HEALTHY AGING: WHAT YOU NEED TO KNOW

1. HEALTHY AGING: WHAT YOU NEED TO KNOW Paul Richard Saunders, PhD, ND, DAHNP Canadian College of Naturopathic Medicine North York, Ontario

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

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

4. 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

5. 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.

6. Calorie restriction ? insulin ? body temperature Must maintain DHEA (dehydroepiandrosterone) Ann NY Acad Sci. 2005;1057:365-371.

7. 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.

8. 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)

9. 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.

10. 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.

11. Ostebro: Acute cerebrovascular disease (stroke) Women and Men similar ? HDL ? total cholesterol ? triglycerides Ugeskr Laeger.1995;157(19):2720-2723.

12. 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.

13. 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.

14. 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.

15. 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.

16. 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.

17. 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.

18. 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.

19. 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.

20. 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.

21. 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.

22. 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.

23. 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.2006;16(3):296-300.

24. 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.

25. 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.

26. 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.

27. Healthy Aging Recommendations Know family history Control calorie intake Control glucose-insulin- ? diabetes risk factors Maintain DHEA Control known risks Hypertension Smoking Physical inactivity

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

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