May
16
2020

Cutting Out Bad Lifestyle Habits Increases Life Expectancy

By | addiction, alcohol, breast cancer, Cancer, Cardiovascular disease, cholesterol, Diabetes, diet, exercise, Fitness, food, heart attack, Inflammation, lifestyle, lung cancer, Mortality, Nutrition, Obesity, Prevention, Stroke

A Jan. 8, 2020 study stated that cutting out bad lifestyle habits increases life expectancy. It was a publication in the British Medical Journal by the Harvard T.H. Chan School of Public Health. The senior author of the study was Frank Hu, chair of the Department of Nutrition at Harvard Chan School. The researchers looked at data collected from a large group of males and females that had been accumulated for 34 years. They found that a 50-year-old male or female who did not change their lifestyle habits had another 25.5 years to live for males and another 29 years to live for females.

Five bad lifestyles and life expectancy 

The 5 bad lifestyle habits were smoking, a body mass index above 25.0, excessive alcohol intake, less than 30 minutes of exercise per day and an unhealthy diet.

When people cut out all of those risky lifestyles, 50-year-old men and women had a life expectancy of 37.6 years for men and 43.1 years for women. This was an addition of 12 years of healthy life for men compared to controls who did not change their lifestyles. With regard to women there was an addition of 14 years of life compared to controls.

Diseases that kill prematurely

The research team wanted to know what diseases caused the most reduction in life expectancy when people did not change their bad lifestyle habits. Men and women who cut out all negative lifestyle habits were 82% less likely to die from cardiovascular disease. They also were 65% less likely to die from cancer. Bad lifestyles caused the two major diseases, cardiovascular disease (heart attack and strokes) and cancer, which increased overall mortality. The overall study time was about 30 years. The third major disease that can cost lives is diabetes. In addition, the research team identified chronic diseases as being another potential cause of people dying prematurely.

Additional life expectancy

When life expectancies were broken down according to diseases, the following was noticed.

For men:

When cancer free    When free of heart issues   Without diabetes

6 more years             9 more years                         10 more years

For women:

When cancer free    When free of heart issues   Without diabetes

8 more years            10 more years                       12 more years

Dr. Frank Hu, who chairs the department of nutrition at Harvard T.H. Chan School of Public Health said: ”We found that following a healthy lifestyle can substantially extend the years a person lives disease-free”. Those who do not shed their bad lifestyle habits will come down with one or more of the mentioned diseases and die prematurely. Others who cut out all their bad lifestyle choices live substantially longer.

Diseases caused by poor lifestyle habits

It is important to review the diseases that shorten life expectancy due to having poor lifestyle habits.

Cardiovascular disease

Smoking, lack of regular exercise and poor eating habits result in being overweight or developing obesity. All of these are risks with LDL cholesterol elevation and HDL cholesterol lowering that leads to heart attacks and strokes. Here is a study that shows how life is shortened after a heart attack.

It is clear from this how important it is to give up all of the poor lifestyle habits to avoid this from happening.

Cancer

90% of lung cancers are the result of cigarette smoking.

Heavy drinking can contribute and also lead to cancer of the liver, esophageal cancer, cancer of mouth and throat and cancer of the breasts in women. In addition, cancer of the colon and rectum are also caused by consuming too much alcohol in both sexes.

Diabetes

There are a variety of risk factors causing diabetes. Obesity, a lack of exercise, a bad diet with too much carbohydrates and the aging process are what contributes to the development of type 2 diabetes.

We see again that it is largely lifestyle issues that drive the onset of this disease. People who have developed diabetes need to control their blood sugar very closely to avoid complications of diabetes. This includes making healthier choices.

Otherwise complications of diabetes are diabetic nephropathy, blindness from macular degeneration of the cornea, heart attacks, stroke and diabetic neuropathy. In addition, vascular complications also include artery occlusions in the lower extremities with frequent foot or below knee amputations.

Chronic diseases

Often chronic diseases develop when there is generalized development of inflammation. COPD, chronic kidney disease and arthritis are examples of such conditions. In addition, Alzheimer’s disease, arthritis, asthma, Crohn’s disease, cystic fibrosis and diabetes belong into this category. All of these chronic diseases have in common that cytokines produce inflammation in the body. This keeps the chronic disease going and makes it more difficult to cure. When the person with a chronic disease makes poor lifestyle choices, the inflammation just becomes more chronic.

Smoking is one of the factors that makes chronic inflammation more chronic. Having a body mass index above 25.0 (being overweight) and above 30.0 (obesity) also creates more inflammation in the body. Excessive alcohol intake damages body cells and releases free radicals. These in turn cause inflammation and make the chronic disease more difficult to treat. An unhealthy diet tends to raise the bad LDL cholesterol, introduces pesticides and other chemicals into the system and adds to the chronic inflammation. Finally, a lack of exercise is not contributing to a healthy circulation and lowers the protective HDL cholesterol, paving the way for heart attacks and strokes.

Cutting Out Bad Lifestyle Habits Increases Life Expectancy

Cutting Out Bad Lifestyle Habits Increases Life Expectancy

Conclusion

Bad lifestyle habits are what causes us to get illnesses and die prematurely. Functional medicine and anti-aging medicine are at the frontier of modern medicine. These specialties are teaching us how to stay well and age gracefully. For decades conventional medicine has treated only symptoms, but not the causes of diseases. But this has not changed the mortality rates of heart attacks and cancer. Smoking, a body mass index above 25.0, excessive alcohol intake, exercising less than 30 minutes of exercise per day and an unhealthy diet are causes that make us sick. These bad lifestyle factors cause chronic inflammation in our system. They are the real cause of heart attacks, strokes, cancer and diabetes, the major killer diseases that prevent healthy aging.

Facing bad lifestyle habits

Bad lifestyle habits cause chronic inflammation. T he C-reactive protein blood test can measure the degree of inflammation that is present. A fasting insulin level can detect whether a person is in danger of developing diabetes and improved lifestyle habits can prevent this from happening. Men can add 12 years and women 14 years of healthy life by eliminating bad lifestyle habits. By eliminating chronic inflammation our new life expectancy, which is 79 to 80 years, now can reach 92 to 94 years. It is up to you how healthy you stay and whether or not you age gracefully.

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Apr
18
2020

Changes of Metabolism by Inflammation

By | alcohol, Allergies, Alzheimer’s disease, antibiotics, autoimmune disease, blood brain barrier, Cancer, Cardiovascular disease, cholesterol, diet, Drugs, fractures, heart attack, Hormones, immune system, Inflammation, kidney disease, mitochondria, Mortality, Osteoporosis, schizophrenia, stress, thyroid disease

Dr. James LaValle gave a presentation about changes of metabolism by inflammation in Las Vegas. I listened to this lecture on Dec. 15, 2020. The 27th Annual World Congress on Anti-Aging Medicine in Las Vegas took place from Dec. 13 to 15th, 2019. His original title was: “Innovations in Metabolism and Metaflammation”. This talk was complex and as a result it may not be easy reading. But it shows how various factors can affect our metabolism and our life expectancy.

In the first place he understands “metabolism” as all of the chemical reactions together that make you feel the way you feel today. In the same way metabolism is the chemistry that drives you toward future health. It is equally important to note that disregulation of your metabolism occurs from global metabolic inflammatory signalling. As has been noted he called this “metaflammation” (inflammation affecting your metabolism).

Dr. LaValle said that understanding disruptors of your metabolism can lead to renew your health on a cellular level. The key to achieve this is to remove inflammatory signals.

Factors that accelerate aging and damage your metabolism

It is important to realize that several factors interfere with the normal aging process. Oxidative stress and inflammation are major factors. But hormone disbalance and increased blood sugar values and insulin resistance can also contribute to accelerated aging and damage your metabolism. Certainly, with a disturbance of the immune balance, autoimmune reactions can take place, which also does not help. In addition, pollutants from the environment derange the metabolism due to heavy metals that block important enzymatic reactions. In the minority there are also genetic factors that can interfere with a normal metabolism.

Many of the metabolic changes can lead to chronic inflammation. One source of inflammation can be lipopolysaccharides that stimulate the immune system to start an inflammatory process.

Many conditions are associated with inflammation such as diabetes, obesity, stress, the SAD diet (standard American diet), and liver or kidney damage.

How Metaflammation is developing

Metaflammation can start in the gut with microbiota alterations. The wrong types of bacteria can release lipopolysaccharides, and low grade endotoxemia develops. With obesity inflammatory kinins start circulating in the body. Stress can activate inflammatory substances in the brain and the rest of the body. Major contributors to inflammation in the body come from faulty diets. The Western diet contains too much sugar and refined carbs; it is too high in trans fats and saturated fats. It contains too many artificial additives, preservatives, salt, sweeteners and dyes. And it is too low in nutrients, complex carbs and fiber.

More problems with metaflammation

Kidney and liver illness can contribute to metaflammation. Several diseases come from chronic inflammation, like cardiovascular disease, type 2 diabetes, chronic kidney disease, depression, cancer, dementia, osteoporosis and anemia. Metaflammation alters the methylation patterns, which can slow down your metabolism. Increased blood lipids and chronic inflammation of the blood vessels lead to cardiovascular problems. The liver and kidneys are the major detoxification organs, and their disease leads to more metaflammation. Metaflammation also leads to hormone disbalances, sleep disorders and dysfunction of the immune system. The brain reacts to metaflammation with cognitive dysfunction and mood disorders. Muscle loss (sarcopenia) is another issue, so is osteoporosis. Finally, chronic metaflammation can cause cancer.

Major causes of metaflammation

The three major causes of metaflammation are changes of the gut microbiome, obesity and chronic stress. When the gut bacteria change because of a Western diet, the wrong bacteria release lipopolysaccharides that are absorbed into the blood. The gut barrier is breaking down and a low grade endotoxemia develops. With obesity adipokines, which are inflammatory substances secreted by the fatty tissue, circulate in the blood. Chronic stress activates inflammation in the brain and in the body.

Two major conditions are common with metaflammation: hyperlipidemia (high fat levels in the blood) and hyperglycemia. Both of these conditions change the metabolism and lead to cardiovascular disease (hyperlipidemia) or to type 2 diabetes (hyperglycemia). Both of these metabolic changes lead to one or more of the conditions mentioned above, accelerate the aging process and lead to premature deaths.

Interaction of various organ systems can cause metaflammation

Dr. LaValle stated that it is vital that your hormones stay balanced. With chronic stress cortisol production is high. This causes increased insulin production, reduced thyroid hormone and lowered serotonin and melatonin production in the brain. It also leads to autoimmune antibodies from the immune system and decreased DHEA production in the adrenal glands. In addition, growth hormone production and gonadotropin hormones are slowing down. We already heard that cortisol levels are up. The end result of these hormone changes is that the blood pressure is up and abdominal visceral obesity develops. The brain shows cognitive decline, with memory loss as a result. The bones show osteopenia, osteoporosis and fractures. The muscles shrink due to sarcopenia, frailty is very common. Heart attacks and strokes will develop after many years. The immune system is weak and infections may flare up rapidly. There are also higher death rates with flus.

Other mechanism for pathological changes with hormone disbalances

When Insulin is elevated, inflammatory markers are found in the bloodstream. This elevates the C-reactive protein and leads to damage of the lining of the blood vessels in the body. A combination of insulin resistance and enhanced atherosclerosis increases the danger for heart attacks or strokes significantly.

There is a triangle interaction between the thyroid, the pancreas and the adrenals. Normally the following occurs with normal function. The thyroid increases the metabolism, protein synthesis and the activity of the central nervous system. The pancreas through insulin converts glucose to glycogen in the liver. It also facilitates glucose uptake by body cells. The adrenal hormones are anti-inflammatory, regulate protein, carbohydrate and lipid metabolism and contribute to energy production.

Change of thyroid/pancreas/adrenals triangle when cortisol is elevated

When cortisol is elevated the balance of the thyroid/pancreas/adrenals’ triangle is severely disturbed. Cortisol is high, the T4 to T3 conversion is limited and, in the brain, there is hippocampus atrophy with memory loss and brain fog. The immune system will change with production of inflammatory kinins (IL-6 and TNF alpha). Insulin sensitivity is down, sugar craving up and weight gain develops (central obesity).

Change of thyroid/pancreas/adrenals triangle when the thyroid is depressed

The thyroid activity can be lower because of autoimmune antibodies (Hashimoto’s disease) or because of hypothyroidism developing in older age. This leads to decreased pregnenolone synthesis from cholesterol. As pregnenolone is the precursor for all the steroid hormones, the metabolism slows down profoundly. Mentally there is depressed cognition, memory and mood. The cardiovascular system shows reduced function. In the gut there is reduced gastric motility. The mitochondria, which are tiny energy packages in each cell, are reduced in number, which causes a loss of energy. There is increased oxidative stress, increased lactic acid production and decreased insulin sensitivity.

Cardiovascular disease not just a matter of high cholesterol

Dr. LaValle stressed that a heart attack or stroke is not just a matter of elevated cholesterol. Instead we are looking at a complicated interaction between hypothyroidism, diabetic constellation and inflammatory gut condition. The inflammatory leaky gut syndrome causes autoimmune macrophages and Hashimoto’s disease. The end result is hypothyroidism. The inflammatory kinins (TNF-alpha, IL-6) affect the lining of the blood vessels, which facilitates the development of strokes and heart attacks. You see from this that cardiovascular disease development is a multifactorial process.

Microbiome disruption from drugs

Drugs affecting the intestinal flora are antibiotics, corticosteroids, opioids, antipsychotics, statins, acid suppressing drugs like protein pump inhibitors (PPI’s) and H2-blockers. Other factors are: high sugar intake, pesticides in food, bactericidal chemicals in drinking water, metformin, heavy metals and alcohol overconsumption. Chronic stomach infection with H. pylori, stress and allergies can also interfere with the gut microbiome.

The microbiome disruption affects all facets of metabolism. This means that there can be inhibition of nutrient absorption and this may affect the gut/immune/brain axis. There are negative effects on blood glucose levels and insulin resistance. A disturbance of the sleep pattern may be present. A significant effect on the hormonal balance can occur (thyroid hormones, sex hormones and appetite related hormones). When liver and kidney functions slow down, there is interference of body detoxification.

Dr. LaValle talked more about details regarding the gut-brain-immune pathology. I will not comment on this any further.

Changes of Metabolism by Inflammation

Changes of Metabolism by Inflammation

Conclusion

Dr. LaValle gave an overview in a lecture regarding changes of metabolism by inflammation. This took place at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019.

This article is complex and contains a lot of detail, but there is one simple truth: oxidative stress and inflammation are major factors that influence our health on many parameters and lead to a list of illnesses. They lead to hormone disbalance and increased blood sugars and insulin resistance, which can also contribute to accelerated aging and damage of your metabolism. Dr. LaValle explained how high cortisol from chronic stress can lead to low thyroid hormones and in the brain, there is hippocampus atrophy with memory loss and brain fog. With alterations of the immune system there is production of inflammatory kinins (IL-6 and TNF alpha). Insulin sensitivity is down, sugar craving up and weight gain develops (central obesity). It does not stop there! We put our hope in medications, but the sad truth is that there are

Drugs that change the gut biome

Many drugs that are common also change the gut biome with resulting increased permeability of the gut wall (leaky gut syndrome). This overstimulates the immune system and leads to autoimmune diseases like Crohn’s disease and rheumatoid arthritis. Whenever there is an injury to the gut barrier, the blood brain barrier is following suit. This is how brain disease can develop as a result of a change in the gut biome. Impaired cognition, memory and mood can result from this. Alzheimer’s disease is one of the worst conditions that may be related to a combination of gut inflammation, chronic stress and inflammatory kinins.

Apr
04
2020

Side Effects of the Birth Control Pill

By | autoimmune disease, birth control pill, breast cancer, Cancer, Cardiovascular disease, cervical cancer, depression, headache, heart attack, Hormones, Menopause, Osteoporosis, Stroke

Dr. Jolene Brighten gave a lecture about side effects of the birth control pill. This was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019. Her exact title was “Your Body on Birth Control- What Prescribers Should Know About the Effects of Birth Control on the Female Body”.

Most commonly the oral contraceptive pill is prescribed to prevent pregnancy. But the long-acting reversible contraceptives like the IUD and progestin implants are also popular. Depot Provera, the ring and the patch are the least popular ones.

Why women use the birth control pill

Women age 15 to 49 are often on some form of birth control method. 58% of women who use the birth control pill use it for reasons other than to prevent pregnancy. They use it to control symptoms of various conditions.

  • 31% use it for menstrual cramps
  • 28% want to regulate their periods
  • 14% hope to improve their acne
  • 4% use the pill for menstrual pains associated with endometriosis
  • 11% for other reasons

What the birth control pill does

The birth control pill exerts a negative influence on the hypothalamus and the pituitary gland. This is called “functional hypothalamic amenorrhea”. The birth control pill is not suitable to treat polycystic ovarian syndrome. Symptoms of bleeding may improve for 3 months, but after that the original symptoms return. Thyroid disease that may be present needs separate investigations.

The hormones that are part of the birth control pill are synthetic hormones. They do not quite fit the body’s hormone receptors. For instance, the progestins, artificial analogues of progesterone behave like estrogens, not progesterone. This causes clotting problems cancers of the uterus, breasts and cervix. It can also cause heart attacks and strokes.

List of side effects of the birth control pill 

From depression to liver health

The list of side effects of the birth control pill (BCP) is long. The BCP can worsen symptoms of depression and anxiety. The deeper the depression is, the higher is the risk for suicide. There is increased risk of hair loss. The BCP depletes nutrients in the body that the thyroid gland needs to produce thyroid hormones. This can result in hypothyroidism.

It also increases thyroid binding globulin, a protein in the blood that binds thyroid hormones. As a result, there are fewer thyroid hormones available to the body cells. Breasts may become tender and enlarged after the start of the BCP. In some women with fibrocystic disease of the breasts the BCP may improve her cyclical breast changes. The BCP changes the liver both structurally and genetically. As a result, there is a higher risk of developing benign liver tumors and liver cancer.

From gallstones to blood clots

Women with a history of gallstones may experience faster gallstone formation on the BCP. The pill also can elevate your blood pressure. You should have blood pressure checks from time to time to prevent a stroke. Weight gain is common on the BCP. However, some women experience weight loss. Usually the BCP is 99% effective for the prevention of pregnancy. Pain from heavy periods or menstrual cramps are often relieved by the BCP. There is an increased risk to develop diabetes, because insulin resistance is gets worse in patients on the BCP. In postmenopausal women on HRT there is an even higher risk of developing diabetes. Blot clots are a common side effect of the BCP. Being a smoker, having a heart or liver condition, a history of genetic risk of blood clots, having migraines with an aura or being overweight are all additional risk factors for developing blood clots.

From effects on the brain to cancer risks

The BCP can change brain function and structure. This may lead to a different mate selection and production of neurotoxins. Some women get relief from hormonal headaches; but others experience exacerbations of migraines and headaches. In some women acne improves on the BCP; in others acne gets worse. When it comes to stress, some women experience an altered hypothalamic-pituitary-adrenal gland response from the BCP. The BCP reduces some cancer risks, like the risk of ovarian, uterine and colorectal cancer. But the risk for breast cancer, brain cancer and liver cancer are higher. The BCP increases gut permeability, leads to leaky gut syndrome and the disruption of the microbiome. There is often overgrowth of yeast in the gut. In addition, people with a genetic predisposition for autoimmune disease of the gut can develop immune diseases. Multiple studies have shown malabsorption of vitamins, minerals and antioxidants when on the BCP.

From vaginal yeast infections to osteoporosis and autoimmune diseases

Many women develop vaginal yeast infections. Women on the BCP often complain about low or a lack of libido. There can be vaginal dryness and pain with sex.

Teenage women on the BCP often develop decreased bone density. Synthetic hormones lack the specificity to the natural hormone receptors, which leads to decreased bone density. On the other hand, bioidentical estrogen and bioidentical progesterone will indeed build up bone mass. In the past it was thought that hormones would be good for the bones and this is still true with the use of bioidentical hormones.

A number of autoimmune diseases have been identified to be directly related to the use of the BCP. These are Crohn’s disease, multiple sclerosis, lupus, interstitial cystitis and ulcerative colitis.

Synthetic hormones will always have side effects

The body is a complex organism with various hormone receptors built into its cells. In order to be able to cash in on patented modified hormones Big Pharma introduced progestins to replace natural progesterone and various synthetic estrogen products to replace natural estradiol. However, the Women’s Health Initiative has shown  in 2002  that these artificial hormones produced heart attacks, strokes, blood clots, colorectal and endometrial cancer and hip fractures. There was an increase of mortality of 15% over 5.2 years compared to controls who did not take artificial hormones within the same timeframe.

Bioidentical hormones have a perfect fit to the natural hormone receptors

In contrast, when bioidentical hormones are given in menopause, there is a 10 to 15 year extension of life expectancy and researchers did not see any of the above mentioned side effects that were noted with synthetic hormones. Many people in Europe have elected to stick to bioidentical hormones for decades; they did not use the synthetic hormones. As a result, there are good data going back to the 1960’s about the safety of bioidentical hormones. In this study several thousand postmenopausal women were followed for 9 years or more and showed no increase in the rate of heart attacks or any cancer. Their postmenopausal symptoms were optimally controlled. I conclude from this that bioidentical hormone replacement in menopause will protect the women from missing hormones safely. There are no side effects and for this reason the bioidentical hormone replacement should become the standard of care.

Side Effects of the Birth Control Pill

Side Effects of the Birth Control Pill

Conclusion

Synthetic hormones have a long list of devastating side effects. Yet, Big Pharma managed to influence general practitioners and gynecologist to prescribe them to postmenopausal women. The Women’s Health Initiative has changed everything. The promise was that synthetic hormones would show heart-protective effects, cancer protective effects and healing effects for osteoporosis. These have been empty promises! None of this occurred with synthetic hormones- to the contrary! Many physicians are now prescribing bioidentical hormone replacement for women in menopause.

No good alternative for teenage girls

However, for teenage girls there is no good alternative for the traditional birth control pill, even though the catalogue of side effects is of serious concern. One compromise is to limit prescribing the birth control pill for up to 5 years only and then switch to several years of a copper T or other intrauterine device (IUD). Suicide in teenage girls on the BCP is of real concern. Despite the list of side effects many doctors continue to prescribe synthetic hormones for decades to the same patients, who trust that it will benefit them. In time patients will know about the side effects, and unfortunately many will experience them. As a result, it is only a matter of time, till this will be exposed as malpractice!

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Mar
28
2020

Fasting Can Prevent Cardiovascular Diseases

By | Anti-aging medicine, Cardiovascular disease, Diabetes, diet, fasting mimicking diet, heart attack, Heart Disease, Inflammation, Obesity, Prevention, stem cells, Stroke

Dr. Joel Kahn gave a lecture in Las Vegas in which he explained that fasting can prevent cardiovascular diseases. Dr. Kahn is a Clinical Professor of Medicine at Wayne State University School of Medicine. He spoke at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas. The conference took place from Dec. 13 to 15th, 2019.

According to the CDC cardiovascular diseases like heart attacks and strokes are hitting the middle age adults in large numbers. Part of the problem is obesity and diabetes, both of which cause an increase of cardiovascular diseases. Heart attacks, strokes, heart failure and other related cardiovascular conditions caused 2.2 million hospitalizations in the US in 2016. This resulted in 415,000 deaths and a health care cost of $32.7 billion.

Fasting can improve the risk for cardiovascular disease

Dr. Kahn asked whether fasting can reduce the aging pathways, build up resilience and protect the heart from aging and heart disease. In a few words: eat less, live more! He showed with slides that fasting can indeed do that. One heart catheterization study showed that a fasting group had only 64% coronary artery disease compared to a non-fasting control group with 76%.

Another study showed that fasting patients had only 10.3% diabetes compared to controls with 22.0%. With heart catheterization 63.2% of fasting patients had cardiovascular disease while 75.0% of non-fasting control patients did have lesions in their coronary arteries.

Animal experiments confirmed that fasting had beneficial effects on heart health as well. In rats, researchers showed that fasting reduced infarct size and inflammation. It also preserved left ventricular function. With mice fasting produced less inflammatory response and less tissue damage.

Alternate day fasting shows benefit in clinical human trial

A 2019 publication reported about a 4-week randomized clinical trial on 60 healthy non-obese human subjects. The effect of alternate day fasting was compared to controls. On average there was a 37% calorie reduction in the alternate fasting group. The fasting group had improved fat mass, improved fat-to-lean ratio and cardiovascular markers. There was a reduction of age-associated inflammatory markers and low-density lipoprotein.

Fasting mimicking diet

A newer form of fasting is the fasting mimicking diet (FMD), which was invented and researched in depth by Dr. Valter Longo. Both animal experiments as well as human trials have shown that the FMD is safe and effective. It can be followed 5 days out of every month and will lead to some weight loss, an increase of telomeres, stem cells and lowered inflammatory markers.

My own experience with the fasting mimicking diet

My wife and I heard about the FMD from Dr. Longo when he spoke about it at the 2017 Anti-Aging Conference in Las Vegas. We immediately started the FMD in December of 2017 and have done it every month for 5 days since. But we never ordered the expensive meal kit. Instead, we calculated calories and use regular food to do the calorie-restricted diet. We eat 600 to 700 calories every day during the FMD days. In between we have unrestricted calories, but we noticed that we are more careful about our meal choices. I find that the result of the FMD is more energy, an improved sleep pattern and an easier way to keep my body-mass index in the 21.0 to 22.0 range. Here is a description of the effects of the FMD.

Use of FMD in high-risk patients

Dr. Khan said that the FMD is an ideal diet that the high-risk population of the US should use. 34% of the US population has a compromised metabolic condition. They are obese and at a high risk to develop diabetes. But on the FMD they gradually lose abdominal obesity, lower their cholesterol and triglycerides levels, which otherwise causes a high risk for heart attacks and strokes. The fasting blood sugar is lowering reducing the risk to get diabetes. The systolic and diastolic blood pressure comes down. And the C-reactive protein, which is a general inflammatory marker, becomes lower.

In non-obese patients the main effect of the FMD is a stimulation of stem cell release and telomere elongation. This postpones the aging process and with it delays the onset of cardiovascular diseases.

Fasting Can Prevent Cardiovascular Diseases

Fasting Can Prevent Cardiovascular Diseases

Conclusion

Dr. Joel Kahn gave a lecture at a Las Vegas conference that fasting can prevent cardiovascular diseases. He compared alternate day fasting with the fasting mimicking diet (FMD). The FMD was more effective in reducing danger markers, abdominal girth measurements and blood markers of cardiovascular diseases. Ultimately, he said, it was easier to follow an FMD where you only reduce your calorie intake to 600 to 700 calories per day for 5 days in one month. In those who are wanting to do this just for good health, the FMD increases stem cells and elongates telomeres. This postpones the aging process and keeps a person younger for longer. At the same time, it delays the onset of cardiovascular diseases.

Mar
14
2020

Telomeres are Important

By | Alzheimer’s disease, andropause, Anti-aging medicine, Cancer, Cardiovascular disease, Diabetes, exercise, fasting mimicking diet, fish oil, Fitness, food, heart attack, High Blood Pressure, Hormones, Menopause, Nutrition, Obesity, omega-3 fatty acids, Smoking, Stress management, telomeres

In the first place, Dr. Joseph Raphaele reviewed why telomeres are important at a Conference in Las Vegas in December 2019. This was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15, 2019. The actual title of his lecture was: “Telomeres in 2019; clinical developments and cutting-edge applications”.

Notably, Dr. Raphaele reviewed how various animals have quite different life expectancies. First, the Aldabra giant tortoises, for instance can live up to 152 years. Second, the house mouse can at the most live up to 6 years, but its predator, the cat lives up to 38 years. Finally, humans can live up to 122.5 years.That is to say, the average mortality rate doubling curve of man is 8 years. Dr. Raphaele introduced the terms “lifespan” and “health-span”.

Lifespan versus health-span

The first thing to remember is that our lifespan is defined by the number of years we live. On the contrary, the health-span is defined by the number of years you do not have any disease and your physical and mental health are good. Dr. Raphaele explained that for the most part the body’s organs have a limit of functioning after 80. For this reason the kidneys, the maximum heart rate, the maximum breathing capacity and the maximum work rate (oxygen uptake) all decline after the age of 80. It is important to realize that in 1961 Dr. Leonard Hayflick showed that there is a limit of how often cells can divide. After 60 doublings cells in tissue culture either die or just stop dividing. The built-in molecular clock resides in the telomeres. The telomeres are the caps at the end of the chromosomes in the cell’s nucleus.

Telomeres and their function in aging

In a word, what is the function of telomeres? In essence, the telomeres protect the integrity of our genes. For the most part, they protect the chromosomes from deteriorating, prevent DNA fusion and massive instability of the genes. In addition, the telomeres allow the cells to divide in an orderly fashion, but only up to the Hayflick limits. In short, the bottom line is that telomeres prevent cells from mutations of the DNA, from senescence and from death.

Shortening of telomere length with age

Dr. Raphaele said that one of the important findings was that telomere length is shortening with age. Notably, he showed a slide similar to this. To clarify, this graph shows telomere length as a function of the lifespan in years. The telomere length is obtained by a blood test. This determines the length of the telomeres in white blood cells. At a young age it has a length of between 8 and 10 kb. kb stands for kilobase. A kilobase consists of 1,000 pairs of nucleic acid sequences. So, 10 kb means 10,000 pairs of nucleic acid sequences. Around the age of 80 people have much shorter telomeres, only 4 to 6 kb. There is an enzyme, called telomerase that can elongate telomeres by approximately 10%. But this may not be desirable as too much telomerase activation can also stimulate cancer growth.

Age changes telomere length

Dr. Raphaele explained further that a telomere loses about 100 base pairs per cell division. But there are other factors that shorten telomeres. Smoking, sedentary lifestyle, high blood pressure, stress and a low antioxidant status all can shorten telomeres. Certain congenital conditions can shorten telomeres by 28%. Dyskeratosis congenita is such a condition where 80% patients die by the age of 30 due to aplastic anemia. This is associated with bone marrow failure. 10% of these patients die from cancer. Apart from age, which shortens telomeres slowly, lifestyle factors are very important. A good lifestyle where you exercise regularly, you don’t smoke and you eat a healthy diet will slow down the shortening of your telomeres. Controlling your stress, sleeping enough hours per night and taking supplements also delays telomere shortening. Certain medications that control diabetes, high blood pressure or thyroid medication that treats hypothyroidism also delay telomere shortening.

Telomeres and shortened lifespan

Researchers could show that good lifestyle practices work by increasing telomerase to a certain degree. This results in lengthening of telomeres and translates into up to 10 years of increased life span. Jerry Shay, PhD said in 2011: “While the aging process is complex and certainly cannot be explained solely on the basis of telomere biology, there is a growing consensus that in some situations telomere biology and telomere tests may have important utility similar to cholesterol assays or blood pressure monitoring measurements.”

Telomeres are not just a biological clock inside our cells. They have a great influence on the function of mitochondria and on how many mitochondria multiply inside cells. This latter process is called mitochondrial biogenesis. In addition, telomeres regulate gene expression.

Chronic diseases associated with shortened telomeres

Here is a list of chronic diseases where all the patients have shortened telomeres.

  • High blood pressure
  • Hardening of the arteries (atherosclerosis)
  • Cancer
  • Chronic obstructive pulmonary disease (COPD)
  • Alzheimer’s disease
  • Diabetes and obesity
  • Chronic stress
  • Metabolic syndrome

Telomeres in cardiovascular disease

Telomere length was found to be shortened in those who developed a heart attack. Researchers compared the telomere length in coronary artery disease (CAD) patients to people with no history of heart attacks. In comparison to this normal group the heart attack victims had telomeres typical for people who are chronologically 11.3 years older than the healthy controls. The researchers calculated that people with telomere shortening had a 3-fold higher risk of coming down with a heart attack.

Telomere length enhancers

  1. Lifestyle changes can have positive effects on telomere length. Examples are smoking cessation, weight loss and stress reduction.
  2. Dietary changes: we know that fish oil (omega-3 fatty acids) supplements elongate telomeres as does a low-fat diet.
  3. Supplements like vitamin D3, antioxidants (vitamin C and E) and astragalus (TA-65) elongate telomeres as well. The astragalus supplement, TA-65 showed a significant elongation of telomeres after 12 months while controls lost telomere length.
  4. Exercise: in a 24-week experiment of care workers regular aerobic exercise increased the telomeres by 67.3 base pairs.
  5. Bioidentical hormone replacement in aging people: when hormones are missing after andropause and menopause, the natural hormones need replacing, or the telomeres are shortening.
  6. High cortisol levels cause telomere shortening.
  7. Human growth hormone elongates telomeres via telomerase activation.
  8. The fasting mimicking diet (FMD) was shown to extend life and telomeres as well.

Therapeutic rationale for telomere lengthening in CAD and AD

Patients with coronary artery disease (CAD) are at risk for developing heart attacks and other cardiovascular diseases. Here is an overview of many clinical trials that have been done in humans with CAD. It shows shortening of telomeres in these high-risk patients. But the review also shows that telomeres can lengthen by changing the risk factors of cardiovascular disease. Researchers were increasing the enzyme telomerase that indirectly lengthens telomeres. Both approaches prevent serious cardiovascular disease and increase life expectancy significantly. In severe cases of telomere shortening the physician can consider TERT gene therapy.

Alzheimer’s disease (AD) also is a condition where telomeres are shortened compared to normal controls. Time will tell whether TERT gene therapy is possible to prevent Alzheimer’s disease.

Telomeres are Important

Telomeres are Important

Conclusion

Telomeres are the caps of the chromosomes in our cells. In the past the word “telomere” appeared obscure and only scientists discussed this among themselves. Now we know that telomere shortening is often the reason for chronic illnesses like high blood pressure, hardening of the arteries (atherosclerosis), cancer, chronic obstructive pulmonary disease (COPD), Alzheimer’s disease, diabetes and obesity. Patients who have these conditions often have shortened telomeres in their white blood cells. Over the years we have learnt that lifestyle changes can have positive effects on telomere length. Smoking cessation, exercise, weight loss and stress reduction are elongating telomeres.

Additional factors elongating telomeres

In addition, supplements like antioxidants (vitamin C and E), vitamin D3 and astragalus root (TA-65) elongate telomeres as well. By elongating telomeres, a person can add 10 to 11 years of disease-free life to the normal life expectancy. Researchers showed that telomerase activation by human growth hormone increased telomere length without causing cancer. Dr. Thierry Hertoghe, an endocrinologist from Belgium spoke about HGH replacement in aging people on other occasions. He said that cautiously treating patients with low doses of HGH when blood tests showed deficiency, adds about two decades of life-expectancy to these patients’ lives.

Mar
07
2020

Eat Right for a Long Life

By | alcohol, Alzheimer’s disease, antibiotics, autoimmune disease, Cancer, Cardiovascular disease, fiber, fish oil, food, heart attack, Inflammation, lifestyle, Nutrition, olive oil, omega-3 fatty acids, organic food, polyunsaturated oil, Processed food, Stroke, sugar, toxins

Dr. Felice Gersh gave a talk at a conference in Las Vegas stressing the importance to eat right for a long life. This was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019. The actual title of her presentation was “Nutrition for Longevity”.
Dr. Gersh has a fellowship in Integrative Medicine at the University of Arizona School of Medicine.

In the first place she pointed out that an anti-inflammatory diet consists of vegetables, fruits, nuts, whole grains, healthy oils like olive oil and fish. This is a modified Mediterranean diet. On the other hand, with a pro-inflammatory diet or Western diet, you eat high fat, cholesterol, lots of protein from red beef, high sugar, excessive salt and a lot of processed and fast-food.

Prevention of diseases

It is important to realize that for prevention of cardiovascular disease, cancer and degenerative diseases you need to eat fruits and vegetables, which contain important phytochemicals. They contain a wide variety of molecules, like carotenoids, vitamins and polyphenols. Another key point is that cruciferous vegetables (broccoli, Brussels sprouts, and kale) contain glucosinolates, which are sulfur-containing compounds. They protect you from cancer.

Vitamins and magnesium

It must be remembered that in order to strengthen the immune system and prevent hardening of the arteries (atherosclerosis) we need the following: omega-3 and omega-6 fatty acids, the enzyme Co-Q10, vitamin A, B complex, C, D, E, carotenoids, phytosterols, stilbenes and flavonoids. Another key point is that magnesium is extremely important. Many of our dietary habits have reduced magnesium intake to a minimum. Our soils are depleted of magnesium, it is no longer in drinking water, and it is absent in processed foods. However, magnesium is involved as a co-factor in more than 700 enzymatic reactions in our bodies. Magnesium is involved in heart contractions, is important to maintain our blood pressure and is important for glycemic control. It is also important for bone development and for DNA and RNA synthesis. Magnesium binds serotonin and dopamine to their receptors and plays a role in many more body functions.

Brassica vegetables

This group of vegetables consists of broccoli, cauliflower, green cabbage and Brussels sprouts. Notably, they have long been recognized to lower the risk of many cancers. The first thing to remember is that the active ingredients in them are glucosinolates and isothiocyanates. Certainly, food preparation has a lot of influence on maintaining beneficial substances in the brassica vegetables. To emphasize, finely shredded vegetables had a marked decline of their glucosinolate levels by 75% within only 6 hours. On the negative side, microwave cooking destroys 74% of glucosinolates, but on the positive side, storage in room air preserves almost all of the glucosinolates for 1 week. In addition, stir frying brassica also preserves the glucosinolates. This reference points out how fruit and vegetables can contribute to cancer prevention.

The gut microbiome

The Western diet leads to a change in the gut flora with Gram-negative bacteria taking over the healthy gut flora and disrupting the intestinal barrier. To emphasize, this result is called endotoxemia. Part of this is increased serum endotoxin, which mainly consists of lipopolysaccharides. Indeed, it causes gut inflammation and a breakdown of the gut barrier. When this happens, autoimmune antibodies are produced. To put it another way, the Western diet undermines your health. In a word, high fat foods and added sugars (refined carbohydrates) lead to increased Gram-negative bacteria and the disruption of the intestinal barrier.

An unhealthy diet causes disease

In the long run this causes autoimmune diseases, leads to higher heart attack rates and to diabetes. Healthy gut bacteria in fact help to digest fibre, which leads to three short-chain fatty acids: butyrate, acetate and propionate. For the most part, they are important as energy source, affect cardiometabolic health and appetite. On balance, butyrate also helps to maintain the blood brain barrier.

Importance of fiber

Higher fiber content in food leads to less cardiovascular disease, has positive effects on obesity and the metabolic syndrome. Fiber changes the microbiome in the gut, leads to less gut permeability and more short-chain fatty acids production.

The best diet

  • 60% to 70% complex carbohydrates are the foundation of a healthy diet. It consists of vegetables, green leafy and root vegetables, beans, legumes, whole grains and fruit.
  • Eat healthy fats from nuts, olives, seeds, krill or fish oil. Limit fat intake to 18 to 28% of your daily calorie intake. Avoid hydrogenated fats. Limit your saturated fatty acid intake. 85% chocolate is OK. Otherwise consume olive oil and omega-3 fatty acid containing foods (from seafood and fish).
  • Add about 12% of the daily calorie consumption as protein per day. Choose fish, seafood, lean cuts of chicken, only the occasional red meat (organic or grass-fed meat)
  • Eat lots of fiber, eat organic and minimally processed food. Limit sugar, fat and salt. Avoid antibiotics from the agricultural industry, sweeteners, gluten and excessive alcohol intake. Take a daily probiotic and eat probiotic food. Eat three meals a day, a big breakfast, a moderately-sized lunch and a small dinner. A fasting mimicking diet once per month for 5 days activates your longevity genes.
Eat Right for a Long Life

Eat Right for a Long Life

Conclusion

Dr. Felice Gersh gave a talk at a conference in Las Vegas. This was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019. She said that we need to eat right for a long life. She gave a thorough outline of what to eat and what not to eat. It is important to note that she suggested to cut out additional refined sugar and processed food. The bacteria in the gut must be normal, or the gut barrier breaks down. This failure can cause autoimmune diseases. Eating lots of vegetables and fruit as well as fiber will help to keep your gut bacteria normal.

What foods to eat

A Mediterranean type diet gives you the right foods that you need for your health. Avoid the Standard American diet as it is unhealthy and kills the good gut bacteria. Brassica vegetables like broccoli, cauliflower, green cabbage and Brussels sprouts prevent the development of many cancers. Eat three meals a day, a big breakfast, a moderately-sized lunch and a small dinner. This fits best into the diurnal rhythm of your gut bacteria. Eat right for a long life!

 

Feb
22
2020

Clinical Applications of the Fasting Mimicking Diet

By | Alzheimer’s disease, Anti-aging medicine, autoimmune disease, Cardiovascular disease, Diabetes, diet, fasting mimicking diet, food, Health, Hormones, Inflammation, lifestyle, mitochondria, Multiple sclerosis, Prevention, regenerative medicine, stem cells, telomeres, Weight loss

Dr. Kurt Hong, professor of clinical medicine spoke about clinical applications of the fasting mimicking diet in Las Vegas. This was at the 27th Annual World Congress on Anti-Aging Medicine on Dec. 14, 2019. Although he spoke on various forms of fasting, he concluded that the fasting mimicking diet had the best results and was most consumer-friendly.

How we age

Dr. Hong reviewed the processes of aging. We age, because our cells experience oxidative damage and our telomeres (the end caps of our chromosomes) get shorter in time. We also age, because there are genetic mutations in our cells’ DNA and our mitochondria are aging as well. The mitochondria are the small energy packages inside the cells that give us energy. When people age, they have lost mitochondria, there is less energy that the body makes out of food and we feel chronically tired.

Above the age of 65 we are also likely to develop diseases of various organs:

  • Heart disease: 31%
  • Cancer: 24%
  • Chronic lung disease (lower respiratory disease): 21%
  • Alzheimer’s disease: 13%
  • Diabetes: 11%

Women are generally healthier than men and their life expectation is 4 to 5 years longer than that of men.

Cellular and molecular aging

Longevity researchers have done mouse experiments and human clinical trials for decades. Dr. Hong asked the question: how much longer could humans live, if we could cure cancer, heart disease, stroke and diabetes? The answer is: 13 years. But if we transfer the animal data to humans it should be 30 years of longer life. Why is there such a discrepancy? The answer is that it is easy to force good lifestyles onto animals, but humans are resistant to changes. Humans have their habits; they like to continue to smoke and eat fast food instead of switching to a healthier Mediterranean diet. Humans also resist a regular exercise program. And they do not want to hear that they should replace missing hormones with bioidentical ones. The result is that we humans will prolong our lives only by less than 50% of what we could achieve.

The concept of intermittent fasting

Dr. Hong stated, that ten thousand years ago, people did not always have enough food to eat. They were forced to intermittently fast. That did not mean that they had long life expectancies, as there was no cure for any disease. But one fact was true: the body learnt to rejuvenate itself during periods of fasting. And these longevity genes are still present in our genes. But they will only help us when we actually fast for some periods of time.

Dr. Hong reviewed what kind of fasting methods are available.

Prolonged fasting and juice fasting are not among the options. With prolonged fasting electrolyte disturbances become an issue. Juice fasting does not remove enough calories and nutrients. This, however is needed to allow the body to stimulate the longevity genes.

How fasting diets work

Dr. Hong explained that there are essentially 5 fasting diets that are effective in regulating the key nutrient sensitive pathways of IGF-1, TOR and PKA. This increases cellular protection and maintenance. It also increases activation of stress resistance pathways and removes and replaces damaged and dysfunctional cells. Finally, a fasting diet also reduces inflammation, which is often the start of disease.

A review of the 5 fasting diets

Time-restricted eating (TRE)

With TRE the person fasts for 12 to 16 hours every day. The person restricts the daily food consumption to a 4- to 12-hour window. The disadvantage is that this fast is done every day. The period of fasting may not be long enough to change the metabolism, where the above-mentioned effects take place.

Alternate-day fasting  

This is a 24-hour fast every other day with a 1:1 day eating-fasting cycle. This does not appear to be physiological and is disruptive with regard to social activities.

5:2 intermittent fasting

With this fast you fast for 2 days every week. With this 2:5 eating-fasting cycle the person fasts for 2 days every week; the other 5 days you eat as much as you desire.

Although this is effective, it can be quite disruptive to your lifestyle.

Periodic fasting

You fast for 48 to 72 hours every couple of months. This fast is socially more acceptable. It is not that often, just a couple of times in a year. The question remains whether it is effective in changing the metabolism to trigger the effects mentioned above.

Fasting-mimicking diet (FMD)

The original suggestion by Dr. Longo, the inventor of the FMD was that you should fast for 5 days once every month. Since then he has modified it and said that you can achieve similar metabolic changes, if you only fast for 3 days and do this a couple of times per year. I have done the FMD since December 2017 and I adhere to the original schedule of doing the FMD monthly for 5 days. This has provided me with more energy. It is easier to keep my body mass index in the 21.0 to 22.0 range. Dr. Hong explained that the FMD allows you to eat, but it tricks the body into acting like you are fasting. Because you are eating 500 to 600 calories per day, you are getting some fluid and nutrients, so the hunger pangs are tolerable.

More details about the FMD

Here is Dr. Hong’s summary about the FMD: “The stomach sees food, while the cells see fasting”. Dr. Hong said that the FMD is the most user-friendly method of fasting. It also has had the most scientific studies to validate that it is indeed working. Poorly functioning mitochondria and misfolded proteins are removed by a process of phagocytosis. The FMD reduces heart disease, cancer, and neurodegenerative disorders. Stem cell production also gets a boost. This promotes cell regeneration and reduces risk factors of premature aging.

Publication on the effectiveness of the FMD

A publication came out in 2017 reporting about the findings of a clinical trial regarding the FMD.

Researchers followed markers of aging, diabetes, cancer and cardiovascular disease in 100 volunteers. They underwent a FMD for 5 days on 3 consecutive months. The results were astounding. The body mass index, the fasting blood sugar level, triglycerides, total and LDL cholesterol and the CRP were all lower. CRP stands for C-reactive protein, which measures the degree of inflammation in the body. The blood pressure was also lower. Overall the 5-day FMD was a safe method with no side effects. The FMD reduced markers and risk factors of aging and age-related diseases. In doing so it prolongs life by reducing the likelihood of coming down with disease.

Who should abstain from fasting?

Dr. Hong mentioned that the FMD is not for everybody. Pregnant women should refrain from going on it, also type 1 and type 2 insulin dependent diabetics. Anybody who has a sign of an active infection (coughing, having a fever or diarrhea) should be excluded. Other exclusions are people who are underweight (BMI less than 18.5) or are malnourished (protein deficiency). Patients with heart failure and advanced kidney or liver disease should not take part in a fasting program.

Autoimmune diseases and FMD

The myelin sheath around the axon of nerve cells in the central nervous system are supported by oligodendrocytes. In multiple sclerosis (MS) patients T lymphocytes activate macrophages and B cells to produce autoantibodies. They destroy oligodendrocytes breaking down the insulating barrier of the myelin sheath. In MS patients the broken-down myelin sheath suppresses the electrical impulses transmitted through the nerve fibers. The FMD led to clinical improvements.

In a pilot study intermittent fasting changed the gut flora into a healthier flora.

This triggered the immune system in the gut to make less inflammatory T cells producing the IL-17 cytokines. There was also an increase in regulatory T helper cells.

Inflammatory bowel disease (IBM) can be improved with several courses of FMD. As the authors showed, intestinal inflammation improved with FMD. The intestinal gut flora improved with the FMD and it promoted intestinal regeneration.

Reversal of physical and functional decline

The fasting mimicking diet (FMD) has a variety of effects on the human body. Dr. Hong showed a slide where we could see that ketone bodies, cortisol and ghrelin levels are increased in the blood. At the same time glucose, insulin, leptin and IGF-1 levels are reduced. In addition, triglycerides and LDL levels are getting lower. Inflammatory markers including the C-reactive protein (CRP) are reduced as well.

Effects of the FMD on various organs in the body

A look at all of the organs shows that in the liver the ketone body production and insulin sensitivity are up. Glycogen production in the liver as well as the liver size are down.

The intestines produce ketone bodies. In the skeletal muscles the insulin sensitivity is increased, while the muscle structure and function are improved. In the brain the hunger feeling increases the release of neurotropic factors including the neuropeptide Y. Cognitive function and stress resistance increase with the FMD. The FMD reduces inflammation and oxidative stress in the brain. With respect to the cardiovascular system the heart rate drops down and blood pressure gets lower. The insulin production in the pancreas is reduced.

Fatty tissue

In fatty tissue lipolysis is up and also the production of adiponectin. This is a protein hormone involved in glucose and fatty acid metabolism. Insulin sensitivity with the FMD is also increased. On the other hand, the FMD reduces fat mass, leptin production and inflammation.

The FMD is the solution to preventing disease and prolonging your life

All of these effects lead to a reversal of physiologic and functional declines. Age-related metabolic diseases like type 2 diabetes are postponed or eliminated. The FMD prevents neuro-cognitive decline like Alzheimer’s disease. In addition, the risk of developing cancer is getting lower. In summary, the FMD improves the health-span, quality of life and can prepare you for a long life.

Clinical Applications of the Fasting Mimicking Diet

Clinical Applications of the Fasting Mimicking Diet

Conclusion

Dr. Kurt Hong is a professor of clinical medicine at UCLA. He gave a talk at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas on Dec. 14, 2019. He discussed what we could do to help patients with various autoimmune diseases like multiple sclerosis, rheumatoid arthritis and inflammatory bowel disease. It turns out that the fasting mimicking diet (FMD) is the best solution to reduce inflammation and modify  the autoimmune response from aggressive T lymphocytes. With the FMD you consume only 500 to 600 calories per day for 5 days every month. The rest of the days of the month you eat a healthy Mediterranean-type diet.

Fasting mimicking diet, the best way to treat autoimmune diseases

Dr. Hong explained in detail what cellular mechanisms are at work to achieve the modification of the immune system in autoimmune diseases. The FMD is also the solution to slow down aging in healthy people. Dr. Hong discussed clinical applications of the fasting mimicking diet fort autoimmune diseases. It is easier to prevent disease than it is to cure an illness. The FMD is an easier way, because you don’t fast completely, you only reduce your food intake to the bare minimum, but your body “thinks” that you are fasting.

Ultimately, this approach does take some effort, and it does take time to familiarize yourself with it. If patients do it for the first time, they will experience some hunger, the first and second day tend to be a hurdle! Once you make it part of a health routine on a regular basis, it is a lot easier.

Nov
23
2019

Omega-6 Fatty Acids Compromise Your Health

By | Alzheimer’s disease, Arthritis, Cardiovascular disease, heart attack, Heart Disease, Inflammation, Nutrition, omega-3 fatty acids, Stroke

In an editorial of the October 2019 edition of LifeExtension William Faloon explained that omega-6 fatty acids compromise your health. He focused particularly on memory loss and the development of Alzheimer’s disease.

After a review of the medical literature he noted that Americans are eating too many foods that are laden with omega-6 fatty acids. Part of it is due to food processing with the wrong oils ). But the other problem is that processed foods also are full of omega-6 fatty acids. The merchants like omega-6 fatty acids, because they prolong the shelf life of products. But recent evidence shows that a high ratio of omega-6 to omega-3 ratio in our food can interfere with our memory and may even lead to dementia.

Evidence that omega-6 fatty acids are interfering with brain function

A recent publication analyzed 116 non-demented subjects aged 69 on average.

Blood tests were taken where 32 nutrients related to a Mediterranean diet were analyzed. In addition the researchers from the University of Illinois did functional MRI scans to assess higher brain function. The researchers also did cognitive tests to assess mental functioning.

  • The results of these experiments showed that higher lycopene levels had an association with better memory and higher executive function.
  • Subjects with higher carotenoids and trans lutein showed higher intelligence on testing.
  • B-vitamins that reduce homocysteine (vitamin B2, folate and vit. B12) and vitamin D showed an association with better executive functioning.
  • Two parts of memory testing showed that a proper balance of omega 6 to omega 3 ratio resulted in a better memory.
  • Higher omega-3 levels in the blood associated with higher overall intelligence and better executive function.

Impact of omega-6 on brain function

Researchers have proven that omega-3 fatty acids can help controlling inflammation in the body. This can prevent cardiovascular disease and neurodegenerative disorders like Alzheimer’s disease. However, our western food contains a surplus of omega-6 fatty acids, which causes inflammation in the body. It depends on our food choices, but it also depends on the preparation of the food. One chicken leg with skin contains about 1800 mg of omega-6 fatty acids. The process of deep-frying the same chicken leg increases the content to 4322mg of omega-6.

One deep fried KFC chicken breast with skin has 12,663 mg omega-6 fatty acids The reason is that a lot of the deep-frying oil is full of omega-6 fatty acids.

Cooking oils

Here is a run down of cooking oils. All of the cooking oils have a different mix of omega-3 and omega-6 fatty acid composition. Many also contain oleic acid, which is an omega-9 fatty acid.

Researchers have proven that omega-3 fatty acids can help control inflammation in the body. This can prevent cardiovascular disease and neurodegenerative disorders like Alzheimer’s disease.

As it is obvious from the table in the second last link olive oil contains 71.27% oleic acid, 9.76% omega-6 and 0.76% omega-3. It is the content of the majority of oleic acid (omega-9), which makes olive oil such healthy oil. Only two table spoons of olive oil per day will prevent heart attacks and strokes because oleic acid lowers the bad LDL cholesterol and increases the good HDL cholesterol. Olive oil removes beta-amyloid plaques inside the brain, which means it prevents Alzheimer’s disease.

Recommendation of best cooking oil

Considering that olive oil has such powerful healing properties, I recommend that you cook and bake with olive oil. Also use olive oil as part of your salad dressing. On the other hand avoid these oils: corn oil, sunflower oil, soybean oil, cottonseed oil and safflower oil. They contain too much inflammatory omega-6 fatty acids.

Our western food contains a surplus of omega-6 fatty acids, which causes inflammation in the body. It depends on our food choices what is in the food. But it also depends on the preparation of the food. One chicken leg contains about 1800 mg of omega-6 fatty acids. When it is deep fried with skin it contains 4322mg of omega-6.

One deep fried KFC chicken breast with skin: 12,663 mg Omega-6 fatty acids. One of the reasons is that a lot of the deep-frying oil is full of omega-6 fatty acids.

Math to calculate retained omega-6 from deep-frying

You notice that many cooking oils are high in omega-6. Soybean oil has 50.42% omega-6 in it. If you cook French fries or chicken in it and the food retains only 1 teaspoon of oil in it, that’s 5000 mg times 50.42%, which is 2521 mg of omega-6 added just from deep-frying your food.

Balancing omega-6 and omega-3 fatty acids

Omega-6 fatty acids are essential fatty acids that are mainly used for energy. But the problem is that in our western diet too many omega-6 fatty acids are in our food. Omega-6 fatty acids can be converted into arachidonic acid, which causes inflammation. This in turn can cause heart attacks and strokes on the one hand and arthritis on the other hand. In the past a healthy ratio between omega-6 and omega-3 was 4:1 or less. The average American now eats food with 16-times the amount of omega-6 fatty acids than omega-3’s. This is an omega-6 to omega-3 ratio of 16:1.

KFC chicken breast example

In the example of a KFC chicken breast with skin 12,663 mg omega-6 fatty acids are consumed. To balance this with omega-3 fatty acids the person would have to consume 3166 mg omega-3 fatty acids. One serving of wild salmon provides 2000 mg of omega-3. I take 3600 mg of molecularly distilled fish oil every day as a supplement (2 capsules in the morning and 2 at night). Together with the wild salmon this is 5600 mg of omega-3. This would result in an omega-6 to omega-3 ratio of 2.26:1, which is considered to be well balanced. But generally people do not consume so much seafood and fish oil supplements to balance the omega-6 fatty acids with omega-3. It comes down to be selective with your food choices.

Prevention of Alzheimer’s disease (dementia)

Since the mid 1980’s dementia cases have reduced by an average of 25%.

This is because people have become more conscious of healthier eating habits and supplements. More people take lycopene, a carotenoid supplement that helps prevent heart disease. Whatever helps the heart also helps the brain. Omega-3 supplements and consumption of seafood, especially wild salmon, is also useful. If people will reduce their omega-6 to omega-3 ratio to 4:1 or less, which too can help prevent Alzheimer’s disease.

Study to show that omega-3 fatty acids preserve the brain in older age

The following study looked at brain structure using MRI scans. 3660 participants aged 65 received MRI brain scans. The researchers recorded their food intake with questionnaires. They rescanned 2313 of these individuals 5 years later. The group highest in omega-3 consumption was compared to the group with the lowest omega-3 consumption. Blood tests were also done both initially and 5 years later to verify the omega-3 intake. The researchers found that the higher omega-3 group had less subclinical infarcts and the white matter of the brain was of a better grade. They concluded that fish consumption, the major source of omega-3 fatty acids, had a beneficial effect on brain health later in life.

Omega-6 Fatty Acids Compromise Your Health

Omega-6 Fatty Acids Compromise Your Health

Conclusion

Omega-6 fatty acids are abundantly present in junk food, deep fries, processed foods and polyunsaturated oils like corn oil, sunflower oil, soybean oil, cottonseed oil and safflower oil. Because food processors like the long shelf life of processed food made with these oils, people’s intake of omega-6 fatty acids has been climbing. Now the omega-6 to omega-3 ratio regarding the average American food consumption is about 16:1. It should be 4:1 or less. It is important that you learn what contains omega-6 fatty acids and that you start cutting down. You do need a certain amount of omega-6 fatty acids for cell energy, but most people do not get enough marine based omega-3 fatty acids. Wild salmon and other seafood provides omega-3 fatty acids.

Balancing omega-6 with omega-3

I have shown using an example how you can balance omega-6 and omega-3. Having the right ratio of omega-6 to omega-3 will also help you prevent dementia down the road. Consuming more olive oil can prevent heart disease and dementia as well. This contains oleic acid (an omega-9 fatty acid), which lowers LDL cholesterol and raises HDL cholesterol.

Aug
17
2019

How Healthy Is Food From The Supermarket?

By | Cancer, Cardiovascular disease, cholesterol, Diabetes, fiber, food, heart attack, lifestyle, milk, Nutrition, Obesity, omega-3 fatty acids, organic food, Processed food, Stroke, sugar

I am asking the question here: “how healthy is food from the supermarket?” We tend to assume that food we buy at the supermarket would be safe to eat. Think again, because below I will explain why it is NOT safe.

The “dirty dozen”

You may or may not have heard about the “dirty dozen”. The Environmental Working Group (EWG) is a non-profit organization that monitors fruit and vegetables for insecticide residues. For 2019 they have determined these unhealthy dozen of fruit and vegetables: strawberries, spinach, kale, nectarines, apples, grapes, peaches, cherries, pears, tomatoes, celery, potatoes and peppers (hot and bell peppers). Yes, you counted right, this “dozen” actually consists of 13 items.

When I want to buy any of these fruit, I strictly get fruit and vegetables, which are organic. If this is not available in the regular supermarket, I go to the health food store and buy organic fruit and vegetables there. Local farmers’ markets also offer organically grown produce. Every year the EWG brings out an up-to-date list of the dirty dozen. If an item is not on this list, you can assume that it is safe to eat.

Sugar and too many starches are the next problem

How healthy is food from the supermarket? We said we wanted healthy food. Unfortunately ample consumption of sugar and starchy foods end up as belly fat and also as atheromatous deposits in the arteries. I do not eat bread unless it is 100% rye, but then only 1 or 2 slices occasionally. I do not eat potatoes, rice or pasta. Those who love pasta can eat the pasta-look-alike, called shirataki, which is made from the glucomannan root (also known as konjac root). The carbs here are bound to fiber, which digest a lot slower than regular pasta. So, this means that you are bypassing the section in the supermarket where they sell muffins, donuts etc.

Processed foods

In the center of the supermarket you find all kinds of processed foods. They are usually full of sugar, salt and unhealthy fats (hydrogenated fats). People who eat a lot of processed foods are more prone to get heart attacks, strokes and may even come down with cancer. It is not the kind of food that I want. Instead I like whole foods like organic apples, berries and raw or cooked vegetables.

Fish section

I like salmon, sole, cod, halibut, trout, mussels, shrimp and squid. But I am careful not to load up on the big predator fish like tuna. One has to be careful about methylmercury content in fish. I reviewed fish, mercury contamination and the benefits in this link.

As this link shows, there are low, medium and high methylmercury contaminated fish. The higher the fish is in the predator chain, the higher the methylmercury content. This is of particular concern for pregnant women as mercury is toxic for the fetal brain tissue. But they can consume low mercury fish and shellfish, like mackerel, herring, wild salmon, shrimps or clams. I figure, what’s good for women who are pregnant is good for other people. As a result, I limit my fish meals to the low methylmercury contaminated fish category.

How healthy is food from the supermarket – Meat section

Now your shopping trip becomes problematical. There has been news from the Word Health Organization at the end of 2015 that red meat and red meat products are class 1 carcinogens.

This would mean that you may come down with colorectal cancer, if you consume red meat and red meat products regularly. This is when I stopped eating red meat and red meat products like prosciutto. Unfortunately this warning includes pork, lamb and all sausages as well. In the meantime further research has shown that antibiotics that are fed to beef before they are slaughtered get into the meat and change the human bowel flora when red meat or red meat products are consumed.

Trimethylamine N-oxide (TMAO)

There is a change in bowel flora that causes chemical reactions in the gut with the consumption of beef and eggs. Beef contains carnitine, which can lead to the production of TMAO (trimethylamine N-oxide).

Egg yolk contains choline, which also raises TMAO levels in the blood.

In the following study 113 healthy men and women consumed either a meat diet (beef), white meat diet or protein from non-meat sources. After one month the beef group had triple the amount of TMAO in their blood compared to the other two diets.

Interestingly, when the diets were switched the TMAO levels normalized again in the former beefeaters, when consuming white meat or protein from non-meat sources.

What meat am I shopping for?

I recommend not to eat beef more often than once per week and to eat only grass-fed beef. I eat organic chicken and ground turkey breast meat from health food stores (the turkeys are NOT fed antibiotics). Otherwise I eat seafood, cheese from non-recombinant growth hormone milk. This means that I only buy European import cheese or Canadian cheese. In the US you have to ask for organic milk and organic milk products.

The deep frozen section

I look for deep frozen vegetables, fruit, and fish as well as meats. As vegetables are quickly readied for the freezer, their vitamin content can be higher than that of a vegetable that has spent 8 days in transit from the field to the produce department. The deep frozen section also gives you access to a lot of variety. You’ll be able to enjoy some organic strawberries, even when they are not in season. Read the labels, as some fruit have been packaged with sugar syrup. Look for the varieties, where no sugar has been added. The frozen section also contains some highly processed items: deep-fried foods and dessert selections, which have nothing to do with health, so I avoid them.

Canned foods

Canned foods can be useful, as long as you are dealing with fruit that are canned in their juices and not in sugar syrup. The vegetables are less valuable in vitamins than their deep frozen counterparts. Watch out for varieties, where less salt is added. The label will tell you ”low sodium”. Also pay attention to the cans. Those that are not lined with BPH have a label that emphasizes this. You can avoid this by buying canned food in glass jars, such as tomato sauce.

Cosmetics

You will not have to navigate all the aisles, except for your cleaning products and your cosmetics. These have their own problems: lots of cosmetics contain Parabens. Leave them on the shelf, and be aware that some cleaning products can be hazardous too. Pick environmentally friendly, non-toxic products!

Staples you need

There are some staples, which you will also require: olive oil, some olives, almonds or macadamia nuts (preferably raw). The one cereal product, which is valuable will be coarse rolled oats and some pot barley. Both varieties carry a lot of fibre, which makes them very useful food staples. Avoid the “quick cooking” or “instant” oats. Due to the processing, the carbohydrates are absorbed a lot faster and consequently trigger a higher insulin response.

Drinks

You will wonder about drinks next. Having passed the colas, ginger ales and other sugar pops you may eye the diet drinks. Beware of drinks sweetened with aspartame. There is increasing evidence that phenylalanine (brand names: Aspartame, NutraSweet and Sweet’N Low) is not a “harmless” sweetener. Newer research has shown that it can cause gastroesophageal reflux (=GERD) and migraine headaches. Stevia, a sweetener from a South American plant, does not have harmful effects. Stevia is safe to use, as it does not cause an insulin response. You are best served with mineral water, purified drinking water, herb teas, tea or coffee. Fruit juices do have vitamins and minerals, but they are high in sugar causing an insulin release.

What is in fruit juices?

You would not really eat 3 large apples in one sitting? Probably not! So why insist on drinking 8 oz. of apple juice? You’ll ingest all the sugar and forgo the fibre! You also notice that a lot of fruit juices have been mixed with sugar, water, artificial flavor, some color, and as an apology some vitamin C has been added. They are appearing on the shelves as “a good source of vitamin C”. In reality we are dealing with flavoured, colorful sugar water. Use your own judgement, whether you want to spend your dollars on this selection!

Power bars, snacks

In the aisle adjacent to the pop you will very likely encounter a huge selection of convenience and snack foods. They have several things in common: you have met them on TV, some will be high in starches and fat (chips), others will be high in starches, sugar, and fat (cookies, donuts, cream pastries), and we are dealing with trans fats. Do take time to read the listed ingredients, and then decide, whether you and those who eat in your household deserve nutritional garbage. 

How Healthy Is Food From The Supermarket?

How Healthy Is Food From The Supermarket?

Conclusion

We have now completed our round trip in the supermarket. You may still be in mild shock, noticing that “healthy” foods are not the general rule on the shelves. When we buy vegetables and fruit we have to be aware of the “dirty dozen”, which is contaminated with insecticides. We will not buy anything on that list, but buy instead the organic version. You may have to go to the health food store to get these items. Red meat and red meat products produce carcinogens in the human gut. It seems to stem from antibiotics that are used in beef farms and chicken farms. With chicken I buy organic chicken. With beef you need to be more careful and reduce the consumption to once per week and eat only grass-fed beef.

It is tricky to buy healthy food from the supermarket

Much of the bakery section is useless. It consists of empty starch that is digested into sugar and leads to an insulin response. I avoid the processed food section, which contains unhealthy ingredients. Fish is great as long as it does not have too much methylmercury in it. Deep frozen foods may be useful.

Shopping for healthy foods from the supermarket has become more complicated than it was in the past. I only select healthy items and supplement the rest from the health food store. This way I get what I need and avoid the pitfalls of merchandise, which is not beneficial.

Aug
10
2019

Fasting Mimicking Diet For 5 Days Every Month

By | Anti-aging medicine, autoimmune disease, Cancer, Cardiovascular disease, cholesterol, Diabetes, diet, fasting mimicking diet, food, heart attack, High Blood Pressure, Multiple sclerosis, Nutrition, Obesity, Pain, Prevention, stem cells, Stroke, telomeres

In December 2017 I heard Dr. Longo speak at a medical conference in Las Vegas. He suggested the use of the fasting mimicking diet for 5 days every month. I am getting into the age group where a little help from nature would not harm (I am 74 years old). I started immediately in December 2017 to do a fasting mimicking diet (FMD) for 5 days.

Effects of fasting mimicking diet

In the beginning you just notice that you are not as hungry as you thought you would be, because you do take in three mini meals of about 200 calories each, which curbs your appetite. It is also important to consume enough liquids. Please note: liquids! Not liquor! Wine, beer or any alcoholic drinks are not part of the diet. You can drink water, but, this may get boring, and you can take water with lemon, herbal teas, black tea and coffee, as long as you stay away from sugar-laced drinks.

How the FMD works

Your total calorie intake will amount to no more than 600 calories per day for the 5 days where you do the fasting mimicking diet. Your body mass index (BMI) decreases between 0.1 and 0.4 per day to a total of 0.5 to 0.9 for the 5 days. This does not seem much, but if it is accumulating every month, a person who is obese now could have a normal weight within one year. The first day of this fast may present some challenges. I found that in the afternoon I felt hungry. What helped was a hot drink( tea, coffee, clear broth). Day two was better, and from day three it has become a routine. There are  no ferocious hunger pangs, no headaches or feelings of weakness or tiredness. I am always surprised that my energy level is improving when I do the fasting mimicking diet for 5 days every month.Dr. Longo suggests not to exercise during the fast. It is obvious that this time is not suitable for half- marathons or taxing hikes, but I found that thirty minutes of aerobics and thirty minutes of weight training felt good. Listen to your body! If you feel lightheaded at any time, stop! The emphasis is on “moderate”.

Dr. Longo noticed the following findings in a mouse model as well as on humans. I summarized this before in a previous blog:

Specific results when on the fasting mimicking diet for 5 days every month

  • Obesity diminishes, because of the weight loss effect due to missing calories.
  • Diabetes: insulin resistance becomes lower and blood sugar levels drop.
  • High blood pressure reduced: many patients were able to reduce their medications or discontinue them
  • Pain conditions improve as all kinds of pain disappears, an effect for which there is no explanation at this point
  • Autoimmune diseases like MS and rheumatoid arthritis improve, likely because of the effect of increased stem cell circulation
  • Prevention of heart attacks and strokes because of reduction of LDL, triglycerides and CRP
  • Cancer cure rates improve by protecting normal cells, the bone marrow and stimulating the immune cells
  • Longevity improved in mice with a 3-fold increase of their life span. Telomere length in humans was increased. Increased stem cells will find defective areas that need repair. This effect leads to less disease in older age.

Meal samples of fasting mimicking diet

Dr. Longo developed a kit containing all pre-packaged foods for 5 days under the name “ProLon Fasting Mimicking Diet”. The package is not larger than a shoebox, and the diet is plant-based, has some nutrition bars, drinks as well as freeze-dried soups. You can argue about the nutritional value, as it has an average rating of 3.5 out of 5. It also comes in at a hefty price of 300.00 USD. In reality it is a matter of calorie-math to consume very little food. There are plenty of tables available on the Internet that tell you the nutritional value of foods, and it does not take much effort to compose your own menu.

Here is a fairly typical list of foods

Breakfast: A typical breakfast consists of 2 slices of rye crisp bread (Wasa or Ryvita) with a bit of almond butter on it, a cup of coffee and either black or with stevia and milk.

Lunch: 8 oz. of tomato soup and coffee or tea.

Dinner: A tossed salad with organic bell peppers, ½ tomato, and two thin slices of avocado, vinegar and 1 tablespoon of olive oil.

Here is an alternative meal sample:

Breakfast: Eat a nutrition bar that is based on nuts. It should not be more than 250 calories. Alternatively make your own! Have tea or coffee.

Lunch: 8 oz. of homemade vegetable soup without the addition of pasta or beans.

Dinner: Miso soup and 4 rice crackers, alternatively a small tossed salad with olive oil and vinegar.

Results of fasting mimicking diet for 5 days every month

Here are typical results that I found over several months. I am using body composition scales every day to measure my weight, body fat percentage, visceral fat percentage, muscle percentage, calories burnt and the BMI.

One month the BMI went from 21.9 to 21.1 during a 5-day FMD. Another month the BMI experienced a reduction from 21.7 to 21. 2. Here is a list of the some of the 5-day losses of my BMI on a couple of occasions: 0.8, 0.4, 0.9, 0.7, 0.6, 0.5, 0.7 and so on.

It is important that you are not going on an eating binge after those five days. The FMD conditioned your body to be content with very small amounts of food. Enjoy your food, but stick to moderate portions.

Discussion of fasting mimicking diet for 5 days every month

An intermittent fasting mimicking diet was shown to have a diversified positive health effect in both animal models and humans. For instance, inflammatory bowel disease improves on FMD by improving the bowel microbiota and by promoting the intestinal regeneration.

Intermittent fasting, as this article shows, can prevent age-associated diseases.

This article suggests that T-killer cells that attack cancers are promoted by the intermittent fasting mimicking diet.

A FMD in type 1 diabetic patients has been shown to restore insulin generation in islets of the pancreas of these patients. The result was an improvement of their type 1 diabetes.

More research data on fasting mimicking diet

A clinical trial with 100 subjects was undertaken by Dr. Longo and his research team. He measured markers after 3 cycles of a fasting mimicking diet for 5 days every month. They found that the FMD reduced aging markers, improved diabetes and reduced susceptibility for cancer and cardiovascular disease. In another publication Dr. Longo and co-authors describe how autoimmune diseases can be improved by the use the fasting mimicking diet for 5 days every month.

Another publication by Dr. Longo describes that “age-related disorders including diabetes, cardiovascular disease, cancers and neurological disorders such as Alzheimer’s disease, Parkinson’s disease and stroke” can be prevented by fasting mimicking diet for 5 days every month.

Even cancer prevention and cancer treatment can be helped by the fasting mimicking diet.  The FMD makes chemotherapy more tolerable.

Fasting Mimicking Diet For 5 Days Every Month

Fasting Mimicking Diet For 5 Days Every Month

Conclusion

I have shown that with the fasting mimicking diet (FMD) done for 5 days in every month you can lower your body mass index (BMI) by 0.4 to 0.9 units. On the long-term this helps you to keep your BMI stable and in the 21.0 to 22.0 range. Dr. Longo has researched the effect of the FMD in both mice and humans. He found that you age better with less age-related diseases. In addition, inflammatory bowel disease, autoimmune diseases like MS, rheumatoid arthritis and type-1 diabetes improve. Cancer patients who need chemotherapy tolerate it better. Their immune system also produces more killer T cells that destroy cancer cells. The FMD prevents heart attacks, strokes and cancer. Dr. Longo also has shown that there is stimulation of stem cell production and telomeres are increasing in length. Telomeres are important for longevity, which allows you to age healthier with less disease.