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The U.S. population as a whole is getting older. Aging baby boomers are becoming more aware of the limitations time is placing on them. This is reflected by the tremendous interest in anti-aging medicine. People do not want to die and they want to look and feel young until they do die. Is living to the age of 100 a realistic goal? Does heredity determine life span? Can length and quality of life be influenced by lifestyle, environment, less stress, positive attitudes? It's the old question of "nature versus nurture."
The number of Americans 100-years or older doubled during the 1990s from about 37,000 to 72,000. It is predicted that the number will keep doubling every decade to a million centenarians by the year 2050. Usually five women reach the century mark for every man who accomplishes that feat. The oldest person is a 114-year old French woman. "But the number of super-centenarians are on the rise," according to Jean-Marie Robine of INSERM's demography institute. She helped to validate the world's most long-lived person according to verifiable records. It was Jean Calment, who died in 1997 at the age of 122. There is some evidence that nonagenarians (people in their 90s) and centenarians have existed throughout much of recorded history.
Other researchers, such as S. Jay Olshansky and colleagues, do not believe that more people will be living much longer or that the average human life expectancy will extend beyond 100 years. "Even if all [current] causes of death were to be resolved tomorrow, the increase in life expectation would not exceed about 15 years." They insist that further increases in life expectancy will be measured in days and months, not years, that life expectancy is unlikely to rise above 85 years.
During the 20th century, U.S. life expectancy rose from 47 to almost 77 years, an increase of 30 years. The Census Bureau now estimates life expectancy at birth to be 79 for a girl and 74 for a boy. However, forecasting life expectancy is "as much guesswork as science". From the beginning to the end of the 20th century, human life expectancy "almost doubled in developed countries". Credit is often given to advances in medical science for this progress. Though one of the most technologically advanced countries, the U.S. ranks only 16th in life span. Further, Americans are not really living much longer than they used to. In 1900 the average life expectancy was 45 years. The 30-year increase in less than a century is almost entirely due to a reduction in infant mortality. If the reduction in infant mortality is removed from the equation, life expectancy has only increased 3.7 years over the last 100 years. And there is a big difference between life expectancy and healthy life expectancy. In 1999, Japan had the highest average healthy life expectancy of 74.5 years. The U.S. placed 24th with 70.0 years.
The 20th century did see significant advances in medical technology. But the emphasis was on perfecting emergency "stop-gap" procedures rather than on preventive measures with potential to prolong a healthy life. Decrepitude is being reached at an earlier age. Many of us can remember people in their 80s living useful lives, but today an independent octogenarian is rare. The fact that sometimes their children are joining them in nursing homes speaks volumes.
Actually, younger generations seem to be failing and dying at earlier ages than their grandparents. One reason is the growing "total load" of environmental poisons and toxins present in our food, water, air, consumer products, etc. Centenarians arrive at age 100 in better condition than many of their grandchildren. "The older that people are at their death, the less likely they are to have received high-cost, high-tech care." The oldest of the old are sometimes among "our healthiest patients." Rather than having survived disease, centenarians are more likely to have avoided chronic and acute diseases associated with aging in order to live to 100. i
GENETICS OF AGING
Why do some individuals survive to their 80s or 90s relatively vigorous, free from chronic illness, and cognitively intact, while others suffer with considerable physical and mental impairment, reduced activity in daily living, and/or a shorter life span? Is it because people are genetically different - programmed to live a fixed life span -- or because they have had different experiences, environments and lifestyles? Researchers like Nancy Pedersen think it is both: "Clearly, both genes and environments are important for aging," though the "notable increase in variation" after age 70 is "exclusively due to an increase in environmental effects." She stresses that "we should remember that evidence for a significant genetic influence does not mean that a trait is immutable." There are genetic tendencies, but there is a lot that can aid, change, or compensate for them. The collective conclusion is that there are no general rules for the importance of heredity.
The work of Thomas Perls and Margery Hutter Silver with centenarians indicates they are "a small but clearly defined group of people who are less vulnerable to the damage and diseases of aging" because of their genes. This is why some have escaped the devastating effects from factors like poor diet, smoking, toxic exposures, etc. But genetics are not the only forces at work. Fixed survival attributes are "less significant than socio-economic status, nutrition, or disease history." Researchers Finch and Tanzi state: "Although the heritability of life-span is relatively minor, some genetic variants significantly modify senescence" with both positive and negative impacts on age-related disorders and life span. They believe gene variants can mediate interactions with nutritional and other environmental factors which influence life span. Their conclusion, given the "relatively minor" effect and variable manifestations of genetic risk factors, is that lifestyle and other environmental influences profoundly change the outcomes of aging. Several studies suggest that only about 25% of the variance in adult longevity is attributable to genetic differences. The other 75% seems to be related to early life events and a person's current environment and lifestyle.
Factors that influence longevity are only partially understood. They may never be totally identifiable since every individual is a unique genetic entity experiencing an equally unique personal environment. Genes do not exist in a vacuum, but rather within a hierarchy of environments that cover all levels of biological organization, from the external environment to the internal environment surrounding a single gene. Gene/environment interactions occur in areas far too numerous to list. Thus the complexities of human existence make any general assumption impossible, making the question of nature versus nurture "more fiction than fact." It will never be possible, say a group of researchers, "to totally disentangle genetic effects from the environments that give them meaning." People age differently, partly due to genetics and partly due to chosen lifestyle.
Some view aging as a pathologic process, a disease. If this is true, then its course should be modifiable through lifestyle changes and therapeutic interventions. Others think aging is part of the natural order of things -- a chronic, progressive, hereditary condition that affects everyone eventually. But there is a major difference between getting older and aging. Everyone gets older, but everyone does not age while doing so. This is the difference between chronological age and biological age.
Centenarians do not suffer long, gradual declines in health. About 95% are physically healthy and cognitively independent into their 90s and beyond. They are far more likely to have almost a lifetime of excellent health followed by a quick decline before death. Thus, "attaining old age is not a process of declining health, but of avoiding disease." Conventional thought was that the older you get, the sicker you get. In actuality, the older you get, the healthier you have been. Centenarians seem to either markedly delay or, often, escape life-threatening diseases such as cancer, diabetes, Alzheimer's disease, heart disease, and stroke. Many say that the only times they saw a doctor was when they gave birth, or when they first began to experience serious illness in their late 90s or early 100s. They and their children are less likely to be taking multiple medications or any medication at all. As Kenneth Manton and James Vaupel of Duke University stress: "The only way we're going to live longer is to stay healthier longer." Statistically, a person's overall life expectancy lengthens with age since he/she survived the risks of dying young. This should encourage thought about current and future health habits!
Drs. J. Michael McGinnis and William Foege, after analyzing 16 years of published research, estimate that half of all deaths can be considered premature and are attributed to: tobacco, diet, activity level, alcohol, infectious agents, toxic agents, firearms, sexual behavior, motor vehicles and illicit drug use. Almost all of these are preventable in part or in whole. People have a great influence over their own health and longevity. ii
Many baby boomers are seeking out designer cocktails of hormones - such as melatonin, growth hormones, and DHEA - in the hopes of producing long life and health. The efficacy of these hormones as well as other quick-fix supplements has yet to be proven. What does consistently show promise is the relationship between a healthy lifestyle and healthy old age. Nutrition is one aspect that plays a role in slowing the biological aging process.
Some think supplementing with melatonin and DHEA (dehydroepiandrosterone) (hormones that decrease in many aging people) will enhance immune system function and affect the aging process in other ways. But this issue is highly controversial. "Just because a hormone declines, doesn't necessarily mean we should automatically replace it," says Jeffrey Bland, Ph.D. "The goal should be balance. We don't want to override the body's ability to normalize itself." Administering hormones is playing with fire. They are drugs that can affect the natural biochemical feedback system of the body. Glands can be adversely affected and decrease or completely cease hormone production - in addition to other possible disrupting effects. It would make more sense to support glands, organs, and tissues so they themselves can produce the hormones and other biochemicals they need for health and long life.
Some products claim to raise levels of growth hormone for maintaining youth, but are not backed by research showing that bodily levels of growth hormone were measured or found to increase. Sufficient sleep, a diet that includes high quality protein and exercise (especially resistance or weight training) can raise levels of growth hormone as well as improve muscle mass, energy, and aid weight control. Actual human growth hormone is available only by prescription, is expensive ($300 to $400 a month), and must be taken by daily injection. This is a drug, not a nutrient, which may disrupt the body's growth-regulating systems. Resulting imbalances can lead to problems including over-stimulation of the heart, prostate enlargement, (perhaps even cancer), acceleration of aging, and shortening of life. Besides, long life and good health relate to many factors, not to a magic pill.
For example, "in the presence of a harmful environment, unhealthy aging will increase." Long before pathology develops - even in terms of declining hormone levels or symptoms of disease - functional systems change on the cellular level. "Aging is a breakdown of cellular communication," says Dr. Bland. "The body stops working as a team." Research indicates that messages residing within one's genes can either be "awakened" or "put to sleep" by exposure to specific conditions. Significant signs of aging, including strength, heart endurance, body fat, resting energy, and so on, can all be modified by altering lifestyle factors to optimize gene expression. Studies on aging show profound differences in the way people age. There is "substantial variability" among healthy and long-lived elders. This includes all ranges of incomes, all ethnic and racial backgrounds, widely varied educational levels, different diets - the variety is incredible. But some similarities stand out. iii
Physically active people have a life expectancy which is, on average, seven years longer than sedentary people. There is less depression, less anxiety, better mental efficiency, higher self-esteem, more restful sleep, more relaxation, spontaneity, enthusiasm, and better self acceptance. In the 1960s, Dr. Ralph Paffenbarger began tracking 17,000 Harvard alumni. His 1986 landmark study showed that death rates fell in proportion to the number of calories burned each week. A few years later, Paffenbarger and colleagues studied a large group of men and women, measuring their physical fitness by a maximal treadmill exercise test. Follow-up at eight years showed that mortality rates from all causes (including heart disease and cancer) fell dramatically across the board the more fit the participants were. Follow-up 10 years later confirmed that those who maintained or improved physical fitness were less likely to die from all causes than persistently unfit men.
Simply walking can be an effective way of strengthening the mind as well as the heart for elderly people. Improvement in memory, planning, and scheduling were seen in one study. Loss of skeletal muscle mass (sarcopenia), increase in body fat, and decreases in strength, basal metabolic rate, and activity level are all assumed to be associated with aging. But research shows that changes in body composition and aerobic capacity are related to the number of hours of exercise per week and energy spent in daily activities. High-intensity strength or resistance training resulted in increases in muscle strength up to 227% and increases in muscle mass up to 11.4% in men aged 60 to 72. Similar training in frail elderly (87 to 93 years of age) resulted in a 189% increase in muscle strength and 11% increase in muscle size in eight weeks. Similar programs resulted in increased gait speed, increased stair-climbing power and balance, and more spontaneous activity levels. "The implications of muscle mass and strength maintenance and its effect in enhancing energy requirements have important impact on the quality of life in the elderly." The capacity to adapt to increased levels of physical activity is preserved even in the "oldest old."
A seven year study of over 40,000 postmenopausal women found that those who frequently took part in activities (including gardening, bowling, golf, etc., or simply walked) were more than 40% less likely to die than women who avoided exercise. Most centenarians studied kept active, both physically and mentally. They "adopt strategies to keep their minds sharp and their limbs strong." iv
PSYCHOLOGY, SOCIETY & CULTURE
Evidence is mounting regarding the importance of emotional and mental life to longevity. A number of studies have concluded that, among the most important emotional predictors of longevity are purposefulness, connectedness with other people, and curiosity. Self-esteem, social ties, and life satisfaction were found to be essential in another study. Living along may have a negative impact - married persons tend to live longer. Other data indicate that psychological and emotional health are good predictors of mortality.
Personality apparently plays an important part in successful aging. This does not mean the most cheerful and optimistic personalities survive longer. Stability of personality, a sense of routine, strong relationships with others, a sense of productivity and worth, faith in God or some other form of spirituality, and other qualities are common among successful agers. Researchers say that centenarians could be described as "survivors" - possessing a pioneering spirit, keeping an interest in new things and change.
Adaptability is a common personality trait among centenarians which allows them to accept losses of loved ones, makes them continue to live with limitations of growing older, and permits them to deal with feelings of impending mortality. They endure upsets and changes in their lives. In fact, they "frequently flourish despite them." The lives of centenarians had not necessarily been easy or without disappointment and difficulties. They experienced stress, privation, poverty, hardship, and oppression. "Longevity is not a result of having avoided stress, but rather of having responded to it efficiently and effectively." In psychological assessments, centenarians score low in neuroticism -- "negative emotionality" or unhealthy feelings such as anger, fear, guilt, sadness, depression, anxiety, hostility, self-consciousness, impulsiveness, and vulnerability. People low in neuroticism are calm and collected even during crises and severe stresses. Centenarians are emotionally stable, flexible, adaptive, and seldom depressed. They are natural stress-shedders. Everyone experiences stress, but it is how stress is viewed, how one copes with stress, how quickly one gets over emotional setbacks that is one of the most important factors in successful aging.
Centenarians enjoy their lives and wish to live longer "so they don't miss out on anything." Dissatisfaction with aging is an influence for death. A large study suggests that old age itself does not increase the risk for depression -- disease and disability are more likely causes. Chronic illnesses (heart disease, cancer, stroke, arthritis, etc.), difficulties in daily activities (bathing, dressing, eating, going to the bathroom), or mental difficulties (forgetfulness) are critical indicators for depression. The belief in one's ability to solve problems and handle on-going, changing personal situations - self-efficacy - is very important. People with this type of attitude are more likely to take an active role as they age in maintaining their mental and physical health. Another key to successful aging is the right kind of social support. Expressions of affection and encouragement are very helpful; receiving a lot of assistance with tasks that a person is capable of doing him/herself is not.
Open awareness, introspection, and spirituality have benefits that apply to physical and mental health. Some years ago a study showed that people who meditated for more than five years were biologically 12 to 15 years younger than non-meditators. Another study demonstrated that older people who meditated daily were in better health, had sharper minds, and lived longer than those who did not. In one study a psychologist taught relaxation techniques, creative word games, or meditation to residents of old-age homes. Each person was taught one technique and was encouraged to practice it daily. The meditators scored highest in mental health, cheerfulness, and improved learning ability, and lowest in blood pressure. Three years later, about one-third of the residents had died. However, all of the meditators were still alive. Not only does meditation seem to prolong life, it enhances the quality of life. After compiling insurance data from 2,000 individuals who meditated regularly and comparing it with comparable data from a group of non-meditators, it was found that meditators required only half as much medical care as their matched controls who did not meditate. There were reductions in hospital admissions in 17 major medical treatment categories including 87% less heart disease; 55% fewer benign and malignant tumors; 87% fewer nervous disorders, and 30% fewer infectious diseases.
Each culture has its own viewpoint towards aging. In many traditional cultures, age is synonymous with wisdom and experience; elders are revered and cared for. In the U.S., there is a negative, rejecting attitude. Growing old is literally treated like the plague. Aging is equivalent to an illness to be prevented or treated with drugs and surgery. Every physical expression of growing old is viewed as a symptom. Sadly, the viewpoint of a culture becomes the viewpoint of its individual members. Older people are treated as if aging were a disease, so they respond by being diseased. People facing old age do not look to the future as a challenge and adventure, but as a condemnation and a death sentence.
The bias of ageism is the belief that the older a person gets, the more senile, sick, dependent, and dispensable he or she becomes. Ageism pervades our culture, our minds, and our bodies. It potentially affects everyone, in every age group. "And this attitude is a distinct and well-documented risk factor for illness." In a Boston study, researchers reported that feeding healthy elderly people, subconsciously, positive images of aging with words like "wise", "accomplished" and "astute", instead of negatives like "senile ", "dependent" or "diseased", created the effect of increasing their walking pace significantly.
Walking was used as a test because walking speed often declines with age and the elderly sometimes shuffle along due to poor balance and other factors such as medication. The positively-influenced group walked 9% faster with much more "swing time" (the time a foot spends off the ground) and much less shuffling.
Many of the myths of aging (such as old age being synonymous with frailty, decrepitude, and senility; that degenerative disease is inevitable, etc.) are reflected in apocalyptic and derogatory terminology (rising tides, demographic time bombs, gray hordes, senior moments), negative stereotypes, and suboptimal care. Even health care practitioners frequently use phrases like: "it's just your age" and "what do you expect at your age?" Some disorders do increase with age, but most do not have to - many conditions associated with old age can be prevented or offset to a major degree. Even the prevalence of disability differs in social groups and in different parts of the country.
Harvard psychologist, Dr. Ellen Langer, studied a group of male volunteers over age 70 at a retreat center for five days. The men were instructed to be who they were in 1959, a year when society would have considered them in their "prime." The men dressed, watched television shows, read magazines, and talked as if it were 1959. They hung pictures of themselves from 1959 on the walls. After the five days were over, Dr. Langer measured a series of parameters that commonly decline with age such as physical strength, perception, cognition, taste, and hearing. Many of these improved. As a result of this and other studies, Dr. Langer wrote: "The regular and ‘irreversible' cycles of aging that we witness in the later stages of human life may be a product of certain assumptions about how one is supposed to grow old. If we didn't feel compelled to carry out these limiting mindsets, we might have a greater chance of replacing years of decline with years of growth and purpose." v
The vast majority of illnesses are the result of how we choose to live our lives. "Solid evidence attests to the profound influence of nutritional status" on the age-related rate of functional decline in most tissues and organs. This evidence, explains Jeffrey B. Blumberg, Ph.D., documents the direct link between nutrition and many of the debilitating chronic degenerative diseases that often afflict elders such as coronary artery disease, angina, respiratory and pulmonary diseases, cancer, cataract, macular degeneration, severe underweight or moderate to severe overweight, diabetes, hypertension, osteoporosis, some dementias, Parkinson's disease, etc. The problem is that physiologic changes of aging increase requirements for many or most nutrients (known and unknown) while, for a variety of reasons, the amounts of nutrients consumed by the majority of older people decreases significantly. Among these reasons are excessive consumption of refined and processed foods (nutritionally depleted or completely absent), and increased exposure to toxins (foods and environment) which increase nutritional requirements from the physiologic stresses they place on the body. In most cases, nutritional deficits are subclinical, not obvious. One obstacle to identifying subclinical deficits in older people is that the symptoms resemble - and are taken for - aging. Complaints such as bone pain, muscle cramps, fatigue, lethargy, poor immune responsiveness, etc., are attributed only to advancing years. In a person over 100-years old these symptoms may indeed be age-related, but it is often a major mistake to dismiss such complaints as merely unavoidable consequences of growing older.
Poor nutritional status (inadequate intake of nutrients and/or excessive intake of nutrient-poor foods) is "a major problem in older Americans." Data show that about 80% of diets of free-living people age 65 or older are "needing improvement" or "poor." Under-nutrition is especially prevalent among hospitalized and nursing home elderly. Deficiencies were found in 53% of males and 61% of females by the time of admission to the hospital. Under-nutrition "precedes debilitation and disease and is a contributing factor to hospitalization." 86% of older Americans have one or more chronic diet-related diseases including diabetes, hypertension, and dyslipidemia, singly or in combination. "These conditions have adverse health consequences that could be prevented or reduced with appropriate nutrition intervention." Increasing evidence points to a link between poor nutrition and chronic diseases in the elderly. More nutrients (such as vitamins complexes C, E, and B) may be required to maintain the aging body, and a diminished ability to fully digest and absorb food may predispose the elderly to nutritional disruptions.
Some nutritive deficits can "cause or worsen cognitive deterioration." Numerous immune-related disorders including tuberculosis, upper respiratory infections, and cancer, are most prevalent in older people. "Marginal and classic deficiencies" of nutrients that enhance immune function exist in the diets and blood of older people. So, "current nutrient recommendations might not be adequate to support optimal immune function and health in the elderly."
Elderly individuals (especially those in poor health) are "likely to have multiple nutrient deficiencies," says Alan R. Gaby, M.D. Sadly, the "scientific method" employed in studies focuses on only one or two isolated nutrients at a time, such as one study that looked at zinc and selenium levels and supplementation. Instead, "a comprehensive supplement program would be more effective." It is not surprising that older people are deficient in nutrients and that supplementing with minerals, trace elements, or vitamins will improve immune function, energy levels, or whatever else is looked for in the trial. "What is surprising," says Mary E. O'Brien, M.D., "is the number of curious assumptions medical researchers continue to make about nutrition, illness, and old age." One assumption is that only a few nutrients are needed for study. Why stop there? "Multiple nutritional deficiencies exist in many, if not most, frail elderly patients." Why assume that a multiplicity of other nutrients is not needed as well? "As a geriatrician," explains Dr. O'Brien, "I want to do more than prevent scurvy. I want to help patients achieve optimal health." The concept should be comprehensive and long-term, not limited in scope and time.
Furthermore, nutrition is not a one-size-fits-all proposition. Every person has different needs, depending on health status, metabolism, physical activity level, previous history including early dietary habits, biochemical individuality, long-term exposure to environmental pollutants and toxins, emotional and physical stress, and more. "Diet is an essential part of healthy aging," says Dr. George Blackburn. It becomes increasingly important to focus on maintaining good health into the later decades. Far too much of the typical American diet is made up of low-fiber, nutritionally empty foods (refined and processed) that do not provide sufficient nutritional punch relative to the calories they contain. And it is even more essential for aging people to eat nutrient-dense foods.
Can sound nutrition help preserve good health and extend one's vitality and youth? Evidence indicates that nutrition is an essential factor. Important considerations for older individuals include the physiological changes occurring with age that may affect the absorption and utilization of nutrients. Certain nutrients and foods - certainly the quality of food -- can play a special protective role in slowing the aging process. It is disturbing that the diets of up to 50% of older persons in the U.S. are deficient in one or (usually) more nutrients. And this is using the minimal RDAs as measurements! Of course, diet is one part of a healthful lifestyle. Physical activity helps build and maintain muscle mass and the need for total calories, making it possible to eat more and thus obtain the necessary nutrients. With inactivity, the reduction in caloric requirements due to a reduction in lean body mass and a reduction in physical activity "leads to a reduced macro- and micronutrient intake of approximately 30% by 80 years of age." Good companionship and a positive attitude should also be added to the diet and exercise components, making up the four main ingredients for a healthier, happier, and probably longer life.
Some single nutrients that were studied and found to be deficient are especially important to aging persons. These include: vitamins B1, B2, B3, B6¸ folate, B12, A, E, D, and C, carotenoids, linoleic and linolenic fatty acids, phosphatidylcholine (precursor of acetylcholine, the chemical messenger that jumps between nerves and muscles to make muscles contract), ribonucleic acid, calcium, magnesium, zinc, copper, iron, selenium, iodine, chromium, molybdenum, manganese and trace minerals in general. A "subtle" deficiency of vitamin B12 occurs in millions of elderly Americans. Only 40% of older persons get enough folate to help keep homocysteine levels sufficiently low - 20% consume less than the RDA. "Five servings of fruits and vegetables as part of a good diet would bring the folate and vitamin B6 intakes of most persons to levels adequate to prevent high homocysteine levels." Deficits of any of the B vitamins almost always means deficiency in the whole B complex and naturally associated nutrients. The elderly appear to be at greater risk for developing vitamin C complex deficiency than other age groups. Requirements of vitamin E complex may be greater in old age compared with younger groups. Protein needs for the elderly may be higher than those of younger adults. About 50% of free-living elderly and 25% of institutionalized elderly habitually fail to consume even less than half of the low amount of protein in the current RDAs (0.8 grams of protein per kilogram body weight per day).
A diet analysis of very elderly people who were self-sufficient showed that high food intake of vitamin C complex, vitamin B2, and linoleic acid (unfortunately, only several single nutrients were studied) was associated with a 50% to 60% reduction in mortality risk. One study showed that regularly eating fruit lessened the risk of bladder cancer in older folks. Those eating fruit every day had a 32% lower rate of death from strokes, a 24% lower death rate from heart disease, and a 21% lower death rate from all causes, compared with those eating fresh fruit less often. Researchers from Cambridge University found a clear link between improved respiratory function and higher blood levels of vitamin C complex. Centenarians have the highest levels of vitamins A and E complexes compared with younger groups of elderly. The activities of both plasma and red blood cell superoxide dismutase, which usually increase with age, were reduced in the centenarians.
A long-term, wide-scale study found a significant link between increased longevity and a consistently varied diet. Other studies have discovered that the diets of centenarians are quite diverse. Some ate very little red meat, if any; others ate red meat every day. One centenarian had been eating bacon and three eggs every day for breakfast for 15 years. Other centenarians swore by dietary concoctions they had invented, such as a breakfast combination of oatmeal, olive oil, raisins, apples, and other fruits. "There was no rhyme or reason to the results we saw." The various national and ethnic backgrounds also confounded any discernible dietary patterns.
Back at the turn of the century when centenarians were young, people ate a lot of fat, a lot of meat and fish, vegetables, pickled and salted foods. This astounds scientists, who believe low-fat, low-sodium, lower-protein diets are healthier. They have accepted the current medical myths as truth. The key is the quality and wholesomeness of the foods being eaten. "Most processed foods had not existed during the centenarians' early formative years." Although there were found no specific foods or nutrients that centenarians consumed, they did all eat moderately and sensibly. About 80% said their current weight was close to what they had weighed their entire adult lives; 99% did not meet the criteria for obesity. None revealed any history of alcohol abuse. Smoking was practically nonexistent. Most kept active, both physically and mentally. Evaluations of diets in elderly people from rural Greek villages showed that for each "1 unit increase in diet score" there was associated "a 17% reduction in overall mortality." Components in the diet score included fruits, vegetables, legumes, cereals, dairy products, nuts, meat products, wine, and monounsaturated fatty acids. Most foods were minimally processed or refined, if at all.
Reports of low-caloric intake prolonging life and exhibiting anti-aging effects are based almost exclusively on animal studies. Animal experiments have shown that calorie reduction extends longevity and slows age-related deficits in behavior, learning, immune response, gene expression, and DNA repair. Can an application be made to humans? Not known. Also, as noted by Dr. Leonard Hayflick, a leading gerontologist, the animals such as mice in these trials are "merely being allowed to reach the limit of their life span. It's overfeeding that kills the control group." In laboratories experimental animals are given refined and processed kibble, and allowed to eat all they want. Like humans, they eat too many empty calories because their bodies are not obtaining adequate nutrients. The processed foods, low or devoid in complex food nutrients, cannot support and maintain healthy cells, and so stress organs and glands, promote production of fat, and otherwise disrupt biochemistry. A reduction of unnatural food may extend the animals' lives. On the other hand, consumption of whole, natural, unaltered, non-processed foods would automatically reduce calories and increase nutrient value. It is extremely difficult to over-eat whole, natural foods because of the presence of needed natural nutrient complexes that signal satiety. A starvation diet is not necessary or advantageous. A few scientists who tried severely restricting their own caloric intake glean only an anorexic, gaunt appearance with a loss of energy and strength. Empty calories and nutrient-dense calories are worlds apart. Rather than counting calories, counting the food value - nutritive content, availability, wholeness, complexity - should be considered.
Many elderly decline and die from a "failure to thrive." "Under-nutrition may be both a cause and effect in failure to thrive." Increasing numbers of scientists say that if a sensible lifestyle is followed that includes eating a variety of whole foods; abstaining from abuse of alcohol, drugs, and smoking; and exercising regularly, there is no reason not to be able to enjoy a long and healthful life span. Researchers generally agree that to retard aging, nutrients must be kept at a level that was present at the time of youthfulness.
The best nutritional benefits virtually always come from whole foods rather than isolated chemicals or synthetic substitutes. Yogurt and other lactic-acid-yeast-containing foods (raw sauerkraut, kefir, etc.), mushrooms, cabbage-family vegetables, extra-virgin olive oil and other items have been esteemed as longevity foods. Essentially, any whole, natural, uncontaminated (pesticide-, drug-, hormone-free) food is found to be healthful. Fresh fruits and vegetables (including freshly-made juices), legumes, whole grains, raw nuts and seeds, plenty of clean water, and other natural products have been linked with increases in overall health and longevity.
Variety will better ensure an abundance of nutrients. For example, green, leafy vegetables encompass arugula, chicory, dandelion greens, cress, endive, purslane, sorrel, spinach, kale, and others. Whole grains can include amaranth, corn, quinoa, millet, brown rice, oat groats, buckwheat, and so on. Just three Brazil nuts provide a healthy dose (about 400 mcg) of selenium. Pumpkin seeds may help relieve prostate symptoms. Almonds provide calcium, B vitamins, and many other nutrients. Filberts (hazelnuts) and avocados are a good source of vitamin E complex. People who eat a lot of fruits and vegetables and get enough protein tend to have good, healthy-looking skin and hair. Enzymes are essential for proper digestion and absorption, and for utilization and function of nutrients in the body. Fresh raw foods and very gently cooked ones are very good sources.
Herbs and spices contain potent natural substances supportive of health and vitality. Classic tonic herbs such as Panax ginseng and Siberian ginseng help the adrenal glands and other members of the endocrine system deal with stress. Reishi and shiitake mushrooms are traditional youth-boosters. Some botanicals like black cohosh have long traditions as anti-aging tonics. Astragalus boosts the immune system, but historically it has also been used for aging. Gotu kola is often taken as a memory tonic, but in the Ayurvedic tradition it is a builder of collagen, the connective substance that forms part of most body tissues. Hawthorn is not only a heart and circulatory system tonic, but also a stomach tonic and collagen support. Bitter herbs like arugula, baby mustard greens, and other spring greens stimulate secretion of digestive fluid. vi
THOSE WHO LIVE LONG
In our culture people automatically assume that age means infirmity. Yet there is plenty of evidence of people from isolated cultures in the recent past and the present who are quite active and vigorous and who enjoy life to very advanced years. In some cultures it is not unusual for men to father children when they are in their 80s, and for women to experience menopause at a very late time in life. These people do not have debilitating senility, arthritis, heart disease, cancer, or any other degenerative diseases common to people in developed countries. When they do pass away at very advanced ages, they die quickly of "natural causes," not slow degeneration. When these long-lived people in isolated cultures relocate and leave behind their healthful lifestyles, they fall prey to degenerative illness and premature death common to their new neighborhood.
Dr. Paul Whelton and his colleagues at Johns Hopkins University have spent years tracking indigenous Yi people of Southwestern China. Generally the Yi are lean, seldom develop hypertension, and enjoy other benefits of health. Their traditional diet is mainly rice, other whole grains, a little meat, lots of fresh fruits and vegetables. Assessing the effect of rural-urban migration particularly on hypertension, the researchers found that the rural farmers had the lowest blood pressure and least rise in blood pressure with age of the three groups studied. A move to an urban setting where diet and lifestyle are different resulted in a significant rise in blood pressure in both Yi males and females.
Dr Alexander Leaf's studies of the inhabitants of Hunza (Pakistan), Vilcabamba (Ecuador) and Abkhazia (Georgia, former USSR) are classic. People in these remote regions reportedly live well past 100. Usually they are married, work hard, keep very active, lead useful lives within their communities, are greatly respected, and eat very simple, locally-produced foods. The long-lived peoples eat locally-grown or produced food, fresh, natural, whole, and minimally (if at all) processed. A study of more than 15,000 people older than 80 in Abkhazia found that more than 70% walked regularly in the mountains and more than 60% still worked. All the older ones had superior cardiopulmonary function and had no symptoms of cardiovascular disease. No reported cases of cancer occurred in a nine-year study of 123 people who were more than 100 years old. The vast majority were found to have good neurological and psychological stability. A study of another group over 90 years of age found that 40% of the men and 30% of the women were able to thread a needle without glasses and their hearing was good in over 40% of the group.
Controversy surrounds extraordinary claims of longevity, and verifying the ages of people in these regions is difficult. A super-centenarian "hoax" occurred in Abkhasia due to folkloric pride and political fuel. Nevertheless, the inhabitants did live to be a ripe old age (over 100 rather than the claimed 130 or 140), were healthy, and trusted in their way of life. "Abkhasians struck Western visitors as remarkably attuned to the rhythms of life, precisely what we have lost in our country." They lead simple lives; eat raw and soured milk, sheep's cheese, whole grain bread, rice soup, and many vegetables. Once a week, they add mutton or chicken to their midday meal.
Though not always totally verifiable, the available evidence leads some researchers to believe there are many cases of extraordinary longevity For instance, Dr. David Davies, a gerontologist, did a thorough job of documenting the ages of a number of centenarians in Vilcabamba. He and his colleagues were "entirely satisfied that the ages of these centenarians are authentic." These people of the Andes were lucid, agile, and active in old age. Attuned to nature, they had balanced temperaments and gentle dispositions, rose with the sun and went to sleep when it set, got plenty of outdoor exercise, ate simplistically from what they grew and raised, primarily plant foods. They did not get cancer, heart disease, diabetes, high blood pressure, or other afflictions of modern cultures. In villages just 50 miles away these diseases were common. When older people who had moved down from their mountains to be near younger relatives in these villages and were exposed to their modern foods and lifestyle, they became less healthy. Symptoms of diabetes and other diseases appeared.
The Hunzas are another culture with a simple life and simple diet. Their diets can be irregular and quite fatty - natural, unaltered fats. They eat lots of fresh fruits and vegetables; freshly ground wheat, buckwheat, millet and barley products; walnuts; beans; sprouted seeds; whole raw goat's milk, some butter and cottage cheese; and homemade wine. Because of a shortage of fuel for cooking, they eat most of their vegetables raw. British physician, Sir Robert McCarrison, wrote that these people were "unsurpassed in perfection of physique and in freedom from disease in general. The span of life is extraordinarily long... During the seven years [1904-1911] I spent in their midst...I never saw a case of asthenic dyspepsia, of gastric or duodenal ulcer, or appendicitis, of mucous colitis, or cancer." Based on her travels in Hunza, Renee Taylor's book, written in the early 1960s, stated that there was little or no sickness of any kind, no need for doctors, and that Hunza is "the land of just enough." She wrote that many of the people were more than 100 years old, and virtually everyone was healthy and happy. Amazingly, a recent article commented that the Hunzas "do not have a very healthy diet" because of the high fat content. Current medical opinion blinds many to the obvious - the high-quality, natural, unaltered fats in whole foods are not harmful or unhealthy.
Okinawa is known for having a large number of people who live to be older than 100. They too continue to work and enjoy life until the end, staying healthy, active and living independently. Their approach to life is based on centuries of Eastern tradition and wisdom. Exercise, living patterns, spirituality, reverence for nature, deep respect for others, reverence for elders, and healthful food are all integrated into the Okinawan philosophy. They consume a variety of foods - a sample of 53 centenarians ate 206 foods in all, including herbs -- 38 regularly, and an average of 18 foods in a day. About 78% of the foods were plant foods including vegetables, whole grains, fruits, legumes, seaweed, with small amounts of fish, meats, poultry, eggs, and dairy. The use of natural or herbal tonics in health care far exceeds that of North America.
Back in the 1930s and 1940s, Dr. Weston Price collected data on many isolated groups of people who enjoyed bountiful health and long life. These peoples followed their traditional diets and lifestyles. A few examples: In Alaska, a medical doctor stated that in his 36 years of contact with the truly primitive Eskimos and Indians, he had never seen a case of malignant disease, although it frequently occurred when they became "modernized". There were no problems with internal organs such as stomach, appendix, kidney, and gallbladder, although surgical intervention was common among the modernized Eskimos and Indians. When possible, he sent them back to "primitive conditions and to a primitive diet, under which the death rate is very much lower than under modernized conditions."
Primitive-living people in an African district did not suffer from appendicitis, gallbladder trouble, cystitis, and duodenal ulcer; malignancy was extremely rare; not a single tooth was attacked by dental caries nor was a single malformed dental arch found. Modernizing forces were associated with a very marked increase in the death rate.
Islanders of the Torres Strait who follow their traditional lifestyle and diet "not only have nearly perfect bodies," but they exhibited happiness, peace, and health. In their native state, "they have exceedingly little disease." The local government physician said he had never, in his 13 years with them, seen a single case of cancer among the 4,000-plus population. During the same time, he had operated on or treated dozens of malignancies in the "white" population.
The Maori people in New Zealand had a reputation of "splendid physiques," "great physical endurance and good minds." Sadly, "much of this has been lost in modernization." Dr. Price found that the diets of the primitive groups had "all provided a nutrition containing at least four times [the] minimum requirements" necessary to life. The foods varied according to location and climate, but they were all whole foods as Nature produced them. Most all the peoples he studied ate plenty of meat, seafood, eggs, or milk, supplying many times the amount of fat-soluble vitamins and fatty acids normally consumed in modern societies.
Associated with the fine physical condition of these isolated primitive groups was a high level of immunity to most of the modern degenerative processes including arthritis, heart disease, cancer, and "affections of the internal organs."
Many primitive peoples retained all their teeth to a very old age, were free from the progressive shrinking of the skeleton as evidenced by shortening of the stature, had good eyesight, were able to (in the case of women) give birth easily and quickly even into their 50s, and remained active and alert. Dr. Price bemoaned the inadequacy of modern, processed and refined foods that "furnish little or no body-building or repairing material." He encouraged people to use Nature's foods "as Nature makes them."
Long-lived populations generally obtain their water from natural springs or wells, rich in minerals. Their foods are closely linked to the earth, packed with enzymes, minerals, proteins, and other nutrients. Their soils are rich and replenished. Any illnesses found in these societies are related to a lack of hygiene and are non-threatening.
While common elements are present among long-lived peoples, a long and healthy life is actually an individual affair. In diet and other factors, each person set his or her own patterns, undoubtedly having an influence on individual longevity. "An extremely active, emotionally rewarding life and a special kind of natural-foods diet appear to be the influences most responsible" for longevity in the studied peoples. Synergistic nutrient packages in natural foods exert extremely beneficial effects on health and life span; "their relative deficiency in modern diets may well prove to be the ultimate cause of the growing epidemic of modern degenerative diseases." vii
The common goal in aging is a clear mind in a capable body. There is much that an individual can do to improve his/her chances of attaining this prize. "A successful old age may lay not so much in our stars and genes as in ourselves," says psychiatrist George E Vaillant. Today's baby boomers must meet challenges of social biases, myopic thinking, overwhelming technological changes, hectic paces, polluted environments, sedentary ways, and calorie-dense but nutritionally-poor foods. Woody Allen was famous for saying that he wasn't planning to achieve immortality through his work, he preferred to do it through not dying. How many people today are making plans to put off dying? viii
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viii B Bower, Science News, 159(24), 16 June 2001, 373; L Casura, Townsend Lttr D&P, #208, Nov 2000, 122-3.
Originally published as an issue of Nutrition News and Views, reproduced with permission by the author, Judith A. DeCava, CNC, LNC.