Nov
09
2024

Vital Information about Cholesterol Drugs

Most people know about statins to treat high cholesterol, but they do not have vital information about cholesterol drugs. Recently an article appeared in CNN, which was very informative. In the following I will review what is new about cholesterol lowering drugs.

PCSK9 inhibitors, which are monoclonal antibodies

Sarah Lewis is a pharmacist and medical writer with over 25 years of experience in various areas of pharmacy practice. She explained that there are injectable cholesterol lowering drugs for use when traditional statins are not powerful enough to lower cholesterol levels. But these injectable drugs are very expensive and payment agencies demand fulfillment of strict criteria before they approve these drugs. The new injectable drug, which the FDA approved in 2015 is an PCSK9 inhibitor. It has the name alirocumab (Praluent) and is a monoclonal antibody. PCSK9 is a natural liver protein that regulates how many LDL receptors you have. Alirocumab reduces LDL receptors, which lowers LDL cholesterol levels. Several months later the FDA approved a second PCSK9 inhibitor, evolocumab (brand name: Repatha).

Side effects of statins and PCSK9 inhibitors

Statins are the gold standard for treating high cholesterol. They work by inhibiting an enzyme that controls how much cholesterol your body makes. But many people have significant side-effects from statins.

There can be side effects in the form of muscle pain. But statins can also cause headaches or dizziness. Others are feeling sick from statins, get unusually tired or develop a physical weakness.

These people often must lower their dose. Alternatively, their doctor switches them to a different statin in order to carry on therapy. PCSK9 inhibitors have none of these side-effects. The main side effect of PCSK9 inhibitors are injection site reactions, flu-like symptoms, and allergic reactions. They can be severe. Overall, there is a better tolerability of PCSK9 inhibitors than with statins. Unfortunately, the cost is around $12,000 to $14,000 per year for PCSK9 inhibitor therapy, which is very difficult to justify. Another disadvantage is that the patient has to self-inject the PCSK9 inhibitor.

PCSK9 inhibitors are added in specific patients

Because of the costs of PCSK9 inhibitor statins are still the first line of therapy in patients with high cholesterol. But there are patients who have familial hypercholesterolemia, which is an inherited condition. The physician treats them first with statins such as atorvastatin (Lipitor) or rosuvastatin (Crestor). The physician pushes the dosage to the maximal dosage. Often in these cases of inherited high cholesterol the new PCSK9 inhibitor drugs have to be added as a second line of therapy.

Patients with hardening of the arteries and a history of a heart attack or a stroke need aggressive cholesterol lowering treatment. These patients require both PCSK9 inhibitors and statin therapy.

Rigid rules from insurance companies

Because of the expense of PCSK9 inhibitors insurance companies have established the following rules.

  • You have to have either familial hypercholesterolemia or a history of a heart attack or stroke.
  • You must see a dietician for comprehensive dietary counseling.
  • You are on the maximum dose of a statin or you can tolerate only a lower dose of a statin because of side effects.

Only when these criteria are fulfilled does the insurance company consider to authorize an addition of a PCSK9 inhibitor to the statin treatment.

Vital Information about Cholesterol Drugs

Vital Information about Cholesterol Drugs

Conclusion

Traditional statin therapy for high cholesterol levels is the gold standard for treating high cholesterol. Statins work by inhibiting an enzyme that controls how much cholesterol your body makes. Unfortunately, statins can have a number of side effects like muscle cramps and fatigue. A new type of cholesterol lowering drug was authorized by the FDA in 2015. This new drug has the name alirocumab (Praluent) and is a monoclonal antibody. PCSK9 is a natural liver protein that regulates how many LDL receptors you have. Alirocumab reduces LDL receptors, which lowers LDL cholesterol levels. It has much less side effects than the statins, but costs are around $12,000 to $14,000 per year, which is very difficult to justify.

How physicians prescribe the new drugs

The new PCSK9 inhibitor drugs are prescribed as an add-on to statin therapy to lower cholesterol. Physicians prescribe this to patients who have a familial hypercholesterolemia and to patients who had a heart attack or a stroke. One inconvenience of these new cholesterol lowering agents is that the patient has to inject it rather than take it as a tablet by mouth. Studies showed that PCSK9 inhibitors have a favorable cholesterol lowering effect. Alirocumab (Praluent) lowered cholesterol between 36 to 59%. The newer evolocumab (Repatha), lowered LDL by 60%. Both drugs showed a risk reduction of cardiovascular events by 50%, which helps long-term survival of patients with cardiovascular disease. PCSK9 inhibitor drugs are powerful cholesterol lowering agents. However, at the present time the cost of this treatment is too expensive.

Oct
12
2024

Cardiovascular Risk Markers Predict Heart Attacks and Strokes

An article in The New England Journal of Medicine stated that cardiovascular risk markers predict heart attacks and strokes. A summary of this study was also published by NBC News.

30-year follow-up of the Women’s Health Study

This is based on a 30-year follow-up study of the Women’s Health Study. In the beginning of the study all women had blood tests taken. In the beginning none of the women had cardiovascular disease.  The blood tests were LDL cholesterol, lipoprotein(a) and high-sensitivity C-reactive protein (CRP). When either of these markers was high at the beginning of the clinical trial, it turns out that 30 years later the person either was dead from cardiovascular disease or had a heart attack or stroke.

More details of the study

In the beginning of the study 27,939 initially healthy U.S. women had 3 of the mentioned blood tests taken. If only one of them was elevated, there was a risk in the next 30 years to get a myocardial infarction, coronary revascularization, stroke, or death from cardiovascular causes. The initial age of the patients was 54.7 years. During the next 30 years of follow-up 3662 cardiovascular events took place. Hazard ratios for the primary end point in a comparison of the top with the bottom quintile were calculated. The following hazard ratios were derived:

  • 70-fold for high-sensitivity CRP
  • 36 for LDL cholesterol
  • 33 for lipoprotein(a)

Each biomarker showed an independent contribution to the overall risk. The risk of developing cardiovascular disease was highest when all three biomarkers were elevated.

Traditional risk calculation

Cardiologists calculated risk for cardiovascular events by the traditional 10-year estimates of risk. The authors suggest that physicians should do screening blood tests with these three biomarkers. If any of the biomarkers is elevated, measures to reduce cardiovascular risk should be initiated. This will be very effective to prevent cardiovascular events for the next 30 years.

Be proactive, prevent heart disease

As we get older, many people develop elevations of high-sensitivity CRP, LDL cholesterol and lipoprotein (a). But don’t wait for this to happen. Here are 9 steps you  can follow to prevent it.

  • Maintain a healthy weight
  • Quit smoking
  • Choose good nutrition
  • Be physically active
  • Treat hypertension adequately
  • Manage diabetes, if you have it
  • Stress management
  • Limit alcohol intake
  • Get enough sleep

Comments to the steps you can take to prevent cardiovascular disease

The ideal body mass index is between 21.0 and 22.0. I found that the fasting mimicking diet helps me to stay in that BMI range. Good nutrition eliminates red meat and emphasizes vegetables and salads. Fish, lean chicken and turkey meat are healthy. Avoid all processed meats like sausages. Watch your calorie intake to keep your body mass index stable. In addition, avoid excessive salt and sugar intake. Avoid highly processed carbohydrates and processed food. Eliminate fried fast food, chips and baked goods from your diet as they contain trans fats. Trans fats cause hardening of the arteries.

Aim to get 30 to 60 minutes of daily activity. Do two or more strength training sessions a week. This raises the protective HDL cholesterol and prevents cardiovascular disease. Excessive alcohol intake leads to cardiovascular disease and high blood pressure. Limit your alcohol intake, if you find it hard to eliminate it altogether.

Cardiovascular Risk Markers Predict Heart Attacks and Strokes

Cardiovascular Risk Markers Predict Heart Attacks and Strokes

Conclusion

A unique 30-year follow-up study of the Women’s Health Study identified three risk factors that a doctor can be determin from a blood sample. They predict whether a person will develop cardiovascular disease 30 years down the road. The three risk factors are high-sensitivity CRP, LDL cholesterol and lipoprotein (a). The best approach to prevention of heart disease is to adopt the approach of the Mayo Clinic described above. It comes down to the basics of good nutrition, regular exercise, maintaining a healthy weight, limiting excessive alcohol intake and stress management.

Aug
17
2024

Exercise for healthy Aging and a young Brain

This article is about exercise for healthy aging and a young brain. A review article in Medical News Today states that several research papers showed that exercise greatly improves brain health, cognition and mood. It also reduces the risk of neurodegenerative diseases.

The benefits of regular exercise 

Here is a list of the beneficial effects of regular exercise:

  • Increased muscle strength
  • Improved heart health
  • Lower blood sugar
  • Improved mood
  • Alleviates stress
  • Improvement of cognitive function

Researchers from Stanford Medicine have examined in a rat model how exactly exercise influences various tissues. Unfortunately, such experiments in humans are not possible and results of rat experiments do not readily translate into the human context. In 8 weeks of regular exercise rats experienced stimulation of the immune system, a reduction of the stress response, an increase of energy production and stimulation of the metabolism. From indirect measurements we know that in humans the same findings likely also hold true. The mitochondria, the area in cells where energy production occurs, are stimulated in muscles, the heart, liver, kidneys, and white adipose tissue.

Effect of exercise on the immune system

Researchers showed in a mouse model that exercise stimulated the T cell response and rejuvenated aging microglia in the brain. The result is a strengthening of the immune system and rejuvenation of the supportive microglia. In the aging human regular exercise rejuvenates microglia in the hippocampus. This can prevent dementia and Alzheimer’s disease.

Exercise strengthens brain cell connections

How does exercise affect the functioning of the brain?

Ryan Glatt is a senior brain health coach and director of the FitBrain Program at Pacific Neuroscience Institute in Santa Monica. He said: “Exercise enhances synaptic plasticity and blood flow while reducing inflammation and increasing the expression of neurotrophic factors like Brain-derived neurotrophic factor (BDNF). These effects can synergistically improve memory, learning, and overall brain health.”

The best forms of exercise for brain health

Glatt said: “Activities combining physical and cognitive challenges, like dance or tai chi, can be especially effective for certain aspects of brain health.”

Brisk walking is a simple method of exercise. However, we also need isometric exercises, which helps muscle strength and endurance. A good way of combining the two forms of exercise is to regularly go to a gym. Use a treadmill for 30 minutes and then use 30 minutes of a workout with 10 weight machines. Mix this with tai chi or ballroom dancing several days per week. This keeps you mentally and physically fit.

Slow your biological age through the use of the “Essential 8”

Research identified 8 factors that determine how long you live. These 8 factors are what can lower your biological age by 6 years. Here are the 8 factors:

  • Diet

    A diet high in fruit, vegetables and lean meats helps you to lower your cholesterol level. In addition, avoid trans fats, fried foods and sugary foods. This helps you to lose weight and prevents Together with regular exercise eating a healthy diet prevents heart attacks and strokes.

  • Activity

    The American Heart Association recommends 150 minutes of moderate-intensity aerobic activity per week. Alternatively, 75 minutes of vigorous aerobic activity achieve the same thing. Examples of moderate aerobic activity are a brisk walk, jogging, biking, social dancing and water aerobics. Vigorous aerobic activity involves spinning, running, swimming laps or jumping rope. Exercise reduces blood pressure, blood sugar, and cholesterol. It also helps people to reduce weight.

  • Quit smoking

    Smoking cigarettes, vaping or using e-cigarettes causes your  body to develop higher blood pressure and damages your blood vessels because of circulating toxins. You also develop shortness of breath from narrowed airways. On the other hand, when people quit smoking, their risk of coronary heart disease drops to half after 1 year.   

  • Getting enough sleep

    People who don’t get enough sleep at night tend to have higher blood pressures, higher cholesterol and higher blood sugar values. This leads to weight increase and obesity. Sleeping at night for 7 to 9 hours improves cardiovascular health.

  • Body mass index (BMI) 

    An elevation of your body weight occurs when you eat the wrong foods and combine this with a sedentary lifestyle. Increased weight causes heart and joint problems as well as diabetes. Eating the right foods and exercising regularly gets your BMI into the normal range. This reduces your biological age.

  • Cholesterol

    An increase of cholesterol can cause heart attacks and strokes. But when you watch your fat and cholesterol intake you can reduce your cholesterol level. Make healthier choices with foods like reducing saturated fats, reducing refined carbohydrate intake, eating more vegetables and leaner meats. This reduces inflammation in the arteries and plaque deposits with much lower risks of heart attacks and strokes.

  • Blood sugar

    Increased blood sugars lead to diabetes. In this case there is accelerated hardening of the arteries in the heart, brain, eyes, and kidneys. This leads to premature heart attacks and strokes. People need to avoid eating refined sugars, carbohydrates (bread, pasta, rice) and sugary drinks. This normalizes blood sugars and your biological age reduces. Regular exercise is also important to burn off any excess sugar in the system.

  • High blood pressure

    An elevated blood pressure strains the arteries and the heart. If you don’t pay attention to this you are at a high risk of getting heart failure, a heart attack or a stroke. Sticking to a heart healthy diet, avoiding salty foods, and exercising regularly allows you to lower your blood pressure and avoid the above mentioned complications. If these measures alone do not reduce your blood pressure to normal, ask your doctor to prescribe blood pressure lowering medications for you.

  • Bioidentical hormone replacement

    What was not contained in the 8 factors was bioidentical hormone replacement. As you can see from the illustration, testosterone in males reduces more slowly in males (with a delay of 10 years) in comparison to estrogen reduction in menopausal women. Several authors describe that men and women in andropause and menopause live longer when bioidentical hormones are administered compared to those that do not use hormone replacement therapy.

Exercise for healthy Aging and a young Brain

Exercise for healthy Aging and a young Brain

Conclusion

Regular exercise even in older age keeps your brain free from dementia or Alzheimer’s disease. But in addition to this other research showed that 7 more factors are important to reduce your biological age. They are a healthy diet, quitting smoking, getting enough sleep and reducing your body mass index. In addition, you need to keep your cholesterol and blood sugar levels normal. Control high blood pressure with a healthy diet, refrain from salty foods and if necessary, treat it with medication.

Life’s essential 8 factors

It is important to simultaneously control all these “Life’s essential 8” factors for optimal control. People who do this were found to consistently have a lower biological age than others who do not. They also tend to not get Alzheimer’s disease whereas controls do. Lifestyle factors matter for healthy aging and a young brain. Studies showed that the biological age of those who take care of their lifestyles is on average 6 years younger than that of controls. You can reduce your biological age even further with bioidentical hormone replacement in andropause and menopause.

Jun
10
2024

About Aging and a Prolonged Life

The topic “about aging and a prolonged life” is always popular with people. CNN recently discussed this topic with the Nobel prize winner and molecular biologist, Professor Venki Ramakrishnan. He shared the 2009 Nobel Prize in Chemistry with Thomas A. Steitz and Ada Yonath for research on the structure and function of ribosomes. Ribosomes are sub particles in the cell responsible for making proteins. In the following I will summarize this interview.

What is aging?

150 years ago, people lived only about to 40 years. Today we can live up to 84 years in most countries. It is because medicine has learnt a lot about the reasons why diseases occur and how they can be cured. Physicians have a number of antibiotics available for those who suffer infections. Heart bypass surgeries and stents can prolong a person’s life when there is hardening of the coronary arteries.

Aging processes

The following aging processes occur all our lives:

  • DNA breaks happen in our cells, but repair mechanisms are in place that deal with this. With older age repair mechanisms are more sluggish.
  • Faulty proteins form inside cells, however, we have mechanisms to take care of that.
  • Chemical damage to molecules in our cells accumulates. The cells can only partially eliminate these.
  • Hormone disbalances occur during menopause and andropause. But anti-aging physicians can correct this by doing hormone tests and ordering bioidentical hormone supplements.
  • There are limits of what anti-aging medicine can do: osteoarthritis affects our joints; our muscles are aging and with it our heart muscle. Degenerative neurological diseases like multiple sclerosis, Parkinson’s disease and dementia occur frequently as we get older with no effective therapies.
  • The immune system weakens with age. To a certain extend vitamin D3 and other supplements can strengthen it, but only to a certain extent.

Systems working together in our body

Dr. Ramakrishnan said that our bodies work like cities. In it are various systems that need to work together to keep us alive. If a major system fails, we die. Some of the essential organ systems are the heart, the brain, kidneys, our gut, the lungs, the bone marrow and all our hormone glands. If one of these organs breaks down, we are in trouble. If an organ donor is not available, we perish. But even when everything is working together well, we are limited reaching a maximal lifespan of about 120 years. This has to do with limits of our cell metabolism and the aging processes mentioned above. Science has not found a way to prolong our maximal lifespan and likely will not find one soon. But there are various lifestyles that can prolong life as I mentioned here before.

Genetic effect on our lifespan

CNN asked Dr. Ramakrishnan what genetic effects there are that would transmit longevity from a parent who lived until 95 or older to a child’s lifespan. He answered the following:There is a correlation between the ages of parents and their children, but it’s not perfect. A study of 2,700 Danish twins showed that heritability — how much of our longevity is due to our genes — only accounted for about 25% of lifespan. Still, researchers have found that mutation in just a single gene can double the lifespan of a certain type of worm. Clearly there’s a genetic component, but the effects and implications are complex.”

Relationship between cancer and aging

The same genes are involved for the growth of the body at a young age, and the older person who comes down with cancer. In old age the same genes can cause cancer and dementia. Dr. Ramakrishnan said: “Our risk of cancer increases with age because we accumulate defects in our DNA and genome, which sometimes cause gene malfunctions that lead to cancer. But many of our cellular repair systems that seem to be designed to avoid cancer early in life also cause aging later.”

Apoptosis (programmed cell death) and senescent cells

The body has two mechanisms in place that counter the danger of developing cancer cells. Dr. Ramakrishnan explained: “For example, cells can sense breaks in our DNA that might allow chromosomes to join in an abnormal way, which could lead to cancer. To prevent that joining, a cell will either kill itself or enter a state called senescence, where it can no longer divide. From the perspective of an organism like us, which has trillions of cells, this makes sense. Even if millions of cells are destroyed this way, these actions protect the whole organism. But the buildup of senescent cells is one of the ways we age.”

Lifestyle changes that help you live longer

Dr. Ramakrishnan said that our grandmothers knew what a healthy lifestyle was. The following is a list of what science now confirms adds years to your life:

  • Don’t be gluttonous. Eating a variety of healthy foods in moderation can prevent the health risks of obesity.
  • Get exercise: this helps us regenerate new mitochondria, which are the powerhouses of our cells providing energy.
  • Avoid stress, which creates hormonal effects that change our metabolism and can accelerate aging.
More life prolonging points:
  • Get enough sleep. This allows our bodies to do molecular-level repair.
  • One of the newer findings is Dr. Longo’s fasting mimicking diet. Do a semi-fast once a month for 5 days with 500 to 600 calories per day. This helps you to shed 0.5 to 0.7 units of body mass index. It also stimulates your immune cells, your stem cells and elongates your telomeres. Long telomeres make you live longer.
  • Replacing missing hormones with the help of an anti-aging physician will add about 10 years to your life. I mentioned this earlier.

A few more points about longevity research

Dr. Ramakrishnan said: “Already the top 10% of income earners in both the US and the UK live more than a decade longer than the bottom 10%. If you look at health span — the number of years of healthy life — that disparity is even greater. Poorer people are living shorter, less healthy lives.” He said further about the concept of “immortality”: “I think this quest for immortality is a mirage. One hundred and fifty years ago, you could expect to live until about 40. Today, life expectancy is about 80, which, as author Steven Johnson has said, is almost like adding a whole extra life. But we’re still obsessed about dying. I think if we lived to be 150, we’d be fretting about why we’re not living to 200 or 300. It’s never-ending.”

About Aging and a Prolonged Life

About Aging and a Prolonged Life

Conclusion

CNN discussed the quest for longevity with Nobel prize winning Dr. Ramakrishnan. He pointed out that the aging process is due to a number of factors that work together. There are DNA breaks, faulty proteins, chemical damage to molecules, hormone disbalances and degenerative changes. We need to watch that we do not overeat, get regular exercise and eat a variety of healthy foods. In addition, we need to avoid stress, get enough sleep and replace missing hormones with bioidentical hormones. A newer boost to your health is the fasting-mimicking diet (FMD) from Dr. Valter Longo that helps you keep your weight in the lower body mass index range. Dr. Longo showed in animal experiments and with humans that the FMD elongates telomeres, which directly prolongs life.

Apply what helps your longevity

While it is far-fetched to believe that we now have a ticket to live for 120 years or longer, it is more important to know that we can do our part to spend our golden years in health and wellness.

May
13
2024

Reduction of Alcohol Intake Is Associated with Less Heart Attacks and Strokes

Recently Korean researchers showed that a reduction of alcohol intake is associated with less heart attacks and strokes. This was published on March 28, 2024. The researchers followed 21,011 participants who were heavy drinkers. The baseline examination took place 2005-2008 and a follow-up exam was between 2009 and 2012. Definition of heavy drinking was as follows:

  • For men: 4 drinks (56 g) per day or more than 14 drinks (196 g) per week.
  • For females: more than 3 drinks (42 g) per day or more than 7 drinks (98 g) per week.

Reduced alcohol intake resulted in a 23% reduced risk of heart attacks or strokes, which was a significant finding. Patients benefited most from alcohol reduction regarding angina and ischemic strokes. This study was also reviewed in Medscape:

Other studies showing benefits of less alcohol intake

A 2018 study in Plos Medicine examined a US population of 99,654 adults (68.7% female).

At the time of the enrolment, they were 55–74 years old. The overall time of follow-up was 8.9 years. Scientists looked at the various risks of cancer development or deaths from cardiovascular disease as a function of the amount of average alcoholic drinks consumed. The results were as follows:

  • Never drinkers: 1.09-fold risk of cancer or death.
  • Infrequent drinkers: 1.08-fold risk of cancer or death.
  • Heavy drinkers: 1.10-fold risk of cancer or death.
  • Very heavy drinkers: 1.21-fold risk of cancer or death.

Heart attack risk and cancer risk from alcohol consumption are different

In addition, with respect to cardiovascular risk it followed a J-curve. This means that light alcohol use reduced the probability of death from a heart attack or stroke, but with moderate or heavy alcohol use the risk of death increased. In contrast, with respect to cancer there was a linear curve, which means that no dose of alcohol was safe for cancer development. The more alcohol you consumed, the higher the risk of cancer development was. Another study also showed that only moderate alcohol consumption benefited people in preventing heart attacks and strokes.

Chinese study

In 2021 a joint US/Chinese study examined the effects of alcohol consumption on cancer, deaths from cardiovascular disease and mortality in general. 83,732 adult Chinese participants were free of cardiovascular disease (CVD) and cancer in the beginning of the study. The researchers categorized participants based on self-reported alcohol consumption into 6 groups.

  1. 0 g alcohol/week (non-drinkers).
  2. 1-25 g alcohol/week.
  3. 26-150 g alcohol/week.
  4. 151-350 g alcohol/week.
  5. 351-750 g alcohol/week.
  6.  > 750 g alcohol/wk.

Results of the US/Chinese study

After 10 years of follow-up there were 6411 cases of CVD, 2947 cancers and 6646 deaths. After 10 years of observation researchers calculated the risk for cancer, CVD and mortality as follows. The risk groups are the same as mentioned above.

The lowest risk was group 2 with 1-25 g alcohol per week, which was set as 1.0. In comparison to these non-drinkers had a risk of 1.38-fold.

  1.     1.38-fold risk
  2.     1.0
  3.     1.15-fold
  4.     1.22-fold
  5.     1.33-fold
  6.     1.57-fold

The peculiar finding in this study was that non-drinkers had a risk of developing cancer, heart attacks or strokes like heavier drinkers. The risk curve has the name of a J-curve, which means the risk goes first down (like group 2, the 1-25 g alcohol/week group). Subsequently the risk curve goes up in a linear fashion. When people smoke and drink the risk is higher than the risks of people who only drink alcohol.

Reduction of Alcohol Intake Is Associated with Less Heart Attacks and Strokes

Reduction of Alcohol Intake Is Associated with Less Heart Attacks and Strokes

Conclusion

The fact that alcohol is a cell poison has been public knowledge for some time. I reviewed three studies that showed that less alcohol consumption saves lives. It does so by causing less cancer, heart attacks and strokes. The peculiar finding was that the group consuming 1-25 g alcohol/week had the best health statistic. This group had the lowest risk of causing cancers or cardiovascular disease (CVD). In comparison non-drinkers had a 1.38-fold risk to cause cancer or CVD. Those participants who were smoking as well had risks much higher than people consuming alcohol alone. If you want to live longer and stay healthy don’t smoke and drink not more than 1-25 g alcohol/week. This translates into 1.6 to 1.8 alcoholic drinks per week.

Apr
13
2024

Eating the right Food Determines your Health

CNN had an interview with Dr. Leana Wen about the fact that eating the right food determines your health. Dr. Wen is a wellness expert, an emergency physician and adjunct associate professor at George Washington University.

How much does the quality of food we eat influence our health?

There are detailed studies that showed the following effects of healthy food on our lives.

  • If you eat a diet consisting of more vegetables, fruits, whole grains and nuts, the following will happen. You could exceed the age of controls eating unhealthy food by 10 to 13 years.

Specifically, a woman starting such a diet at age 20 would add 10 years to her life, when starting at age 60 she could add 8 years to her life. For men starting this diet at age 20 would allow him to gain 13 years, when starting at age 60 he would add 9 years to his life.

Additional healthy food studies

  • A 2023 Nature study found that men can add 10.8 years, women 10.4 years by switching their diets. This switch was from unhealthy diets to a longevity diet with more whole grains. In addition, the healthy diet contained more nuts and fruits and less sugar-sweetened beverages and processed meats.
  • Another 2023 study from the Jama network followed over 100,000 people for more than 30 years. There was an association between adopting healthy eating patterns and a reduction in early mortality. People on a healthy diet reduced their risk of early death by 20%! The study also noticed that people who ate more whole grains, fruits, vegetables, nuts and legumes had fewer other diseases. They were less likely to die from cancer, cardiovascular illness and respiratory and neurodegenerative disease. These were important findings. 

What kinds of food make you live longer?

Dr. Wen stated clearly that it is only minimally processed, whole food that allows a person to live longer. The highly processed foods like processed meats, sausages, cakes and cookies are a “no go”. They are the ones that cost lives from heart attacks, strokes and cancer. On the other hand, leafy green vegetables, fresh fruits and whole grains associate with significantly reduced mortality. Fish contains omega-3 fatty acids, which reduce heart disease and dementia. It is also a good source of protein. So, stay away from hot dogs and chicken nuggets, instead enjoy salmon fillet or roasted chicken.

Foods that you need less of

Avoid sugar sweetened sodas and energy drinks, as they elevate cholesterol levels and cause heart attacks. Next, stay away from ultra-processed foods like chips and candies. In one study with more than 11,000 participants people who ate a lot of ultra-processed foods had a 31% higher risk of mortality.

With what do you replace junk food?

Here are a couple of examples. Somebody who used to drink a lot of sodas can replace them with water, sparkling water, flavored water or lemon juice, sweetened with stevia. Instead of snacking on ultraprocessed foods like chips, candies or pretzels eat nuts instead. Look at the list of ingredients before you buy anything in the grocery store. If there is a long list of ingredients including chemicals, this is ultraprocessed food. Replace it with minimally processed foods with only a few items on the ingredient list.

Other advice for health and longevity

  1. If possible, eat three meals a day (breakfast, lunch and dinner). Stop eating 2 hours before bedtime to allow your guts to digest the food you previously ate. This avoids heart burn and interference with your sleep.
  2. Exercise regularly. Studies showed that 150 minutes of vigorous exercise per week reduced mortality by 23%.
  3. Take care of stress in your life. Cherish your social life and socialize; it is important for longevity. See your doctor regularly to take care of any medical problems you may have.
  4. Watch your sleep habits. Many studies have shown that adults need 7 to 8 hours of sleep. Sleep restores your hormone glands, gets them ready for the next day, but it is also important for longevity.
  5. Keep your body mass index (BMI) between 21.0 and 24.0. Personally, I keep my BMI between 21.0 and 22.0. Any extra pounds of fat merely lead to elevated cholesterol and triglycerides. Eventually this leads to heart attacks and strokes, but also to diabetes.
Eating the right Food Determines your Health

Eating the right Food Determines your Health

Conclusion

A recent article in CNN described that eating the right food determines your health. One study said that you should eat a diet consisting of more vegetables, fruits, whole grains and nuts. Doing this increases your life expectation by 10 to 13 years compared to controls who ate unhealthy food. It is only minimally processed, whole food that allows a person to live longer. You must eliminate ultraprocessed food. This means you should not consume sausages, fries, chips, pretzels and other overprocessed foods. Instead, eat leafy green vegetables, fresh fruits and whole grains that associate with significantly reduced mortality. Yes, eating the right food determines your health.

Mar
02
2024

Living with the Aging Process

The following article describes living with the aging process. Older adults undergo the process of aging between the ages of 50 and 80. This is a complex process affecting various systems parallel. There are hormone factors that are particularly prominent in women during menopause. Joints are affected by degenerative changes, which can lead to total knee and hip replacements. The aging process was described in an article by Monica Jimenez at Tufts University.

What is aging?

Aging is the loss of function over time. The body is much more complex than a car, so there are more possible points of failure.  Christopher Wiley is a scientist on the Basic Biology of Aging Team who studies the role of nutrition and metabolism in aging at a cellular level at Tufts University. He said:” The fact that life works is amazing”. He went on to say: “The body tries to maintain itself and restore homeostasis(self-healing) even in the face of all this stress and all this damage. We have these really sophisticated programs for dealing with these points of failure.”

Aging goes on relentlessly

He explains the aging process this way: “It can start with something as simple as a broken molecule, one little thing that goes wrong in one cell, and then it’s like the butterfly effect,” Wiley said. “The tissue starts struggling, and then the organ, and then your entire body.”

Dr. Wiley warns about those who say physicians could make people “immortal”. “There’s definitely a misconception out there that we’re trying to make people immortal. But there is never going to be an immortality vaccine,” Wiley said. “There’s never going to be one thing that defeats all of aging. There’s always going to be another point of failure.”

Slowing down biological aging

The emphasis of research about aging is not to add chronological years. It is on biological aging and on how well our cells and tissues are functioning. Dr. Sarah Booth is the director of the Human Nutrition Research Center on Aging (HNRCA) at Tufts. She said: “Lengthening the time in which we can continue to move around, care for ourselves, and participate in social life and activities, is a worthier goal than extending years of suffering.” Many people become disabled in their last years of life, then they die. “Healthspan” is a new term for our years of freedom from disability, Booth noted.

Factors that prolong healthy aging

  1. Telomere length: One of the factors of longevity is our telomere length. Telomeres are the protective caps at the end of each chromosome. When they wear down, it leads to mistakes in the DNA copies of genetic information. There are supplements and herbs that can elongate telomeres. Exercise and the fasting mimicking diet also make telomeres longer. Older adults in good shape have longer telomeres, which stabilizes the DNA in their cells.
  2. Healthy diet: Researchers have determined that several diets are healthier than others. The Mediterranean diet is anti-inflammatory, so is the DASH diet, which was developed for people with high blood pressure. The HNRCA of Tufts is one of six organizations that got research grants recently to investigate life-prolonging diets. The amount was for $8.5 million.

Exercise and lifestyle factors

  1. Regular exercise: Over the years a lot of research accumulated data that shows regular exercise makes people biologically younger. Heart vessels have less atheromatous deposits and the brain stays younger as well. One study reported that 30 minutes of exercise daily prevents dementia.
  2. Other lifestyle factors: other factors are whether or not you are smoking (it goes without saying that you must quit). In addition, genetics (longevity gene), the environment (polluted or not), stress levels and socioeconomic class all play a factor in how fast we age. These latter points are difficult to tease apart, but they influence us globally. Target organs for aging are: the brain, heart, eyes, and bones, along with cancer, obesity, and more.

Hormone replacement 

  1. Bioidentical hormone replacement: One factor about delaying aging significantly was not mentioned in the review article by Monica Jimenez. But I am including it, because bioidentical hormone replacement is important for women who undergo menopause in their 50’s. I also mention it because men enter andropause in their 60’s. BiEst estrogen and progesterone cream make a big difference for the symptoms of menopausal women. Similarly, men experience a lot of relief with testosterone injections twice a week, when blood testosterone levels are low. If they have a lack of erections (erectile dysfunction) they may in addition need to take the “happy pill”. Sildenafil or tadalafil can treat erectile dysfunction by giving a good erection to a menopausal male. Hormone replacement can add as much as 10 healthy years to your life.

Discussion

Dr. Booth said: “We’re looking at the same question through different lenses with different tools, technologies, and perspectives. Progress in aging research is only going to be achieved by bringing together different disciplines addressing the same problem.”

Christopher Wiley added: “The biggest change I’ve seen in the past ten years is that we really are finding new, different ways of actually intervening somewhere that could potentially extend the healthy years of life, and prevent people from getting age-related diseases.” He mentioned that scientists are gradually reducing the suffering associated with aging: “What aging research is really trying to do is compress the morbidity and make it as small as possible – to alleviate suffering,” Wiley said. “I think that’s a much more humanitarian goal, and I think we’re having a lot of success with those efforts.”

Living with the Aging Process

Living with the Aging Process

Conclusion

Aging is a slow process that starts the moment we are born. But between the age of 50 and 80 we age faster. I mentioned 5 specific areas that can slow down the aging process. If somebody smokes, he/she must stop smoking. Cigarette and tobacco smoking  the biggest aging factor. The protective caps at the end of each chromosome go by the name of telomeres. When they shorten prematurely, mistakes occur in the DNA copies of genetic information. This leads to premature aging.

What keeps you younger for longer

The good news is that exercise, the fasting mimicking diet and several supplements can elongate telomeres. A healthy diet like the Mediterranean diet and regular exercise keeps the arteries open preventing heart attacks and strokes. Bioidentical hormone replacement helps to rebalance your hormones, which is important for normal cell function. In anti-aging circles they talk about life prolongation of about 10 years for hormone replacement alone. It comes down to not simply extend your lifespan, but to extend your years of healthy living without disability.

Jan
07
2024

Backup your New Year’s Resolutions by looking at short-term Consequences

In the New Year it pays to backup your New Year’s resolutions by looking at short-term consequences. An article in “the conversation” explains how you can keep yourself motivated to stick to healthy habits. The alternative would be to fall back into unhealthy habits, which lead to various disease conditions. Traditional thinking centered around keeping long-term outlooks in front of your mind when tempted by the smell of doughnuts. In these cases, you think that the long-term consequences of eating doughnuts or consuming sugary drinks result in diabetes and obesity. But the smell or taste of unhealthy foods can be so overpowering that the long-term consequences of potential diseases is forgotten. This is the point when your New Years resolution may fade away in favor of falling back to unhealthy eating habits.

Think short-term to resist temptation

The new approach is to replace the thinking of long-term outlooks by short-term outlooks. The authors cited an example of 4000 participants in 7 separate studies. When the short-term consequences of anxiety and a sugar and caffeine crash were explained for caffeine containing sugary drinks, 25% of participants were able to abstain from the energy drinks in comparison to those who were informed about long-term consequences.

Another experiment

A similar experiment involved the consumption of sugar in the form of cookies. One group of participants read about the short-term effects of eating sugar. A second group read about the long-term effects of eating sugar. A third group did not get any information about the effect of sugar. There was also a “reward system” for all the participants: they had to decide between receiving a tote bag or eating cookies. Those who had read about the short-term effects of sugar were 30% less likely to choose cookies than the ones who read about the long-term effects. The ones who read the short-term effects were 45% less likely to choose the cookies than the ones who read nothing about the effects of sugar.

Verbalizing short-term consequences

Here are some thoughts that help to verbalize short-term consequences:

  • For alcohol: excessive drinking can lead to poor sleep and hangovers.
  • Fast food can make you feel bloated or give you indigestion.
  • Sugar and starchy meals: make you bloated and give you an acidy stomach, also will lead to rapid weight gain.
  • Focus on the good taste of apples and carrots. People will eat more of it and get the health benefits without mentioning it.

You can keep your goals easier when you combine them with small rewards here and there. When you have achieved one thing, you could watch your favorite TV show. Another reward could be a brief visit to the gym that makes you feel more fit. Or go and buy yourself a new pair of shorts for the gym. The authors of this article provide evidence from studies that showed that several mini rewards distributed throughout the day are more effective than big rewards at the end of the day.

Measurements of weight fluctuations

I found that body composition scales are very useful to monitor your diet intake. Here is an example how I use this device. My weights, fat% and body mass index for a number of days is listed below. The first line shows the baseline measured in the morning. On Saturday lunchtime I was invited to a Christmas family dinner. I ate more than I should have had. You can see the results on the Sunday readings: weight up, fat up and BMI up. I watched my calorie intake throughout Sunday.

Weekday              Weight (KG)                 Fat %        Body mass index

Saturday:                   63.6                           13.2                  21.7

Sunday:                     64.0                           14.2                  21.9

Monday:                    63.4                           14.3                  21.7

It took another two days (Wednesday) before the fat percentage was down to 12.9.

There is another powerful tool, Dr. Valter Longo’s fasting mimicking diet. I reported about this under this link. Briefly, once a month I eat only 500 to 600 calories daily for 5 days. This helps me to lose my body mass index from 21.8 down to 21.1 or 21.2. After that I can eat a normal diet until the next month when I do the fasting mimicking diet again. It is an easy way to keep my body mass index in the 21.0 to 22.0 range. My wife and I prepare our own 500 to 600 calorie diet with natural food.(No, you do not get much, but it can taste good!) We do not buy Dr. Longo’s expensive diet boxes.

Backup your New Year’s Resolutions by looking at short-term Consequences

Backup your New Year’s Resolutions by looking at short-term Consequences

Conclusion

Focusing on short-term goals and consequences increases the percentage of success for those who have New Year’s resolutions. You can use this for many different approaches: eating less sugar, losing weight, getting regular exercise, reducing your alcohol intake, cutting out fast food and increasing your healthy vegetable and fruit intake. I also added a description of what I do with the help of body composition scales to control my weight and body mass index. I also use Dr. Longo’s fasting mimicking diet once per month for 5-days. Since December 2017 (for 6 years) I practiced this. I find it extremely useful to maintain my body mass index in the 21.0 to 22.0 range. Medicine knows that it is important to keep your body mass index below 25.0. This will prevent heart disease, type 2 diabetes and cancer. It also helps to look forward to a healthy New Year.

Dec
23
2023

Any Form of Exercise is good

Here are a few items that can prolong life; among them any form of exercise is good. This article concentrates on the exercise part in relation to longevity. A recent publication described how regular exercise prolongs your long-term survival. According to a study released on occasion of the American Heart Association’s Scientific Session 2023 there are 8 major factors that prolong life: healthy diet, physical activity, nicotine exposure, sleep health, BMI, cholesterol, blood sugar, and blood pressure.  Among this group of factors regular physical activity plays a major role to prolong your life. Researcher who studied various people found that those who neglected their physical health had a chronological age of 53, but their average biological age was 57. On the other hand, a group of fit people who engaged in regular physical exercise had a chronological age of 41 years, but a biological age of 36.

Clinical trials showing that any form of exercise is good

JAMA Internal Medicine study by Dr. del Pozo Cruz 

This study examined what the optimal amount of physical activity per week is to reduce mortality compared to an inactive population. 500,705 eligible US adults were observed for about 10 years. The abbreviations that the authors used in the study were as follows:

MPA: moderate aerobic physical activity

VPA: vigorous aerobic physical activity

MSA: muscle-strengthening activity

Results of mortality reduction with various amounts of physical activity

  • The best group engaged in more than 0 to 75 minutes of MPA combined with more than 150 minutes of VPA and 2 or more MSA sessions per week. Their mortality rate was 50% lower than an inactive comparison group.
  • The optimal combination for reduction of cardiovascular disease (CVD) and cancer mortality risk was as follows: more than 150 to 225 minutes of MPA, more than 0 to 75 minutes of VPA, and 2 or more MSA sessions per week. This reduced combined mortality of CVD and cancer by 70%.
  • The researchers stated that the adjusted mortality rates represented 50% lower mortality rate for all-cause and cancer mortality. The mortality rate for CVD mortality was 3-fold lower than for inactive controls.

Smallest amount of exercise that reduces mortality

In a study published in the European Heart Journal the authors asked how little exercise per week was enough to reduce mortality from heart disease. They found that it takes at least 15–20 min/week of vigorous physical activity (VPA) to reduce mortality from heart attacks by 16–40%. If you increased the exercise level by 50–57 min/week the mortality rates reduced even further.

Are physically active jobs healthy?

Recent research showed that people who work in physically demanding jobs are more likely to develop early cognitive impairment. This is the pre-stage of Alzheimer’s disease. 15.5 % of people who worked in high levels of occupational physical activity developed dementia. This compared to 9% risk for people whose work involved a low level of physical activity, not too much and not too little. The finding confirms the notion that there is a need for balance of physical exercise. Several publications stressed what is optimal in terms of exercise: vigorous (75 to 300 minutes per week) and moderate physical activity (150 to 600 minutes per week). People who expose themselves to these amounts of exercise live the longest and stay healthy.

Discussion

The studies discussed here showed that the right amount of exercise can reduce mortality from heart disease and cancer. However, exercise is not the only factor that can do this. It is important to combine regular exercise with a healthy diet. Your diet should consist of fruits and vegetables, whole grains, low-fat dairy products, lean proteins and limit saturated and trans-fat, added sugars, and sodium. In addition, you need enough sleep, maintain a healthy weight, manage your stress, and don’t smoke.

Any Form of Exercise is good

Any Form of Exercise is good

Conclusion

In this review I touched on the importance of regular exercise to reduce mortality from heart disease and cancer. Vigorous (75 to 300 minutes per week) and moderate physical activity (150 to 600 minutes per week) reduce mortality from heart attacks by 16% to 40%. But physical exercise is only one factor of mortality reduction. If you want the full benefit from other factors, you must quit smoking, eat a Mediterranean type diet with fruits and vegetables, whole grains, low-fat dairy products and lean proteins. Also you should limit saturated and trans-fat, added sugars, and sodium. In addition, you need enough sleep, maintain a healthy weight and manage your stress. Once you adopted this lifestyle, you live longer and you will get less diseases.

Oct
23
2023

News from the Blue Zones Regarding Longevity

This article is about news from the Blue Zones regarding longevity. Blue Zones are areas where many centenarians live. Medical News Today ran a review article about Blue Zones on Sept. 23, 2023. These Blue Zones are located in Sardinia, Italy; Ikaria, Greece; Nicoya, Costa Rica; Loma Linda, California and Okinawa, Japan. Many studies looked at centenarians in these areas and analyzed what lifestyles led to their longevity. Dan Buettner summarized at a conference that only 20% of deaths in the world are due to genetic conditions. 80% of people can postpone their death date by adopting healthy lifestyles.

Factors associated with longevity

Dan Buettner called the factors that lead to prolonged life “Power 9”. The following factors must be adopted simultaneously, if you want to reach 100 years of age and more:

  • Moving naturally and regularly
  • People in Blue Zones have a purpose in life
  • Reduce stress in your life
  • Practice the 80% diet rule, which is to stop eating when 80% full
  • Adopt a plant-based diet.
  • Consume alcohol in moderation
  • Be part of a community
  • Put family first
  • keep a social circle that supports healthy behaviors

A diet for longevity

Dan Buettner analyzed the dietary habits of centenarians. He found that 90% of the diet they consumed consisted of whole food, plant-based sources and about 65% of their diet were complex carbs. Buettner noted: “The pillars of every longevity diet in the world are whole grains, nuts, greens, and other garden vegetables, tubers and beans.” For years the benefits of a Mediterranean diet were investigated and found to be life prolonging. It also emphasizes vegetables, whole foods, greens, grains, nuts and beans. The review article in Medical News Today that I mentioned above contains recommendations of how to change your diet to a healthier one.

Regular exercise

We are built in a way that requires regular exercise. When you exercise regularly, your body produces healthy HDL cholesterol that balances the unhealthy LDL cholesterol. Overall, this counteracts clogging of arteries and prevents heart attacks and strokes.

When you prevent strokes and heart attacks, you live longer.

Have a purpose in life

When you have a purpose in life, your mind is focused on what excites you. Achieving what is your dream satisfies you. Your brain releases feel-good brain hormones (dopamine, serotonin, endorphins, and oxytocin). When these hormones are released, you relax and cope with stress better. Your blood pressure normalizes, hardening of the arteries is postponed. At the same time, you prevent heart attacks and strokes. This contributes to longevity.

Reduce stress in your life

When under stress, your adrenal glands release adrenaline and cortisol. In the short term these stress hormones help you to cope better with stress. But when stress gets chronic, it weakens your immune system and increases your risk for a heart attack or stroke. It ages you faster. You can counter stress in your life by adopting stress management techniques. Regular exercise stabilizes your emotional life. You can listen to relaxation recordings or to relaxing music to calm your nerves. Developing friendships is another method of coping with stress. Here is more information on how to reduce stress in your life.

Limit alcohol consumption

In the past it was thought that small amounts of alcohol would prevent cardiovascular disease. But these studies overlooked the fact that even small amounts of alcohol can cause various cancers. So, by limiting the amount of alcohol consumption you also limit your probability of getting cancer.

Be part of a community

Many psychological studies showed that social isolation leads to health problems. It follows from this that being part of a community stabilizes your health and prevents disease. When you socialize with other people you counter stress and prevent loneliness.

Putting family first

When you care about your family, family members will care about you. Studies showed that this is an important factor in preventing disease. It even reduces mortality. Lower mortality leads to longevity.

Keep a social circle that supports healthy behaviors

Strangely enough here is another psychological factor that leads to longevity: getting support from a social circle. Being part of a social circle can create positive energy that prevents health problems.

Discussion of factors that lead to longevity

It is interesting to see that a lot of the longevity factors are psychological in nature. But physical factors are also important, like a Mediterranean diet and regular exercise. One factor that was not mentioned by Dan Buettner is the importance of preservation of hormone stability. I attended many yearly conferences of the American Academy of Anti-Aging Medicine (also known as A4M). They take place in the middle of December in Las Vegas every year. Over the years many lectures centered around hormone deficiencies. They collectively lead to premature aging and deaths. However, speakers also stressed that when you replace the missing hormones, you can reach a balance point where life gets prolonged.

Hormone replacement

One of the speakers, Dr. Hertoghe, an endocrinologist from Brussels mentioned in various talks that a lack of human growth hormone (HGH) in older age can lead to premature death. When IGF-1 levels in the blood are low, replacing the missing HGH with regular HGH injections can add 26.5 years to your life expectancy. But other hormones like thyroid hormones, testosterone in males, and progesterone and estrogen in females can prolong life when replaced after menopause or andropause (the male version of menopause).

News from the Blue Zones Regarding Longevity

News from the Blue Zones Regarding Longevity

Conclusion

Many factors contribute to longevity in centenarians. A lot of the factors are psychological in nature, like having a purpose in life or reducing stress in your life. Others are: be part of a community, put family first and keep a social circle that supports healthy behaviors. Physical factors causing longevity are moving naturally and regularly; adopt a plant-based diet; and consume alcohol in moderation. There is one important factor of longevity that Dan Buettner overlooked: your hormone balance. When we approach age 60 and beyond many people stop producing adequate amounts of hormones.

Replacing missing hormones

Anti-aging doctors have done studies showing that replacing missing hormones in proper doses will prolong life. Dr. Hertoghe, an endocrinologist from Brussels mentioned in various talks that a lack of human growth hormone (HGH) in older age can lead to premature death. When IGF-1 levels in the blood are low, replacing the missing HGH with regular injections can add 26.5 years to your life expectancy.