A4M News & Reviews July 2008

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VOLUME 2008 issue 4

Anti-Aging

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LONGEVITY

news & review Longevity News and Review provides readers with the latest information in breakthroughs pertaining to the extension of the healthy human lifespan. These news summaries are compiled by the American Academy of Anti-Aging Medicine (A4M; www.worldhealth.net), a non-profit medical society composed of 20,000 physician and scientist members from 90 nations, united in a mission to advance biomedical technologies to detect, prevent, and treat aging related disease and to promote research into methods to retard and optimize the human aging process. Dr. Ronald Klatz, M.D., D.O., A4M President, and Dr. Robert Goldman, M.D., Ph.D., D.O., FAASP, A4M Chairman, physician cofounders of the anti-aging medical movement, distill these headlines and provide their insightful commentary.

Low Testosterone Increases Bone Fracture Risk in Older Men While osteoporosis, a disease that thins and weakens the bones to the point that they become fragile and break easily, is more common in women than men (80% of those affected are women), men are at-risk for osteoporosis-related fractures as well. In the Dubbo Osteoporosis Epidemiology Study, Christian Meier, from the University of Sydney (Australia), and colleagues followed a group of 609 men for six years, tracking and analyzing testosterone levels in the blood and the incidence of fractures. The team found that men ages 60+ with low levels of testosterone are at increased risk for fractures resulting from osteoporosis. For each standard deviation decrease in testosterone below normal levels, the risk of fracture rose by 28%. For men with particularly low testosterone levels, the risk was twice that seen in other men.

[Meier C, Nguyen TV, Handelsman DJ, Schindler C, Kushnir MM, Rockwood AL, Meikle AW, Center JR, Eisman JA, Seibel MJ. “Endogenous sex hormones and incident fracture risk in older men: the dubbo osteoporosis epidemiology study.” Arch Intern Med. 2008 Jan 14;168(1):47-54.]

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Dr Klatz remarks: ”In the United States, 10 million people already have osteoporosis. Millions more have low bone mass, or osteopenia, placing them at increased risk for the disease.

This study shows that testosterone can be a valuable marker of bone fracture risk in aging men. It provides an option for early detection and monitoring of osteoporosis in a patient group for which the disease is often overlooked.”

Vitamin B-6 Slashes Colorectal Cancer Risk Globally, 945,000 new cases of colorectal cancer are diagnosed every year, and the disease is responsible for 492,000 deaths worldwide every year. Evropi Theodoratou, from the University of Edinburgh (United Kingdom), and colleagues tracked almost 5,000 men and women and found that an increased intake of Vitamin B-6 reduced the risk of colorectal cancer by over 20%.The team also conducted a meta-analysis of previously published studies, finding that other researchers have observed that high Vitamin B-6 intake reduced the risk by 19%. Further, the protective effect was found to be higher among individuals age 55+.

[Theodoratou E, Farrington SM, Tenesa A, McNeill G, Cetnarskyj R, Barnetson RA, Porteous ME, Dunlop MG, Campbell H. “Dietary vitamin b6 intake and the www.spamanagement.com

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risk of colorectal cancer.” Cancer Epidemiol Biomarkers Harvard School of Public Health, and colleagues followed 15,000 men over a 13-year period, tracking Prev. 2008 Jan;17(1):171-82.] the onset of prostate cancer. The team found that the Dr. Goldman observes: “In the United States, colorectal highest blood levels of trans oleic acid and trans linoleic cancer is the second leading cancer killer, yet it is among the acids were associated with 116% and 97%, respectively, most preventable cancers (as poor diet and smoking have been increased risk of non-aggressive prostate tumor risk. found to be leading contributing factors for the disease). This [Chavarro JE, Stampfer MJ, Campos H, Kurth T, Willett study shows that Vitamin B-6, consumed either as part of the WC, Ma J. “A prospective study of trans-Fatty Acid daily diet or as dietary supplements, can be a powerful weapon levels in blood and risk of prostate cancer.” Cancer Epidemiol Biomarkers Prev. 2008 Jan;17(1):95-101.] in significantly slashing one’s risk of colorectal cancer.”

VOLUME 2008 issue 4

Trans Fats Increase Risk of Prostate Cancer

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Trans fats (trans fatty acids, or TFAs), are common in many processed foods, in the form of partially hydrogenated vegetable oils. However, recent scientific studies report that trans fats raise LDL (“bad”) cholesterol, lower HDL (“good”) cholesterol, promote inflammation, and increase a number of risk factors for cardiovascular diseases. Jorge Chavarro, from the

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Dr. Klatz comments: “This study identifies trans fats as a contributing factor to prostate cancer., the third most common cause of death from cancer in men of all ages. According to the European School of Oncology, over 500,000 new cases of prostate cancer are diagnosed every year worldwide. The incidence of the disease is increasing at a rate of 1.7% over 15 years. The simple choice of avoiding foods with trans fats and partially hydrogenated vegetable oils may be among the key health promoting decisions we make each and every day.”

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P, Manolis A, Karasik P, Greenberg M, Papademetriou V, Singh S. “Exercise Capacity and Mortality in Black Women who drink three or more cups of coffee per day and White Men.” Circulation. 2008 Jan 22; [Epub may significantly reduce their risk of ovarian cancer. ahead of print].’

Shelley Tworoger, from Harvard Medical School (USA), and colleagues analyzed data from more than 121,000 Dr. Goldman observes: “Because the study covered 6,749 female registered nurses participating in the nurses’ black men and 8,911 white men and monitored them for an Health Study, and found a 20% risk reduction in average of 7.5 years, this work is a significant contribution to ovarian cancer among women whose daily caffeine the body of scientific data on the role of exercise in extending intake was 500 milligrams or more daily, compared to longevity. The study’s take-home message is clear: exercise women with a daily intake of less than 136 milligrams. works on anybody, regardless of race or income. It also shows Among postmenopausal women, the highest intake of it is never too late for someone to begin a regular exercise caffeine was associated with a 43% reduction in the risk routine and still reap the life-extending benefits.” of ovarian cancer. This protective effect was not observed with consumption of either decaffeinated coffee or tea. Low Vitamin E Correlates to Physical Decline in [Tworoger SS, Gertig DM, Gates MA, Hecht JL, Elderly Hankinson SE. “Caffeine, alcohol, smoking, and the risk of incident epithelial ovarian cancer.” Cancer. 2008 Jan Older adults with low levels of vitamin E are likely to see a steeper deterioration in physical function than those 22; [Epub ahead of print].’ with higher vitamin E levels. Bbenedetta Bartali, from Dr Klatz remarks: “Ovarian cancer has the highest Cornell University, and colleagues studied 698 men and mortality of all the cancers of the female reproductive system. women ages 65+ who resided in Tuscany, Italy. Over the The Ovarian Cancer National Alliance (ONCA) estimates course of a 3-year study period, the team monitored that 1 in 69 women will develop ovarian cancer in their micronutrient levels of vitamins (folate, vitamin B-6, lifetime and 1 in 95 women will die from it. This study vitamin B-12, vitamin E, and vitamin D) in blood, and suggests the potential role of a simple dietary substance, physical function (walking speed, standing balance, and caffeine, in modulating estrogen concentrations thus resulting other physical abilities). Vitamin E was the only micronutrient associated with reduced physical function in a cancer protective effect.” (after other factors were adjusted). Compared to people Exercise Sharply Reduces Death Rate Among Older with the highest levels of vitamin E, those with the lowest amount were 62% more likely to experience a drop in Men their physical capacities.

Peter Kokkinos, from the Veterans Affairs Medical [Bartali B, Frongillo EA, Guralnik JM, Stipanuk MH, Center (USA), and colleagues, have completed a study Allore HG, Cherubini A, Bandinelli S, Ferrucci L, Gill involving 15,000 military veterans that is one of the TM. “Serum micronutrient concentrations and decline largest yet to demonstrate the broad population-wide in physical function among older persons.” JAMA. 2008 benefits of exercise. In this study of men ages 50 to 70, Jan 23;299(3):308-15.’ older men who were classified as “highly fit” died at half the rate of those who were not fit. Additionally, men who Comments Dr. Klatz: “This study demonstrates how were “very highly fit” had a 70% lower risk of death as vitamin E, a powerful antioxidant, may be of value in those in the “low fit” category. The researchers observe preventing physical decline as we age. This study suggests that that just 30 minutes of brisk walking 5 to 6 days a week 15 to 30 milligrams per day of alpha tocopherol, a form of would be enough to raise a middle-aged or older man vitamin E, is needed a day to achie4ve the protective effect. from the “low fit” to “very highly fit” category in a matter Elevate your vitamin E levels by boosting consumption of foods high in this vitamin, such as almonds, tomato sauce, and of months.

[Kokkinos P, Myers J, Kokkinos JP, Pittaras A, Narayan sunflower seeds.

VOLUME 2008 issue 5

Coffee Reduces Ovarian Cancer Risk

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VOLUME 2008 issue 6

Poor Dietary Choices Contribute to Metabolic Syndrome

Metabolic Syndrome is a group of health risk factors that are associated with cardiovascular disease and diabetes. Factors include enlarged waist circumference, high blood pressure, elevated triglycerides, low HDL (“good”) cholesterol, and high fasting glucose levels. Lyn Steffen, from the University of Minnesota (USA), and colleagues, analyzed dietary intake data of more than 9,500 men and women, ages 45 to 64, who enrolled in the Atherosclerosis Risk in Communities (ARIC) study. The team assessed food intake and categorized people by their dietary preferences: Western, which is heavy on refined grains, processed meat, fried foods, red meat, eggs, and soda, and light on fish, fruit, vegetables, and whole grain products; or prudent, which favored vegetables, fruit, fish and seafood, poultry, whole grains, and low-fat dairy products. After 9 years of follow-up, 40% of the study participants had 3 or more risk factors for Metabolic Syndrome, and (after adjusting for other factors) the researchers found this to be correlated to a Western dietary pattern.

Specifically, the researchers found that eating just two servings of meat a day can increase the risk of developing Metabolic Syndrome by 25%, as compared to eating meat only twice a week. In addition, fried foods and diet soda were significantly associated with an increased risk of developing Metabolic Syndrome [Lutsey PL, Steffen LM, Stevens J. “Dietary Intake and the Development of the Metabolic Syndrome. The Atherosclerosis Risk in Communities Study.” Circulation. 2008 Jan 22; [Epub ahead of print].]

Dr. Klatz observes: “This study warns of the hazards of the Western diet. For a healthy alternative, we can look to the Okinawan diet. Okinawa, a prefecture in the Japan, has the highest proportion of centenarians in the world, with more than 33% aged 100 years or older. Okinawans have 80% fewer heart attacks than Americans, and 75% fewer cancers, including breast cancer and cancer of the ovaries in women and prostate cancer in men. The Okinawan diet is rich in complex carbohydrates and plant-based foods, and low in fat, as compared to the average Western diet. For these reasons, the Okinawan diet reflects key anti-aging principles for longevity.”

Breakfast Curbs Middle-Age Weight Gain Nita Forouhi, from Addenbrooke’s Hospital (United Kingdom), and colleagues followed more than 6,700 men and women, ages 40 to 75 for a period of nearly four years, to establish the role of breakfast in weight gain. The researchers found that people who ate a greater proportion (22 to 50%) of

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their total daily calories at breakfast time gained 0.79 kilograms of weight over time. By contrast, those who consumed 11% or less of their total day’s worth of calories at breakfast gained an average of 1.23 kilograms. The team notes that each 10% increase in calorie consumption at breakfast equated to approximately 210 to 320 grams less weight gain on-average over a four-year period.

[Purslow LR, Sandhu MS, Forouhi N, Young EH, Luben RN, Welch AA, Khaw KT, Bingham SA, Wareham NJ. “Energy intake at breakfast and weight change: prospective study of 6,764 middle-aged men and women.” Am J Epidemiol. 2008 Jan 15;167(2):188-92. Epub 2007 Dec 12.]

Remarks Dr. Goldman: “This study is one of the latest to support the adage that ‘breakfast is the most important meal of the day.’

Simply by shifting a greater proportion of a day’s total calorie intake to breakfast may be beneficial to lower weight gain over time among middle-aged men aged women. This effect can be further reinforced by initiating a regular exercise regimen and by making healthy lifestyle choices (don’t smoke, drink alcohol in moderation, and similar.).”

Omega-3 Supplements Slow Late-Onset Alzheimer’s Disease Qiu-Lan Ma, from the University of California/Los Angeles (USA), and colleagues, have found that supplements of docosahexaenoic acid (DHA), a type of omega-3 fatty acid, can increase levels of LR11, a protein that is key in clearing enzymes that produce beta amyloid plaques implicated in Alzheimer’s Disease (AD). The team’s research suggests that DHA may be most useful for early intervention and prevention of late-onset AD, with DHA inducing increases in LR11 in a lab model of Alzheimers.

[Qiu-Lan Ma, Bruce Teter, Oliver J. Ubeda, Takashi Morihara, Dilsher Dhoot, Michael D. Nyby, Michael L. Tuck, Sally A. Frautschy, and Greg M. Cole. “Omega-3 Fatty Acid Docosahexaenoic Acid Increases SorLA/LR11, a Sorting Protein with Reduced Expression in Sporadic Alzheimer's Disease (AD): Relevance to AD Prevention.” The Journal of Neuroscience, December 26, 2007, 27(52):14286-14298; doi:10.1523/JNEUROSCI.4122-07.2007.]

Comments Dr. Klatz: “Alzheimer’s Disease (AD) is the most common form of dementia and currently afflicts over 13 million people worldwide. Late-onset AD is the most common form of the disease and has no obvious family inheritance pattern. This study adds to a growing body of evidence linking DHA to brain health, and indicates a potential therapeutic benefit for the supplement in reducing the risk for a devastating neurological disease.

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VOLUME 2008 issue 7

Carotenes Correspond to Lower Cardiovascular Disease Deaths

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[Cherkas LF, Hunkin JL, Kato BS, Richards JB, Gardner JP, Surdulescu GL, Kimura M, Lu X, Spector TD, Aviv A. “The association between physical activity in leisure time and In a study involving 559 men followed for fifteen years, Brian leukocyte telomere length.” Arch Intern Med. 2008 Jan Buijsse, from Wageningen University (The Netherlands), and 28;168(2):154-8.] colleagues found that an increased consumption of alpha- and beta-carotene in the diet significantly reduced the risks of Dr. Goldman observes: “This study is a clear demonstration that heart disease deaths. Specifically, the team found that the adults who participate in regular physical activity are biologically increased intake of carrots, rich in alpha- and beta-carotene, younger than sedentary individuals. There is, as the authors suggest, corresponded to a 17% reduction in the risk of a clear ‘potential anti-aging effect of regular exercise.’ In general, cardiovascular-related death. Interestingly, the researchers people should aim for 30 minutes of moderately intense physical also found that increased intakes of other carotenoids, vitamin exercise at least five days a week (check with your doctor first).”

C, or alpha- and gamma tocopherol (the two most common types of vitamin E in the diet), had no influence on the risk of Lead Exposure Effects May Masquerade as “Normal cardiovascular-related death.

Mental Decline” [Buijsse B, Feskens EJ, Kwape L, Kok FJ, Kromhout D. “Both alpha- and beta-carotene, but not tocopherols and vitamin C, Although sharp reductions in environmental lead levels were are inversely related to 15-year cardiovascular mortality in mandated more than twenty years ago, new research suggest Dutch elderly men.” J Nutr. 2008 Feb;138(2):344-50.] that past exposure to lead may have detrimental and lasting effects. W.F. Stewart, from Geisinger Clinic (Pennsylvania Dr. Klatz remarks: “Almost 700,000 Americans die of heart USA), and colleagues conducted three independent diseases each year (29% of all the nation’s deaths), and longitudinal studies to determine whether cumulative lead approximately 700,000 strokes occur in the US each year, many of exposure was associated with persistent or progressive brain them resulting in long-term disability. According to the American effects. The team studied 1,109 American workers previously Heart Association, cardiovascular diseases cost $403.1 billion in exposed to lead occupationally, 803 Korean workers currently 2006, including health care services, medications, and lost or previously exposed to lead occupationally, and 1,140 50productivity to the nation. This study suggests the potential to 70-year old Baltimore (Maryland USA) residents exposed therapeutic effect of alpha- and beta-carotene intakes for heart and to lead via the environment. They found lead build-up in the vascular health, which may be able to be achieved simply by choosing bones of all the study subjects, with greater amassed lead to consume greater quantities of foods rich in those compounds.” concentrations associated with poorer cognitive function performance. The researchers concluded that: “Our data suggest that a significant proportion of what is considered to Lack of Physical Activity Accelerates Aging be ‘normal’ age-related cognitive decline may, in fact, be due to Telomeres are the endcaps on chromosomes, and telomeric past exposure to neurotoxicants such as lead.” shortening is thought to govern the number of times a cell can [Stewart WF, Schwartz BS. “Effects of lead on the adult brain: divide. In white blood cells (leukocytes), telomere shortening a 15-year exploration.” Am J Ind Med. 2007 is used as a marker of biological age. Lynn Cherkas, from Oct;50(10):729-39.]

King’s College London (United Kingdom), and colleagues, studied 2,401 twins, tracking their physical activity level, Dr. Klatz comments: “Lead is no longer present in gasoline and lifestyle habits, and examining the length of the telomeres in house paints sold in the United States, but leaded products may be the subjects’ white blood cells (leukocytes).The team found available in other nations, putting those residents at-risk. Drinking telomere length decreased with age, and men and women who water may also be a possible source of lead, as the toxin can be were less physically active in their leisure time had shorter introduced via older plumbing. In the United States, consumers leukocyte telomeres than those who were more active. The should check their dishware for the presence of lead. In some mean difference in leukocyte telomere length between the countries lead is a component of decorative paints used to embellish most active subjects (who performed n average of 199 minutes plates and cups; through heating and/or exposure to acidic foods of physical activity per week) versus the least active subjects (such as tomatoes and citrus fruit), the lead can leach out of the (16 minutes of physical activity per week) was 200 dishware and contaminate the food. Simple, do-it-yourself lead tests nucleotides. This translated to mean that “the most active are available at local hardware stores. If you suspect that you have subjects had telomeres the same length as sedentary been excessively exposed to lead, ask your doctor to conduct a blood or urine toxic metal screening. individuals up to 10 years younger, on average.”

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VOLUME 2008 issue 8

B-Vitamin Deficiencies Increase Dementia Risk

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JM Kim, from Chonnam National University Medical School (Korea), and colleagues completed a study of 518 men and women, average age 74, for 2.4 years. They team found thatdementia occurred more commonly in those with a decline in folate, with folate deficiency correlated to a 3.5-time increase in the likelihood of developing the disease. Additionally, the researchers found low concentrations of vitamin B-12 to be associated with the risk of dementia.

[Kim JM, Stewart R, Kim SW, Yang SJ, Shin HY, Shin IS, Yoon JS. “Changes in folate, vitamin B12, and homocysteine associated with incident dementia.” J Neurol Neurosurg Psychiatry. 2008 Feb 5; [Epub ahead of print].]

Dr. Klatz remarks: “Dementia is the progressive loss and impairment of activities such as memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other intellectual capacities. Alzheimer’s Disease (AD) is the most common form of dementia and currently affects over 13 million people worldwide. This study underscores the value of a healthy lifestyle, and particularly the consumption of a diet rich in B vitamins.”

Antioxidants and Carotenoids Preserve Aging Eyes

[Parisi V, Tedeschi M, Gallinaro G, Varano M, Saviano S, Piermarocchi S; CARMIS Study Group.

“Carotenoids and antioxidants in age-related maculopathy italian study: multifocal electroretinogram modifications after 1 year.” Ophthalmology. 2008 Feb;115(2):324-333.e2. Epub 2007 Aug 22.]

Dr. Goldman observes: “AMD causes central vision loss and leaves only peripheral vision. Early detection has been the primary mode of prevention, in that treatment or rehabilitation can be key if implemented in the initial phase of the disease.

This study suggests a role for antioxidants and carotenoids beyond prevention, and a potential utility for supplementation of these nutrients to actually improve retinal health.”

Western Diet Promotes Metabolic Syndrome Metabolic Syndrome is a condition characterized by central obesity, hypertension, and disturbed glucose and insulin metabolism. Pamela Lutsey, from the University of Minnesota (USA), and colleagues, found that the high calorie, low fiber dietary pattern associated with the Western diet contributes to an increased risk of Metabolic Syndrome. The team followed more than 9,500 subjects, ages 45 to 74, for 9 years, administering a food frequency questionnaire to assess dietary intakes.

The team found that fried foods, diet soft drinks, and meat consumption were linked to an increase in the risk of Metabolic Syndrome. Regular consumption of dairy products was found to be beneficial.

[Lutsey PL, Steffen LM, Stevens J. “Dietary Intake and the Development of the Metabolic Syndrome. The Atherosclerosis Risk in Communities Study.”

Circulation. 2008 Jan 22; [Epub ahead of print].]

Age-related macular degeneration (AMD) is the leading cause of legal blindness for people age 55-plus in the Western world. Vincenzo Parisi, from the Fondazione G. B. Bietti-Istituto di Ricovero e Cura a Carattere Scientifico (Italy), enrolled 27 men and women, average age 69.6, in a year-long study: 15 participants received daily antioxidant and carotenoid supplements and 12 received placebo.

Dr. Klatz comments: “Previous studies have implicated the Western diet as a causal factor in a range of conditions, from The daily supplement provided 180 mg vitamin C, 30 obesity to colorectal cancer. This study now adds Metabolic mg vitamin E, 22.5 mg zinc, 1 mg copper, 10 mg lutein, Syndrome to the list. This study shows that by simply 1 mg zeaxanthin, and 4 mg astaxanthin. Participants reducing our daily consumption of meats and processed foods, who received the supplement showed a significant we can beneficially impact our risk of Metabolic Syndrome, improvement in the function of the central retina (the which affects 32% of Americans and 15% of the adult portion of the eye most adversely impacted in AMD).

European population.”

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VOLUME 2008 issue 9

Berries Bring Heart Health Benefits

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Berries are a rich source of polyphenols and other bioactive substances (such as Vitamin C), demonstrating their antioxidant potential. Iris Erlund, from the National Public Health Institute (Finland), and colleagues have found that a diet rich in berries may bring heart health benefits as well. In a study of 77 men and women (average age 58), the team found that those who consumed a 100 grams or more of whole berries [or 50 grams or more of berry products (nectars or purees)] for two months were able to reduce their systolic blood pressure by 7.3 mm and increase their levels of HDL cholesterol by 5% or more. In addition to improvements in blood pressure and cholesterol levels, the berry-rich diet also was associated with an 11% inhibition of platelet function (increased rates of which are correlated to blood clotting and atherlersclerosis).

[Erlund I, Koli R, Alfthan G, Marniemi J, Puukka P, Mustonen P, Mattila P, Jula A. “Favorable effects of berry consumption on platelet function, blood pressure, and HDL cholesterol.” Am J Clin Nutr. 2008 Feb;87(2):323-31.]

normal blood pressure, did not have diabetes, and exercised regularly had a 54% chance of living for at least 20 years. But among 70-year olds who smoked, were obese, had hypertension and diabetes, and were sedentary, a mere 4% reached age 90. The longer-lived men also maintained better physical function and mental well-being as they aged, and developed heart disease or cancer years later than their shorter-lived peers.

[Yates LB, Djoussé L, Kurth T, Buring JE, Gaziano JM. Exceptional longevity in men: modifiable factors associated with survival and function to age 90 years.

Arch Intern Med. 2008 Feb 11;168(3):284-90.]

Remarks Dr. Goldman: “This study points to the significant extension of longevity, and prolonged quality of life, associated with healthy habits. By making smart lifestyle choices, we reward ourselves with longer, healthier, productive lifespans.”

Mechanism of Cholesterol-Reducing Diets Explored

For Men, Healthy Habits Lead to Longer Lives

High cholesterol levels (hypercholesterolemia) have been long-associated with cardiovascular disease. David Jenkins, from St. Michael’s Hospital (Ontario, Canada) and colleagues enrolled 42 men and women (average age 63) in a study that assigned participants a diet low in saturated fat, and high in soy protein, fiber, and plant sterols. After a period of 80 weeks, LDL (“bad”) cholesterol levels decreased by 15.4% (as compared to a 9% reduction in the study counterparts who were not consuming plant sterols).

[Jenkins DJ, Kendall CW, Nguyen TH, Marchie A, Faulkner DA, Ireland C, Josse AR, Vidgen E, Trautwein EA, Lapsley KG, Holmes C, Josse RG, Leiter LA, Connelly PW, Singer W. Effect of plant sterols in combination with other cholesterol-lowering foods.

Metabolism. 2008 Jan;57(1):130-9.]

Laurel Yates, from Brigham and Women’s Hospital (Massachusetts, USA), and coilleagues analyzed 25 years of data from a group of 2,357 men (average age 72), who participated in the Physicians’ Health Study. Fortyone percent (41%) of the men lived to be 90 or older. At age 70, men who did not smoke, were not obese, had

Comments Dr. Klatz: “The modern era diet is low in plant sterols, intake of which was far greater when societies were more oriented on plant-based diets. This study suggests a protective role for plant sterols in reducing the risk of cardiovascular disease. Green leafy vegetables and nuts (raw or dry roasted) are good sources of plant sterols.”

Dr. Klatz observes: “Almost 700,000 Americans die of heart diseases each year (29% of all the nation’s deaths), and approximately 700,000 strokes occur in the US each year, many of them resulting in long-term disability. According to the American Heart Association, cardiovascular diseases cost $403.1 billion in 2006, including health care services, medications, and lost productivity to the nation. This study is significant in that it is may help to elucidate the heartprotective value of a diet rich in fruits – specifically that of strawberries, black currants, bilberries, and lingonberries.”

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VOLUME 2008 issue 10

Hostility + Depression = Heart Risk

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Symptoms of depression and hostility may act together to increase the circulating levels of inflammatory markers, thus raising the risk of cardiovascular disease.

Jesse C. Stewart, from Indiana University-Purdue University (USA), and colleagues followed a group of 316 healthy older adults (ages 50 to 70 years). In those study participants exhibiting depression, the team identified an association between greater hostility and elevated inflammatory markers of heart disease (specifically, interleukin-6 and C-reactive protein).

[Stewart JC, Janicki-Deverts D, Muldoon MF, Kamarck TW. “Depressive symptoms moderate the influence of hostility on serum interleukin-6 and C-reactive protein.” Psychosom Med. 2008 Feb;70(2):197-204.

Epub 2008 Feb 6.]

Dr. Klatz observes: “While a link between depression, hostility, and cardiovascular disease has previously been suggested in age-specific groups of men, this study extends the correlation to the general community, and to women. Thus it suggests that there may be physical health reasons, not merely mental health reasons, to treat depression and hostility amongst the general population.”

Physical Job Activity Reduces Prostate Cancer Risk Previous studies have suggested that physical activity decreases the risk of certain cancers. Working in a job that requires a continuous level of high physical effort may decrease the likelihood of a man to develop prostate cancer. Anusha Krishnadasan, from the University of California, Los Angeles (USA) compared the physical activity of 392 workers who developed prostate cancer with 1,805 men similarly employed and of similar age.

Amongst a group; of aerospace workers,the majority – 64% - were involved in work that required sustained and high levels of physical activity; among this group, the odds for prostate cancer was 45% lower than that of less active coworkers. Amongst a group of nuclear power workers, only 34% of whom were involved in physically demanding work on a continual basis, the odds for prostate cancer did not differ with respect to physical activity levels. The researchers suggest that the difference in the level of physical activity – that is, if it

MEDI CAL SPAS • July/August 2008

is sustained or intermittent – may explain the difference in prostate cancer risk.

[Krishnadasan A, Kennedy N, Zhao Y, Morgenstern H, Ritz B. “Nested case-control study of occupational physical activity and prostate cancer among workers using a job exposure matrix.”

Cancer Causes Control. 2008 Feb;19(1):107-14. Epub 2007 Dec 7.]

Remarks Dr. Goldman: “This study provides an interesting glimpse into the beneficial value of continual or prolonged occupationally based physical activity. Coupled with other studies that demonstrate the benefits of leisure-time physical activity, it is difficult to ignore the evidence regarding the role of regular physical activity to ward off disease.”

Obesity Linked to Rise in Stroke Rates in Women Previously, an analysis of stroke prevalence rates in the United States from 199 to 2004 revealed that middleaged women (ages 35 to 54) were more than twice as likely as men of similar age to have a stroke. Amytis Towfighi, from the University of Southern California (USA), and colleagues analyzed data from women who participated in selected timeframes of the National Health and Nutrition Surveys (NHANES) study. The team found that 1.79% of women ages 35 to 54 who participated in the more recent NHANES study years, versus 0.63% in the earlier survey. The researchers further observed that women in the more recent study were “significantly more obese than women a decade prior,” with increased BMI (28.6 versus 27.1) as well as waist circumference (4 centimeters greater), and higher glycated hemoglobin (an indicator of poor blood sugar control).

[A Towfkghi, R Engelhardt, B Ovbiagele, Abstract P241: Obesity linked to stroke increase among milddleaged women.” Presented at the International Stroke Conference 2008 (American Stroke Association), 20 February 2008.]

Comments Dr. Klatz: “Abdominal obesity is a known predictor of stroke, especially in women, and extra pounds may be a key factor in the surge in the rates of midlife stroke in this population. This study underscores the importance to intensify efforts to curb the obesity epidemic.”

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VOLUME 2008 issue 11

Black Tea May Slash Parkinson’s Disease Risk

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Parkinson’s Disease is degenerative neurological disorder that impairs motor skills and walking, and is most notably characterized by a tremor most prominent at-rest. Louis Tan, from the National Neuroscience Institute of Singapore, and colleagues studied data on over 63,200 Chinese men and women enrolled in the Singapore Chinese Health Study.

During the twelve-year study period, the team monitored the participants’ intake of tea and the onset of PD. They found that a daily consumption of _ of a cup of black tea reduced the risk of developing PD by 71%. Green tea was not observed to have any protective effect on the risk of PD. In that when black tea is made, the flavonoids undergo a complex transformation, the researchers suggest that the “ingredients of black tea … appear to be responsible for [its] inverse association with Parkinson’s Disease.”

[Tan LC, Koh WP, Yuan JM, Wang R, Au WL, Tan JH, Tan EK, Yu MC. “Differential Effects of Black versus Green Tea on Risk of Parkinson's Disease in the Singapore Chinese Health Study.” Am J Epidemiol. 2007 Dec 20; [Epub ahead of print].]

(compared to men in the lowest quartile). Among women, those in the higher CRF level had a 43% lower relative risk (as compared to less fit counterparts). Perhaps most importantly, the team found the overall stroke risk dropped substantially at the moderate CRF level, with the protective effect persisting nearly unchanged through higher fitness levels. According to the researchers, a moderate CRF level equated to 30 minutes or more of brisk walking, or an equivalent aerobic activity, five days a week.

[S Hooker, X Sui, N Colabianchi, J Vena, J Laditka, M LaMonte, S Blair. Abstract 119: Moderate levels of aerobic fitness may lower stroke risk. Presented at the International Stroke Conference 2008 (American Stroke Association), 21 February 2008.]

Dr. Goldman observes: “Stroke ranks as the third leading cause of death in the United States. With 780,000 Americans suffering a stroke annually, it is also a leading cause of long-term disability.

While stroke death rates have declined over the past few decades, the public health burden of stroke-related disabilities is enormous and will likely increase in coming years as the population ages. In that physical activity is a major modifiable cardiovascular disease factor, this study sends a powerful message that by increasing our Dr Klatz remarks: “The number of individuals with Parkinson's cardiorespiratory fitness (CRF), each of us can lower our risks of Disease in 15 of the world's largest nations will double over the next succumbing to stroke.” generation, according to a study by Ray Dorsey, of the University of Rochester (USA), and colleagues, that was published in the journal Daytime Dozing May Warn of Stroke Neurology earlier this year. Amongst a group of the five largest countries in Western Europe (France, Spain, Germany, the United Bernadette Boden-Albala, from Columbia University (USA), Kingdom, and Italy) and the 10 most populous nations worldwide and colleagues studied the relationship between daytime (China, India, Indonesia, the United States, Brazil, Pakistan, doziness and stroke in older adults. In a study of 2,153 men Bangladesh, Nigeria, Japan, and Russia, the number of individuals and women, average age 73, the team found the risk of stroke with PD is projected to surge, from 4.1million in 2005 -- to 8.7 to be 2.6-times greater for those who dozed during the day (as million by the year 2030. This study suggests a potent protective compared to those who did not doze). Those who dozed effect of a strikingly simple daily dietary choice, to drink one cup of significantly had 4.5-times greater stroke risk. While those black tea per day, to reduce the risk of developing Parkinson’s who had the most trouble staying awake had the highest stroke Disease.” risk, the researchers also found that those who dozed moderately had a 60% increased risk of any vascular event.

[B Boden-Albala et al. Stroke, Feb 2008; 39: 527 - 729.

Aerobic Fitness, at Moderate Levels, Decreases [Abstract presented at the International Stroke Conference Stroke Risk 2008 (American Stroke Association), 21 February 2008.]]

A moderate level of aerobic fitness can significantly reduce stroke risk for men and women. Steven Hooker, of the Comments Dr. Klatz: “Daytime sleepiness in older adults is an University of South Carolina School of Public Health (USA), often underassessed problem. Sleep apnea, a disorder in which and colleagues analyzed data on more than 60,000 people, people stop breathing throughout the night, can be a contributing ages 18 to 100, who participated in a longitudinal study. The factor. Excessive alcohol consumption and eating a carb-rich or fatty team measured each participant’s cardiorespiratory fitness meal may also be sources of daytime sleepiness. Now that the (CRF) and correlated it with the risk of stroke. Men in the top condition is correlated to an increased risk of stroke, it is imperative 25% of CRF level had a 40% lower relative risk of stroke to identify and correct it.”

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ng/mL were correlated to increased risk of death.

[Bleys J, Navas-Acien A, Guallar E. “Serum Selenium In the latest of studies studing the association between Levels and All-Cause, Cancer, and Cardiovascular dietary food intake and the incidence of Type 2 diabetes, Mortality Among US Adults.” Arch Intern Med. 2008 Raquel Villegas, from Vanderbilt Epidemiology Center Feb 25;168(4):404-10.]

(Nashville, Tennessee USA), and colleagues followed over 64,000 women residing in China, ages 40 to 70, Remarks Dr. Goldman: “Most Americans get adequate for nearly 5 years, assessing their daily fruit and selenium from dietary sources, consuming from 60 to 200 micrograms daily. Foods rich in selenium include whole grains, vegetable intakes and the onset of diabetes. nuts, beef, and tuna.”

Those women who consumed the most vegetables -- Daily Ginkgo Reduces Memory Difficulties averaging 428 grams, or 15 ounces, daily – had a 28% Ginkgo biloba extract (GBE), derived from the leaves of lower risk of developing the disease.

[Villegas R, Shu XO, Gao YT, Yang G, Elasy T, Li H, the ginkgo tree, has been used for thousands of years in Zheng W. “Vegetable but not fruit consumption reduces Traditional Chinese Medicine (TCM). In a new the risk of type 2 diabetes in Chinese women.” J Nutr. randomized clinical trial (RCT) conducted by Hiroko Dodge, from Oregon State University (USA), and 2008 Mar;138(3):574-80.] colleagues, 118 men and women, age 85+, with no Dr. Klatz observes: “In Europe, 19 mullion people – 4% of memory problems, received either a ginkgo biloba the total population – has Type 2 diabetes. The condition extract (240 mg daily) or placebo for 3 years. In those affects more than 20 million people, or 7% of the total participants who took the supplement every day as population, in the United States. Around the world, the stipulated, the team found a 68% lower risk of the number of cases is projected to rise in the coming decades, due development of memory problems during the study to factors such as aging, obesity, and the pervasiveness of a period. Ginkgo contains potent antioxidants called sedentary lifestyle. Vegetable consumption is characterized by flavoglycosides that have been shown to have higher dietary exposures to fiber, antioxidants, and neuroprotective effects. magnesium. Vegetables are also rich in other diabetes-reducing [H. H. Dodge PhD*, T. Zitzelberger MPH, B. S. Oken MD, D. Howieson PhD, ABPP, and J. Kaye MD. “A compounds, such as phytates, lignans, and isoflavones.” randomized placebo-controlled trial of ginkgo biloba for Selenium, In Moderation, Is Beneficial to Longevity the prevention of cognitive decline.” Neurology 2008, doi:10.1212/01.wnl.0000303814.13509.db; Selenium is a trace mineral involved in numerous Published online before print February 27, 2008.] functions in the body, including maintaining optimal cardiovascular function. In a study involving over Comments Dr. Klatz: “A number of previous clinical trials 13,800 participants for 12 years, Joachim Bleys, from have suggested long-term improvements in cognitive function Johns Hopkins University of Public Health (USA), and in older adults with dementia, though several other studies colleagues found that a modest selenium level, between have shown no such benefits. This is the first randomized 130 and 150 ng/mL, was associated with a reduced risk clinical trial (RCT) to report clear dementia preventive results of death from all causes, including cancer and of ginkgo extract among older study subjects, and as such this cardiovascular disease. Selenium levels above 150 study suggests a strong protective benefit for the compound.”

VOLUME 2008 issue 12

Vegetable-Rich Diet Slashes Diabetes Risk

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VOLUME 2008 issue 13

Compounds in Black Tea Protective Against Diabetes

Amy Cameron, from the University of Dundee (Scotland), and colleagues have discovered that black tea mimics insulin and may help prevent Type 2 diabetes.

Specifically, two compounds present in black tea, theaflavins and the arubigins, were found to affect insulin-like signaling of a transcription factor that regulates aging in response to dietary factors. The team is hopeful that their findings lead to the future identification of dietary interventions to treat or defer Type 2 diabetes.

[Amy R. Cameron, Siobhan Anton, Laura Melville, Nicola P. Houston, Saurabh Dayal, Gordon J. McDougall, Derek Stewart, Graham Rena (2008) Black tea polyphenols mimic insulin/insulin-like growth factor-1 signalling to the longevity factor FOXO1a.

Aging Cell 7 (1) , 69–77 doi:10.1111/j.14749726.2007.00353.x] Dr. Klatz remarks: “In Europe, 19 million people – 4% of the total population – has Type 2 diabetes. The condition affects more than 20 million people, or 7% of the total population, in the United States. Tea is second only to water as the most popular drink around the world. This study offers a unique research pathway to potentially utilize the ubiquity of tea to beneficially impact the onset of diabetes.”

In Older Men, Low Testosterone Levels Correspond to Depression Osvaldo Almeida, from the University of Western Australia (Perth, Australia), and colleagues studied nearly 4,000 men, ages 71-89 years, for a three-year period. Participants underwent testing for depression and cognitive difficulties, and were surveyed for various physical health conditions. The researchers collected blood samples to test their levels of total and free (unbound) testosterone. The team found that men in the lowers quintile (20%) of free testosterone levels had three-times the odds of having depression (as compared to men in the highest quintile). The team states that: “A

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randomized controlled trial is required to determine whether … low free testosterone is associated with … depression. If so, older men with depression may benefit from systematic screening … and testosterone supplementation.”

[Almeida OP, Yeap BB, Hankey GJ, Jamrozik K, Flicker L. “Low free testosterone concentration as a potentially treatable cause of depressive symptoms in older men.”

Arch Gen Psychiatry. 2008 Mar;65(3):283-9.]

Dr. Goldman observes: “Declining testosterone levels in aging men are suspected to be an underlying cause of many of the symptoms and diseases of aging. Testosterone levels in men decrease gradually over time, a phenomenon sometimes referred to as andropause. This study offers another potential benefit to Testosterone replacement therapy (TRT) in older men.”

Mental Distress May Increase Risk of Stroke Paul Surtees, from the University of Cambridge (United Kingdom), and colleagues studied more than 20,600 men and women (ages 41 to 80) for an 8 _ year period.

They evaluated the participants for major depressive disorder or psychological distress, charting these conditions on a standardized scale; as well as the onset of stroke. The team found that those people who reported the most psychological distress at the start of the study period had a 40% increased risk of stroke, as compared to those who were the least psychologically distressed.

They also found that major depression was not found to increase the risk of stroke.

[Surtees PG, Wainwright NW, Luben RN, Wareham NJ, Bingham SA, Khaw KT. Psychological distress, major depressive disorder, and risk of stroke. Neurology. 2008 Mar 4;70(10):788-94.]

Dr. Klatz comments: “Stroke is the third leading cause of death in Europe and the United States, and is a significant cause of long-term disability. This study identifies an important and modifiable risk factor contributing to stroke.

The ability to modulate our levels of psychological distress may be an important strategy in stroke prevention.”

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VOLUME 2008 issue 14

Combination of Vitamin D and Calcium Fights Bone Loss in Men

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Robin Daly, from Deakin University (Australia), and colleagues assessed the long-term bone densities of 109 men (ages 50+) who had previously completed a twoyear long study in which they were given daily supplements of calcium and vitamin D3 (in the form of fortified milk). The team found that an average of 1.65% increase in bone mineral density persisted for up to 18 months after the supplements were halted.

[Daly RM, Petrass N, Bass S, Nowson CA. “The skeletal benefits of calcium- and vitamin D3-fortified milk are sustained in older men after withdrawal of supplementation: an 18-mo follow-up study.” Am J Clin Nutr. 2008 Mar;87(3):771-7.]

Dr. Klatz remarks: “Osteoporosis affects 75 million people in Europe, the United States, and Japan, While the condition is more four-times more common in women, it does affect aging men as well. This study shows the sustained benefits of vitamin D and calcium for bone mineral density, making a strong case for the value of supplementation in older men.”

Green Leafy Vegetables Slash Lung Cancer Risk Olga Dosil-Diaz, from the Galician Public Foundation for Health Emergencies (Spain), and colleagues studied the dietary intakes of 295 Spanish residents with lung cancer and 322 healthy counterparts. The researchers found that consumption of at least one portion daily of green leafy vegetables (such as cabbage, lettuce, turnip tops) correlated to a 50% reduction in the risk of lung cancer. Consumption of other vegetables, such as tomatoes and green beans, showed a protective but nonsignificant effect. The team also found that fruit was only nominally protective. They cite that green leafy vegetables contain 10 to 100 times the level of Vitamin A than other vegetables and fruit, and thus conclude that: “Vitamin A possesses the greatest protective effect against lung cancer by reducing the risk posed by different mechanisms, particularly with regard to its

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antioxidant potential.”

[Olga Dosil-Díaz, M.D., Ph.D.Alberto Ruano-Ravina Ph.D., Juan J. Gestal-Otero M.D., Ph.D., and Juan M. Barros-Dios M.D., Ph.D. “Consumption of fruit and vegetables and risk of lung cancer: A case-control study in Galicia, Spain.” Nutrition, published online ahead of print 7 March 2008, doi:10.1016/j.nut.2008.01.005.]

Dr. Goldman observes: “As oxidative stress is generally considered to be a contributor to the onset of cancer, this is among the latest of a group of studies suggesting that antioxidant-rich diets may protect against certain cancers.

This underscores the impact of making smart dietary choices on an everyday basis.”

Caretonoids and Zinc Slash Risk of Age-Related Vision Loss Age-related macular degeneration (AMD) is a condition that causes loss of central vision and the leading cause of legal blindness for people age 55+ in the Western world.

Jennifer Tan, from thee University of Sydney (Australia), and colleagues followed 3,654 men and women, average age 49 years at the study’s start, for a ten-year period. They found that people with the highest dietary intake of the carotenoids, lutein and zeaxanthin, had a 65% reduced risk of AMD (as compared to those with the lowest intakes). Additionally, the team found that higher zinc intake correlated to a 44% reduction in any type of AMD, and a 46% reduction in early-onset AMD. [Tan JS, Wang JJ, Flood V, Rochtchina E, Smith W, Mitchell P. “Dietary antioxidants and the long-term incidence of age-related macular degeneration: the Blue Mountains Eye Study.” Ophthalmology. 2008 Feb;115(2):334-41. Epub 2007 Jul 30.]

Dr. Klatz comments: “AMD causes central vision loss and leaves only peripheral vision. This study suggests a role for carotenoids and zinc in warding off or delaying the disease, which, when coupled with early detection, may significantly reduce the total worldwide numbers of AMD cases.”

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[Bamia C, Trichopoulou A, Trichopoulos D. “Age at retirement and mortality in a general population sample: Jianping Zhang, from the Cleveland Clinic (USA), and the Greek EPIC study.” Am J Epidemiol. 2008 Mar colleagues have found that higher anxiety levels may help 1;167(5):561-9. Epub 2007 Dec 3.] elderly women live longer, but may be harmful to older Dr. Goldman observes: “For many people, early retirement men. may bring a higher quality of life, but it may also usher in a The team’s fifteen-year long study of 1,000 retired number of new negative effects, such as financial concerns, seniors found that women with higher levels of anxiety at reduction in daily physical activity, or depression. This is the the start of the study lived longer than others. Lead latest among studies that suggest that by keeping both researcher Dr. Zhang states that: “Our research indicates mentally and physically active, we can promote health and that anxiety may have a protective effect on women, longevity.” possibly causing them to seek medical attention more frequently than men.” Co-researcher Dr. Leo Pozuelo Boom in Alzheimer’s Cases Predicted for Baby suggests that: “Baseline higher anxiety could have led the Boomer Generation [women] to be more active and health conscious.” [“Anxiety helps elderly women live longer,” US News & New data from the Alzheimer’s Association projects that World Report, 14 March 2008. Abstract by Zhang et al, 14 million, or 18%, of the American Baby Boomer in Psychosomatic Medicine, Volume 70, Number 3 population (numbering 79 million in-total) will develop Alzheimer’s Disease (AD) or dementia in their lifetime.

(April 2008).]

According to the Alzheimer’s Association, if no cure for Dr. Klatz remarks: “Anxiety is perhaps one of the most the disease is found, the US will be faced with 500,000 insidious factors influencing not only how long we live, but how new cases in 2010 and nearly 1 million a year by 2050. well we live. This study shows an interesting connection The coming Alzheimer’s epidemic is projected to strain between anxiety and mortality, highlighting a potential gender the US healthcare system: in 2005, Medicare spent $91 difference that may be a major factor in why, in general, billion in AD and other dementias, and spending could jump to $160 billion by 2010 and $189 billion by women live longer than men.”

2015. [“18% of all boomers expected to develop Alzheimer’s,” Early Retirement May Contribute to Early Death USA Today, 18 March 2008; reporting on “2008 Christina Bamia, from the University of Athens Alzheimer’s Disease Facts and Figures” by the (Greece), and colleagues have revealed a connection Alzheimer’s Association.] between early retirement and early death among people who are otherwise in good health. The team studied Dr. Klatz comments: “Age is the singlemost greatest risk nearly 17,000 Greek adults, ages 20s to 809s, who were factor for Alzheimer’s. The likelihood of developing AD followed for more than 7 years. During that time, the doubles every five years after age 65. While medical researchers found the number of deaths among retirees advancements have made great strides in diseases such as was nearly 51% greater than among the same-aged cancer and heart disease, breakthroughs to prevent, delay, and counterparts who were not retired. In particular, early effectively treat AD have been lagging. This is a major public retirement seemed to increase the risk of dying from health issue that directly impacts public policy.” cardiovascular disease.

VOLUME 2008 issue 15

Anxiety Promotes Longevity in Women

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regardless of whether the person was of normal weight overall, overweight, or obese, and regardless of health conditions such as diabetes, stroke, and heart disease.

The evidence for the beneficial role of essential fatty [Whitmer RA. “The epidemiology of adiposity and acids, of which fish oil is a specific type, to counter dementia.” Curr Alzheimer Res. 2007 Apr;4(2):117inflammation, continues with the results of a study 22.] conducted by B. Galarraga, from the Ninewells Hospital and Medical School, (United Kingdom), and colleagues. Dr. Goldman observes: “Previous research has shown that In a five-year long study involving 97 patients (ages 37 belly fat in middle age elevates the risk of diabetes, stroke, and to 78) with rheumatoid arthritis, participants were either heart disease, but this is the first study to suggest the clinical given a daily fish oil supplement (as 10 grams of cod implications on cognitive health. Those who carry extra weight liver oil) which contained 2.2 grams of EPA and DHA around their midsection need to be aware that they potentially fatty acids, or a placebo. Fifty-nine percent (59%) of the are at increased risk of developing Alzheimer’s Disease or subjects given fish oil reduced their daily requirement of another form of dementia.” painkillers (NSAIDs) by 30% at nine months.

[B. Galarraga, M. Ho, H. M. Youssef, A. Hill, H. Resveratrol Beneficial for Pancreatic Cancer McMahon, C. Hall, S. Ogston, G. Nuki and J. J. F. Belch. “Cod liver oil (n-3 fatty acids) as an non- Resveratrol, an antioxidant compound found in the steroidal anti-inflammatory drug sparing agent in skins of grapes, has previously found to be clinically rheumatoid arthritis.” Rheumatology Advance Access valuable for its anti-inflammatory and anti-cancer published online on March 24, 2008, Rheumatology, properties. Paul Okunieff, from the University of Rochester Medical Center (New York, USA), and doi:10.1093/rheumatology/ken024.] colleagues, assessed the way in which resveratrol may aid Dr. Klatz remarks: “The potential anti-inflammatory patients with pancreatic cancer. The team found that benefits of essential fatty acids were first suggested in the early resveratrol increased the sensitivity of pancreatic cancer 1980s by epidemiological studies in the population of cells to chemotherapy, by reducing the function of Eskimos living in Greenland, where fatty acid intake from specific proteins in pancreatic cancer cell membranes seafood is high and there is a lower prevalence of inflammatory that otherwise pump chemotherapy out of the cells. conditions. This study strongly supports the option to Additionally, in pancreatic cancer cells, resveratrol supplement rheumatoid arthritis patients with fish oil, with triggered cell death and destabilized mitochondrial the clear benefit of reducing their dependence on painkillers, membranes, thus crippling their stability. which are often associated with gastrointestinal and [Sun W, Wang W, Kim J, Keng P, Yang S, Zhang H, Liu C, Okunieff P, Zhang L. “Anti-cancer effect of cardiovascular side effects.” resveratrol is associated with induction of apoptosis via a mitochondrial pathway alignment.” Adv Exp Med Biol.

Belly Flab in 40s Raises Alzheimer’s Risk in 70s 2008;614:179-86.]

Rachel Whitmer, from the Kaiser Permanente Division of Research, Etiology and Prevention (California, USA) Dr. Klatz comments: “Worldwide, pancreatic cancer ranks and colleagues tracked 6.583 men and women residing 13th in incidence but 8th as a cause of cancer death in northern California, for an average of 36 years, worldwide. The incidence of pancreatic cancer worldwide starting when they were ages 40 to 45. A total of 1,049 appears to correlate with increasing age, and medical of them – nearly 16% – developed Alzheimer’s Disease conditions (including diabetes and chronic pancreatitis, as well (AD) or dementia when they reached their 70s. Those as nutrition and lifestyle factors (such as smoking) may play subjects in the upper 20% in terms of belly size in important role in the disease’s etiology. This study suggests a middle-age were almost three times more likely to promising future for resveratrol, which appears to confer a develop dementia./AD than the study participants who number of other benefits for human health, in the treatment of were in the lowest 20% of belly size. The team found pancreatic cancer.” that having a large belly raised one’s risk of dementia

VOLUME 2008 issue 16

Daily Dose of Fish Oil Reduces Pain from Rheumatoid Arthritis

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VOLUME 2008 issue 17

Apples Ward Off Colon Cancer

Dieter Schrenk, from the University of Kaiserslautern (Germany), and colleagues, have found that apple pectin and apple juice are high in a compound known as butyrate, a short-chain fatty acid. Butyrate not only contributes to the maintenance of healthy colon tissue, but the team found the compound exerts an anti-cancer effect on the colon, by inhibiting the enzymes necessary for tumors to develop.

[Waldecker M, Kautenburger T, Daumann H, Veeriah S, Will F, Dietrich H, Pool-Zobel BL, Schrenk D. “Histone-deacetylase inhibition and butyrate formation: Fecal slurry incubations with apple pectin and apple juice extracts.” Nutrition. 2008 Apr;24(4):366-74. Epub 2008 Feb 11.]

Dr Klatz remarks: “Colorectal cancer is the fourth commonest form of cancer occurring worldwide. Most prevalent in industrialized countries, colorectal cancer represents 12.6% of all incident cancer in westernized nations in men and 14.1% in women. Many researchers believe that a majority of colorectal cancer cases are a result of dietary factors, such as a lack of adequate daily fruit and vegetable consumption. This study is promising in its identification of a simple, adoptable dietary habit that may offer protection against colon cancer”.

Tooth Loss May Predict Accelerated Aging Poul Holm-Pedersen, from the University of Copenhagen (Denmark), and colleagues, tracked 573 70-year old Danish men and women for 21 years, following their oral health, disability onset, and death rate. At the start of the study, fewer than 20% of the group had 20 or more teeth, and 40% had no teeth.

Compared with those maintaining 20 or more natural teeth, those with no or few teeth at age 70 were significantly more likely to report mobility problems, such as difficulty walking or climbing stairs, within the next 5 or 10 years. Toothlessness at age 70 was also correlated to greater mortality during the study period.

The researchers state that: “It is important to take dental health seriously, in that [it associates with] general physical and/or cognitive decline.”

[Holm-Pedersen P, Schultz-Larsen K, Christiansen N, Avlund K. “Tooth loss and subsequent disability and mortality in old age.” J Am Geriatr Soc. 2008 Mar;56(3):429-35. Epub 2008 Jan 5.]

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Dr. Goldman observes: “An estimated 500 species of microorganisms live in the mouth, and thus oral health is potentially a significant source of disease. Studies by other researchers have established a causal association between poor periodontal health and cardiovascular disease, and recently a team from University of Kentucky (USA) have identified tooth loss as a predictor for the onset of dementia later in life.

This study establishes yet another medical reason to maintain good oral health as we age.”

Macadamia Nuts Reduce Cholesterol A number of studies have established a body of evidence linking nut consumption, specifically almonds and walnuts, to improvements in the ratio of total cholesterol to HDL (high-density, or “good”) cholesterol., a marker of cardiovascular health. Amy Griel, from Pennsylvania State University (USA), and colleagues, followed a group of 25 men and women with mildly elevated cholesterol levels, for a five-week period. One subgroup consumed an “average” American diet [33% total fat, including 11% monunsaturated fatty acids (MUFA) and 5% polyunsaturated fatty acids (PUFA)] and the other subgroup ate a Macadamia nut-rich diet [33% total fat, including 18% MUFA and 5% PUFA]. In the group consuming the macadamia nut-rich diet, the ratio of total cholesterol to HDL cholesterol decreased (4.60, versus 4.90 in the group following the American diet).

In addition, the macadamia nut-diet group experienced a decrease in LDL (low-density, or “bad”) cholesterol (3.14 mmol/L, versus 3.44 mmol/L in the group following the American diet).

[Griel AE, Cao Y, Bagshaw DD, Cifelli AM, Holub B, Kris-Etherton PM. “A macadamia nut-rich diet reduces total and LDL-cholesterol in mildly hypercholesterolemic men and women.”

J Nutr. 2008 Apr;138(4):761-7.]

Comments Dr. Klatz: “Cardiovascular disease causes nearly 50% of all deaths in Europe, and more than one-third of the American population has some form of cardivascular disease.

This study furthers the notion that nuts can be part of a hearthealthy diet pattern that can beneficially impact cardiovascular disease risk factors.”

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VOLUME 2008 issue 18

Aspartame Compromises Brain Health

Aspartame is an artificial sweetener commonly found in prepared or processed foods aimed at diet-conscious individuals. A group of South African researchers from the University of Pretoria and the University of the Limpopo have found that excessive consumption of aspartame may inhibit the ability of enzymes in the brain to function properly. Specifically, the team found that aspartame disturbed the metabolism of amino acids, protein structure and metabolism, the integrity of nucleic acids, neuronal function, and endocrine balances. Additionally, they found aspartame causes nerves to fire excessively, and changes the brain’s concentrations of the neurotransmitters dopamine, epinephrine, and norepinephrine. The South African researchers observe that: “We propose that excessive aspartame ingestion might be involved in the pathogenesis of certain mental disorders, and also in compromised learning and emotional functioning.”

[Humphries P, Pretorius E, Naudé H. “Direct and indirect cellular effects of aspartame on the brain.” Eur J Clin Nutr. 2008 Apr;62(4):451-62. Epub 2007 Aug 8.]

Dr. Klatz observes: “Previous studies have found that aspartame consumption can cause neurological and behavioral disturbances such as seizures, headaches, and insomnia, in sensitive individuals. Studies in lab animals have also liked aspartame to cancer. The findings by this team add to this long list of reasons to be concerned with the long-term health effects of aspartame.”

Wine and Tea Compounds Beneficial for Type-2 Diabetes Dietary phenolic compounds, found in high concentrations in red wine and certain teas, may play a role in slowing the passage of carbohydrates into the bloodstream. Kalidas Shetty, from the University of Massachusetts (USA), and colleagues, have found that red wine inhibits the activity of alpha glucosidase, an enzyme responsible for triggering the absorption of glucose by the small intestine, by almost 100%; black tea

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extracts produce a 90% inhibitory effect. State the researchers: “It is clear that [red] wines and [some] teas have high antioxidant activity and good inhibitory profiles on carbohydrate … absorption in the intestine.”

[Young-In Kwon, Emmanouil Apostolidis, Kalidas Shetty (2008) Inhibitory Potential of Wine and Tea Against _-Amalyse and _-Glucosidase for Management of Hyperglycemia Linked to Type 2 Diabetes.”

Journal of Food Biochemistry 32 (1), 15–31 doi:10.1111/j.1745-4514.2007.00165.x.]

Remarks Dr. Goldman: “Type-2 diabetes is a leading cause of long-term dependence and disability. In the United States, the disease affects 7% of the population; in the EU, it affects 4%. Around the world, experts predict the numbers of cases of type-2 diabetes to rise as the global population ages. This study is the promising in that it suggests a dietary-based approach to modulate type-2 diabetes.”

The Promise of Caffeine as a Neurological Therapy A lab study conducted by Jonathan Geiger, from the University of North Dakota School of Medicine and Health Sciences (USA), and colleagues, has identified a potential therapeutic role for a daily dose of caffeine in neurological diseases. Specifically, the team found tat the equivalent of one cup of coffee daily can help protect the blood-brain barrier from damage caused by a cholesterol-rich diet.

[Chen X, Gawryluk JW, Wagener JF, Ghribi O, Geiger JD. “Caffeine blocks disruption of blood brain barrier in a rabbit model of Alzheimer's disease.” J Neuroinflammation. 2008 Apr 3;5(1):12. [Epub ahead of print].]

Comments Dr. Klatz: “High levels of cholesterol are a risk factor for Alzheimer’s Disease, which currently afflicts about 13 million people in the United States and cases of which are projected to triple by 2050. This study, in that it identifies that caffeine blocks the disruptive effects of cholesterol which cause the blood-brain barrier to become leaky, suggests a future therapeutic role for the compound to prevent or treat a variety of neurological disorders, perhaps the most critical of which is Alzheimer’s.”

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VOLUME 2008 issue 19

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Wine May Protect Women Against Dementia

the American Physiological Society, April 7, 2008.]

Wine may contain compounds that protect women against dementia. Lauren Lissner, from the Sahlgrenska Academy at Göteborg University (Sweden), and colleagues conducted a study involving 1,458 Swedish women (ages of 38-60 years at the start of the study) for a 34-year period. At the end of the study’s duration, the women with the lowest rate of dementia were those who reported that the only alcohol they drank was wine. No correlation between dementia and the regular consumption of beer or other liquor was found.

[Mehlig K, Skoog I, Guo X, Schütze M, Gustafson D, Waern M, Ostling S, Björkelund C, Lissner L. “Alcoholic beverages and incidence of dementia: 34-year follow-up of the prospective population study of women in Goteborg.” Am J Epidemiol. 2008 Mar 15;167(6):684-91. Epub 2008 Jan 24.]

Dr. Goldman observes: “Osteoporosis, a disease that thins and weakens the bones to the point that they become fragile and break easily, affects 2 million men and 3 million more are at-risk. Previously, Christian Meier, from the University of Sydney (Australia), and colleagues found that men ages 60+ with low levels of testosterone are at increased risk for fractures resulting from osteoporosis. The above study is the first clinical trial that definitively shows the benefits of TRT on the bone health in aging men.”

Dr. Klatz remarks: “While this study does not provide a clear reason to recommend that women drink wine, or increase their consumption of it, it does suggest a future identification of a biochemical basis for the beneficial effect of wine on dementia and Alzheimer’s Disease (AD), the most common form of dementia today. More than 26 million people worldwide were estimated to be living with Alzheimer's disease in 2006; by 2050, AD will afflict more than 106 million people. As disease of epidemic proportion, it is now critical to elucidate mechanisms that affect the rate of onset and progression of dementia and AD.” Testosterone Replacement Therapy Beneficial to Aging Men’s Bone Health A study by E. Lichar Dillon, from the University of Texas Medical Branch (USA), and colleagues, is the first clinical trial involving men ages 60 to 85 that demonstrates the positive effect of testosterone replacement therapy (TRT) on markers of bone health in men. TRT reduced bone turnover and exerted a protective effect on existing bone mass. [E. Lichar Dillon, et al. Presented at the 121st Annual Meeting of

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Mid-Life Diabetes Increases Risk of Alzheimer’s Disease Men who develop diabetes in mid-life appear to significantly increase their risk of developing Alzheimer’s Disease (AD). Elina Rönnemaa, from the Uppsala University Hospital (Sweden), and colleagues studied 2,269 Swedish men for a period of 32 years.

Each underwent glucose testing at age 50 to assess diabetes. At the conclusion of the study period, those men with low insulin secretion capacity at age 50 were nearly 1.5-times more likely to develop AD. The team states that: “Our research suggests a link between insulin problems and the origins of Alzheimer’s Disease and emphasize the importance of insulin in normal brain function. It’s possible that insulin problems damage blood vessels in the brain, which leads to memory problems.”

[Rönnemaa E, Zethelius B, Sundelöf J, Sundström J, Degerman-Gunnarsson M, Berne C, Lannfelt L, Kilander L. “Impaired insulin secretion increases the risk of Alzheimer disease.”

Neurology. 2008 Apr 9; [Epub ahead of print].]

Dr. Klatz comments: “The number of Alzheimer’s cases worldwide is projected to triple by the year 2050, stressing many nations’ healthcare resources. This study identifies a potentially significant causal link between diabetes and AD, and may represent a future primary interventive route to reduce or delay the onset of Alzheimer’s.”

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VOLUME 2008 issue 20

High Cholesterol in Your 40s Increases Risk of Alzheimer’s Disease

People with high cholesterol in their early 40s are more likely to develop Alzheimer’s Disease (AD), as compared to those with low cholesterol. Rachel Whitmer, from Kaiser Permanente Division of Research (California USA), and colleagues studied 9,752 men and women who underwent health evaluations in the 1960s and 1970s when they were between the ages of 40 and 45.

Then between 1994 and 2007, the team obtained the most recent medical records for group, finding that 504 of the study participants were diagnosed with Alzheimer’s Disease and 162 with vascular dementia.

Those with total cholesterol levels between 249 and 500 mg were 1.5-times more likely to develop AD than those with levels of 198 or less. People with cholesterol levels of 221 to 248 mg were more than 1.25-times more likely to develop AD. The researchers conclude that: “High mid-life cholesterol increase[s] the risk of Alzheimer’s Disease regardless of diabetes, blood pressure, obesity, smoking, and stroke [later in life].”

[Whitmer R. et al. Presented at the 60th Annual Meeting of the American Academy of Neurology, April 16, 2008.]

Dr. Klatz remarks: “The number of Alzheimer’s cases worldwide is projected to triple by the year 2050, stressing many nations’ healthcare resources. This study identifies a causal link between cholesterol and AD, and mandates that patients and physicians take action to attack high cholesterol levels before it causes irreversible damage in the body.”

Vitamin D Linked to Artery Health Peripheral artery disease (PAD) occurs when arteries in the legs become narrowed or clogged with fatty deposits, thereby reducing blood flow in the legs. Michal Melamed, from the Albert Einstein College of Medicine (New York USA), and colleagues analyzed data from 4,839 participants of the National Health and Nutrition Examination Survey (NHANES) and found that PAD occurred an average of 4.4% less often in people with increased blood levels of Vitamin D. After adjusting for age, sex, race, and co-existing health problems, the team found that PAD was 64% more

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common in the group with the very lowest vitamin D levels. Further, for each 10 ng/mL drop in Vitamin D level, the risk of PAD was found to increase by 29%.

[Melamed ML, Muntner P, Michos ED, Uribarri J, Weber C, Sharma J, Raggi P. “Serum 25Hydroxyvitamin D Levels and the Prevalence of Peripheral Arterial Disease. Results from NHANES 2001 to 2004.” Arterioscler Thromb Vasc Biol. 2008 Apr 16; [Epub ahead of print].]

Dr. Goldman observes: “Peripheral artery disease affects about 8 million Americans and is a significant cause of cardiovascular disease and death. Previous studies have correlated low Vitamin D levels with an increased risk of coronary heart disease, stroke, and congestive heart failure.

While this study does not prove that increased levels of Vitamin D protect against PAD directly, it does suggest that higher Vitamin D levels may be a marker of general cardiovascular health.”

Vitamin E Improves Longevity of Alzheimer’s Patients In people with Alzheimer’s Disease (AD), Valory Pavlik, from Baylor College of Medicine (Texas USA), and colleagues found that regular Vitamin E supplementation significantly reduced mortality. The team followed 847 men and women with AD, average age 73.5, for an average of 4.9 years. The study participants were supervised on a high-dose Vitamin E supplementation regimen, which was found to reduce their odds of dying by 26%.

[Pavlik, V. et al. Presented at the 60th Annual Meeting of the American Academy of Neurology, April 18, 2008.]

Dr. Klatz comments: “Previous studies have shown that Vitamin E plays a role in delaying the progression of moderately severe AD. This study suggests that Vitamin E increases the lifespan of patients with AD, Further research in this vein may ultimately discover nutritional interventions to improve the quality of life for AD patients, thereby reducing dependence as well as healthcare costs. This will become an increasingly important issue as the global population ages and the numbers of cases of AD rise.”

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Health Disparities Cause Decline in Life Expectancy by A_1–40 in rats.” Journal of Nutritional Biochemistry, 15 February 2008, in the United States doi:10.1016/j.jnutbio.2007.08.008.]

Majid Ezzati, from the Harvard School of Public Health (USA), and colleagues conducted data analyses for life Remarks Dr. Goldman: “In the United States, Alzheimer’s expectancies for US counties for every year betw4een costs over $100 billion in direct and indirect expenses.

Because age is the leading factor in AD onset, and that the 1961 and 1999. nation’s population is aging rapidly and in large numbers, the Their study showed that 4% of men and 19% of women costs of AD will skyrocket in the coming decades. This study experienced either a decline in, or stagnation of, offers a hopeful intervention in reducing the numbers of cases mortality from the 1980s until 1999. “The worse off of Alzheimer’s, which will reduce both the personal and are getting worse,” write the team, which also observed societal burdens of the disease.” that: “There is now evidence that there are large parts of the population in the United States whose health has Diabetes Increases Risk of Alzheimer’s Disease been getting worse for about two decades.”

[Ezzati M, Friedman AB, Kulkarni SC, Murray CJ. “The Previous studies have shown that diabetes is a risk factor Reversal of Fortunes: Trends in County Mortality and for Alzheimer’s Disease (AD). Dave R. Schubert, from Cross-County Mortality Disparities in the United The Salk Institute For Biological Studies (California, States.” PLoS Med. 2008 Apr 22;5(4):e66. [Epub USA), and colleagues have now identified the molecular connection between the two diseases. In a study ahead of print].] involving lab animals, diabetes was found to damage Dr. Klatz observes: “This study identifies that economically blood vessels in the brain by the interaction of elevated disadvantaged Americans are experiencing rises in rates of blood glucose levels (characteristic of diabetes) and low diabetes, chronic obstructive pulmonary disease, and cancers. levels of beta-amyloid protein (the protein suspected to It is entirely conceivable that these diseases are being caused cause the plaques characteristic in AD). The researchers by environmental factors, such as air pollution, pesticides, and observe that: “While all people have a low level of radiation. It is up to each of us to be aware of the potentially amyloid circulating in their blood, in diabetics there may detrimental factors in our everyday lives and take prudent be a synergistic toxicity between the amyloid and high level of blood glucose, that leads to the problems with preventive actions to minimize the risk to our health.” proper blood vessel [function].”

[Burdo JR, Chen Q, Calcutt NA, Schubert D. “The Green Tea Protects Against Plaques Causing pathological interaction between diabetes and Alzheimer’s Disease presymptomatic Alzheimer's disease.” Neurobiol Aging.

The plaques that result from the build-up of beta- 2008 Mar 25; [Epub ahead of print].] amyloid protein in the brain, suspected to cause Alzheimer’s Disease (AD), are linked to brain cell Comments Dr. Klatz: “In the United States, the rates of damage and cell death due to oxidative stress. Abdul both Alzheimer’s and diabetes are increasing at an alarming Haque, from Shimane University Faculty of Medicine rate. Alzheimer’s affects 1 in 10 Americans age 65+, and (Japan), and colleagues found that catechins, one of diabetes afflicts 7% of the population – the vast majority of green tea’s antioxidant compounds, inhibits the loss of them being over age 60. Previous studies have shown that reference and working memory otherwise linked to diabetic patients have a 30 to 65% higher risk of developing plaque formations in the brain. The team reports that: AD than non-diabetics. This study identifies a complex and “Long-term administration of [green ttea] prevents deleterious interaction between elevated blood glucose and cognitive deficits caused by oxidative stress, induced by beta-amyloid protein, and will hopefully lead to further beta-amyloids and otherwise, by facilitating elucidation of whether the reduction of the diabetic state can ward off Alzheimer’s.” antioxidative defenses.”

[Abdul M. Haque, Michio Hashimoto, Masanori Katakuraa, Yukihiko Harab and Osamu Shido.

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news & review Anti-aging medicine is the fastest-growing medical specialty throughout the world and is founded on the application of advanced scientific and medical technologies for the early detection, prevention, treatment, and reversal of age-related dysfunction, disorders, and diseases. It is a healthcare model promoting innovative science and research to prolong the healthy lifespan in humans. As such, anti-aging medicine is based on solid scientific principles of responsible medical care that are consistent with those applied in other preventive health specialties. The goal of anti-aging medicine is not to merely prolong the total years of an individual's life, but to ensure that those years are enjoyed in a productive and vital fashion.

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