrition for the raw materials. Only more recently have we come to realize that natural whole foods, spices and herbs that humans have traditionally eaten are also filled with their own antioxidants and detoxifiers, which we can then utilize as well.
For example, one reason carrots are good for you is because they contain several antioxidants: carotenoids and beta carotene, the precursor to vitamin A. Prunes, meanwhile, offer much more than just fiber. Like most deep red, blue or purple fruits, they are super-rich in antioxidant flavonoids and oligoproanthrocya-nosides (OPCs).
Cruciferous vegetables (broccoli, cabbage, cauliflower, Brussels sprouts and such) are highly touted because they help our livers break down toxins to harmless, even useful chemicals, some of which are the potentially toxic forms of estrogen. (isothiocyantes). Perhaps more familiar is the idea of eating lots of fiber, which helps "clean out" our disposal system, and can even rid our blood of the excess "bad" low-density lipoprotein (LDL) cholesterol. Of course, on the other side, it is wise to minimize or at least moderate exposure and intake of oxidants and toxins as best as reasonably possible.
Do your patients need to take additional antioxidants and detoxifiers? The general answer is that the more we have followed the last "hah" of step one, healthy alimentary habits, eating a moderate calorie, micro-nutrient-dense diet of small, frequent meals rich in fruits and vegetables. The more beans and legumes; whole grains, nuts and seeds; cold water fish; lean free-range (even wild) meats and eggs; and a variety of health-promoting fermented foods, herbs, spices and healthy oils - the less we need supplementation. The more we have been or continue to be exposed to oxidizing radiations, chemicals, poisons and pollutants, the more we need to consider adding supplemental antioxidants and detoxifiers.
Step Three: Keep Down the "Hormones of Age": Insulin, Cortisol, (and DHT)
The neuro-endocrine theory of aging tells us that we age because as we past our prime, some hormones get lower and some get higher. Unfortunately, the three most common ones to get higher, insulin, cortisol and DHT, are all generally considered "bad," at least when in more-or-less constant excess.
Have you ever wondered why diabetes is often called "adult onset" diabetes? This by far the most common form of diabetes, hallmarked by hyperglycemia, meaning "too much blood sugar." The reason for this excess sugar is that in order for sugar to get from our blood into our cells where it can be used for energy, insulin must carry it into our cells. With adult onset diabetes, the insulin receptors become unresponsive or resistant, leading to "insulin resistance." To combat this resistance, our bodies make more insulin. Because of insulin's many jobs, this rise in turn leads to fat storage, especially around the middle, a catabolic breakdown of muscle, and bad triglyceride and cholesterol levels, leading to pot-bellied men, apple-shaped women, and cardiovascular disease in both, now ominously known as syndrome X.
Even this excess insulin eventually fails, and blood sugar climbs, eventually spilling over into the urine. This excess sugar in the blood infiltrates our body's protein tissues with advanced glycation end-products (AGE). It is this process that leads to blindness; peripheral neuropathy; non-healing foot ulcers; kidney disease; hardening of the arteries; and the like. And perhaps up to half of all diabetics do not even know they have diabetes or pre-diabetes.
Everyone knows that stress is the ultimate ager. Did you ever wonder why? Well, it may be that ongoing stress causes continuous high levels of cortisol, the major stress hormone. Though this hormone is vital in helping us cope with true emergencies and threats, continued high levels eat us up inside, and throw our metabolism into a catabolic state, or state of breaking down, faster then we repair or build ourselves back up.
Dehydrotestosterone (DHT) is a metabolite of testosterone that tends to rise with age and is thought to be in large part responsible for male pattern baldness and benign prostatic hypertrophy (BHP).
It is important to note that the best way to control blood sugar and insulin is a high-fiber; low sugar; healthy fat and protein; nutrient dense; moderate calorie diet of small, frequent meals combined with regular exercise. Yes, step one. And antioxidants help protect us from highly oxidizing, immoderate, carbohydrate-laden meals (step two).
For those that already suffer from dysglycemias, there are supplements like chromium; niacin; magnesium; vanadium; flax and fish oils; and herbs like cinnamon, that can help restore our insulin sensitivity. And there are herbs like gymnema sylvestre and fenugreek, and antioxidants like vitamin C and alpha lipoic acid, that can help lower blood sugar and protect against AGE infiltration. And of course, today there are better and better medications should these more natural products prove ineffective.
One of the best ways to lower cortisol is to exercise. Another is to make time for relaxation, meditation or "re-creation." Just being deeply attentive to some of the more relaxing pieces of classical music has been shown to dramatically reduce stress hormones. We should not overlook adequate sleep, frequent hugs, and social support. Minimizing caffeine, sugar, nicotine and alcohol is a positive step in the right direction. These all, of course, are actually step-one and step-two endeavors!
Of course, few of us live like Okinawans. Fortunately, there are nutrients that will lower cortisol and help minimize its effects. These include nutrients like phosphatydilserine; vitamins C, B5, and B6; herbs to help one relax and sleep, like valerian and kava kava; and hormones such as DHEA and melatonin.
And if one already suffers, there are herbs like saw palmetto and nettles that usually work to lower "toxic" levels of DHT as well, and with less side-effects than prescription medications.
But notice how the very best way to follow step three is to follow steps one and two!
Step Four: Maintain the "Hormones of Youth"
Recall that in step three, we said that the neuro-endocrine theory of aging tells us that we age because some hormones get lower and some get higher. As anyone over 40 can tell, the ones that get lower with age must be the "hormones of youth"!
The hormones of youth are by and large anabolic hormones. There are two kinds: amino-acid-based and steroid.
The amino-acid-based hormones include human growth hormone (hGH), melatonin, thymus (immune system) hormones, and thyroid hormones. These hormones help one to grow, sleep, fight off microbial invaders and cancers, and burn fat as energy. As patients get old, they must admit there is a tendency to shrink, wake frequently at night, get deadly pneumonias and cancer, and get fat and tired.
The steroid hormones are made from cholesterol, which is why a very low cholesterol level is associated with increased morbidity! Cholesterol becomes pregnenolone which can either become mostly cortisol when highly stressed, or turn into one of the sex hormones like progesterone and DHEA, and from there to testosterone and the estrogens. These later hormones help keep people trim, strong and sharp.
It should be noted that a good way to help maintain a more youthful hGH and testosterone level is to perform regular medium intense exercise, like heavy weightlifting, wind sprints, competitive sports, and yes - sex! Even optimizing zinc and magnesium can help raise testosterone levels.
We should also know that insulin and hGH are antagonists, while DHEA and cortisol ratios (10 to 1, respectively) are more important than absolute levels.
Again, we see how following steps one, two and three may minimize the need for step four, while also supporting any endeavors in that direction.
One breakthrough for the modern anti-aging movement is the discovery of more or less affordable, reliable, safe and convenient ways to restore the hormones of youth to a more "youthful" level in those of us well into middle age and older.
Estrogen was first used on a wide scale as a youth hormone, and it is still commonly prescribed for the symptoms of menopause, when estrogens often plunge, relatively speaking!
Unfortunately, the estrogen prescribed is mostly synthetic estradiol, which is taken from the urine of a mare! It is often prescribed with little investigation into the total steroid hormone picture, including the other two main estrogens (estriol and estrone) as the steroid hormone functions are intertwined in a delicate balance.
Today, however, we can find doctors more familiar with anti-aging paradigms who will, by thorough questioning, exam, and lab testing determine which, if any, of the steroid hormones need to be enhanced, preferring natural (meaning "identical to human") hormones to synthetic analog ("almost like" human) hormones.
And anti-aging doctors do the same for men as well, who also experience a middle-aged sex hormone decline, albeit much more gradual, called the "androcline."
Though the promise inherent in optimizing the hormones of youth is exciting, admittedly we are on the frontier, with much to be learned. And if history is any judge, some things will be learned the hard way. This same promise has also regrettably, though hardly surprisingly, lead to marketing hyperbole, questionable products, and profit driven encouragement of indiscriminate shotgun use. As always, but in this arena especially, caveat emptor! Just make sure to proceed with guidance and the proper tools and resources necessary for a science-based pursuit of vital longevity for your patients.
Step Five: Shore up High Risk Factors
Half of us will die of cardiovascular disease. The other 35 percent will die of cancer, diabetes and pneumonia. Interestingly, a recent John Hopkins Medical Letter found that Okinawans have 80 percent fewer heart attacks and 75 percent fewer cancers of the breast, ovaries and prostate than North Americans. So step one is again the most important step.
For too many people, that major risk factor is obesity. This, of course, is a huge topic, but let me suffice it to say that that lean body mass optimization strategy that best incorporates the above four steps is the strategy most likely to bring long-lasting results and the related health benefits we seek.
Senile dementia is, of course, frightening to patients, for it takes away their independence, dignity, minds and families. In addition to the four steps above, there are true "brain foods" called nootroopics, both over-the-counter and prescription, that truly "feed our heads." Over 25 percent of people over 65 already have clinical signs of senile dementia.
Patients can counter the downward- spiraling effects of age-related mild or mild-moderate depression using natural products that help restore a more youthful profile of brain messenger chemicals (neurotransmitters), restoring for us the joie de vivre.
Macular degeneration is the leading cause of blindness in those over 65. We can diagnose it early and help delay its onset by using herbs (gingko biloba, vinpocetine) that increase the flow of blood and oxygen to our retinas and special antioxidants (from fruits and vegetables) that protect them from the oxidizing effects of ultraviolet light. We can do the same for cataracts, glaucoma and diabetic neuropathy if we start early.
Osteoporosis is one of the banes of those who have made it into their 80s, but are often in otherwise good health. This is equally true for both men and women by that age by the way! And just taking calcium and estrogen is clearly not the answer. But today we can measure our bone density in middle age and begin and monitor the progress of our efforts by simple urine tests to see what truly is and is not working for us. And then adding to the four steps above, we can supplement macro and trace minerals efficaciously.
Osteoarthritis is almost universally familiar to at least some extant to those over 50. Instead of just temporarily masking the pain with nonsteroidal anti-inflammatories (NSAIDs) one can take nutrients like glucosamine, chondroitin and MSM, that help to keep cartilage young, moist, springy and pain-free.
In all these step five endeavors, the following are generally true:
- The earlier your patients start the better, and the more likely over-the-counter products will be useful, as compared to prescribed medications.
- The more patients incorporate the above first four steps, no matter how tardily, the more likely the success with over-the-counter products or, as needed, prescription meds.
Though all the above means considerable effort and investment of time and money, the alternative is spending time and money on diseases with age. The only sure way out of this conundrum is for patients to die earlier than most!
If, as the old and infirm have constantly reminded us, that there is no wealth greater than health, then let me encourage you and those under your care to start investing wisely, beginning today.
Editor, Longevity News
Click here for previous articles by John Maher, DC, DCBCN, BCIM.