Medical Articles by Dr. Ray

Nov

2015

Eat Your Avocado

By Ray Schilling | Anti-aging medicine, Arthritis, Cancer, Cardiovascular disease, Health, heart attack, Heart Disease, Nutrition, Obesity, Stroke, Vitamins and supplements

“Eat your avocado” is an appropriate invitation to eat this super food with many positive effects on people’s health. That is to say, first, it helps arthritis, in addition it is good for your vision, besides it protects against cardiovascular disease, moreover it fights metabolic syndrome, further it helps in weight maintenance and finally, it even protects against some cancers. Avocado contains healthy oils and many vitamins and minerals.

Avocado composition

80% of an avocado is fiber making it a valuable food to prevent colon cancer. Among the minerals it is noteworthy that avocados are rich in boron and potassium. In terms of vitamins it is rich in vitamin E (alpha-tocopherol), vitamin B6, folate, vitamin K and pantothenic acid. It does not contain cholesterol, but contains monounsaturated fat (oleic acid). In fact, oleic acid is the compound in olive oil responsible for lowering your blood pressure. The oils in avocado contain first 71% monounsaturated fatty acids, secondly 13% polyunsaturated fatty acids and thirdly 16% saturated fatty acids. This mix promotes healthy blood lipids, but also helps in the absorption of fat-soluble vitamins and phytochemicals. In addition to all that avocados contain phytosterols, a number of carotenoids, non-carotenoid antioxidants, alpha-linolenic acid (an omega-3 fatty acid) and glutathione.

Cardiovascular disease protection

The combination of fiber and folate in avocado help to reduce LDL cholesterol. Oxidized LDL leads to hardening of arteries. The folate reduces homocysteine, which is a risk factor for heart disease. Phytosterols that are similar in structure to cholesterol compete with cholesterol absorption in the gut.

In a 2015 study several diets were compared with regard to LDL lowering potential, either a low fat diet, or two forms of medium fat diets, where one contained one avocado per day. The results were surprising in that the low fat diet led to a reduction of LDL by 7.4 mg/dL while the avocado diet caused a reduction of LDL by 13.5 mg/dL.

The oils in avocados also seem to suppress the appetite center in the brain helping people to eat less and controlling obesity and diabetes.

Arthritis prevention

In a 2014 study hip osteoarthritis was examined for over 3 years. Researchers could show that an extract from avocados and soybeans was protective of osteoarthritis. The anti-inflammatory components of avocado like omega-3 fatty acids, carotenoids, phytosterols and non-carotenoid antioxidants all work together in countering joint inflammation. Boron abundantly contained in avocado also was found to be essential for healthy joints.

Eye protection

Avocado has its own mixture of carotenoids, like alpha- and beta-carotene, lutein, zeaxanthin, neochrome, chrysanthemaxanthin and others. The green pulp contains these. They have anti-inflammatory properties. The fatty acid profile of avocados helps to absorb carotenoids, as they are fat-soluble. Researchers conducted a a two phase clinical study to show that avocado added to salsa or to salad was leading to a 5- to 15-fold higher absorption of the carotenoids in salsa and salad when compared to avocado-free salsa and salad.

This is an important observation that we should remember: always eat some avocado with any fruit or vegetable that contains carotenoids, as this will improve the absorption of the carotenoids tremendously.

Why is that so important for eye disease? In a 2008 study a total of 1802 women aged 50 to 79 years from Iowa, Wisconsin, and Oregon were followed who had intakes of lutein and zeaxanthin above the 78^th percentile. Researchers compared these women to women below the 28th percentiles in the Women’s Health Initiative Observational Study. This involved eye examinations in both groups. The eye specialists examined their eye lenses for nuclear cataracts. The surprising finding was that women with the highest quintile category of diet or serum levels of lutein and zeaxanthin had 32% less nuclear cataracts than women in the lowest quintile of lutein and zeaxanthin.

The conclusion was that carotenoids of avocados have vision protective effects.

Metabolic syndrome and obesity

This 2013 study included 17,567 US adults and part of the National Health and Nutrition Examination Survey (NHANES) 2001-2008. Researchers compared avocado eaters and non-avocado consumers. Interestingly, avocado eaters had a much better overall food quality in their diet. They ate more vegetables, fruit, fiber and less added sugar. Calorie and sodium intake were identical in the two groups. But body weight, body mass index and waist circumference were significantly lower in avocado eaters than in the non-avocado control group. The cardio protective HDL cholesterol was significantly higher in the avocado group. The odds ratio for developing metabolic syndrome, the change in metabolism due to obesity was 50% lower in avocado consumers than in non-consumers. All of this is good news for the consumer, if we eat some avocado.

Skin, beauty and anti-aging

We don’t like to develop too many wrinkles, as they are a sign of premature aging. The oils of avocados have been used for some time in skin care products as they stimulate collagen production in the skin and reduce wrinkles. But when you eat avocados, the carotenoid substances (such as lutein and zeaxanthin) serve for skin protection, protecting you from UV light damage. In addition, avocados contain vitamin E and glutathione, which help to scavenge free radicals. Otherwise the skin would prematurely age and wrinkle. The end result is that you see a reduction in the development of wrinkles, when you consume avocados. The beneficial effects on your blood vessels in combination with protecting your skin will age your body slower, a point that has been noted in the anti-aging literature.

Cancer blocking properties

In the following I will briefly review the findings of several cancer research groups, but this review is by no means complete.

Leukemia

This 2015 study describes a new chemotherapeutic agent, derived from avocado that they named Avocatin B. Avocatin B is active against the difficult to treat acute myelogenous leukemia (AML). It works by targeting mitochondrial components of AML, but does not affect healthy leukocytes or leukocyte progenitor stem cells.

Colon and esophageal cancer

The authors of this study from Iran describe four phytoextracts of avocado for treatment of patients with esophageal cancer and colon cancer. They noted that the phytoextracts have a much lower toxicity than standard chemotherapeutic agents and significantly slow growth of these cancers. They plan to use these phytoextracts as complementary treatments of esophageal and colon cancers.

Oral cancers

This paper describes that avocado extracts were shown to be successful in treating oral cancers.

Cancer prevention

In this paper it is discussed that the phytochemicals in avocados arrest cancer cells in their cell division cycle and lead to apoptosis, which is natural cell death. The authors believe that eating avocado regularly can help prevent a whole array of different cancers by this mechanism.

Eat Your Avocado

Conclusion

Avocados are a super food, which has many beneficial effects. Perhaps one of the outstanding effects is prevention of obesity and the metabolic syndrome as discussed. Women may want to eat it because of the beneficial effects on skin and beauty. We all should have an interest in wanting to prevent heart attacks, strokes and cancer.

But who does not want to prevent cataract surgery and keep good vision until a ripe old age? It is possible by eating avocados. And would you not want to prevent osteoarthritis? Eat avocados and add some omega-3 fatty acid from distilled fish oil as well to get the full anti-inflammatory effect. Your joints will thank you and let you swiftly move wherever you want to go.

I thought you should know about the health benefits of eating avocados. They make a nice addition to your food, not only as guacamole, but in a wide variety of dishes. Use a few slices on your salad. Make a tasty dip. And find inspiring recipes online that you can easily find and copy.

Oct

2015

There Is Help For Hair Loss

By Ray Schilling | Anti-aging medicine, Cosmetic surgery, hair loss

It is good to know that there is help for hair loss. One area where aging shows is the head! Often people who are aging are experiencing hair loss. Some individuals have a genetic trait that makes them vulnerable to early hair loss, while others are keeping their hair until a ripe old age. With regard to hair pigment it is similar: some people keep their own hair color well into their 40’s or 50’s, but later the grey hair shows. Loss of hair color is about loss of hair pigment. One or more genes regulate whether or not we lose the hair pigment early or not. While there is not much we can do about our hair pigment other than coloring our hair every 3-4 weeks, there is something we can do about hair loss on our scalp.

Androgenic alopecia

Physicians call male and female hair loss “androgenetic alopecia”. It occurs in individuals who are genetically exposed. Interestingly baldness is rare in Chinese, Japanese and in Native American populations. Baldness more commonly affects men of Caucasian descent.

Onset of hair loss

In people who are prone to hair loss baldness typically starts in the temporal areas.

The genetic factors that lead to baldness can be inherited either from father or mother’s side. They are polygenic, meaning that there is not only one cause of hair loss. Gene frequency is most commonly associated with Caucasians. In Africans the frequency is lower and lower still in American Indians, Asians, and the Inuits.

Types of hair loss

The Norwood scale is used as classification of hair loss in men. In women hair loss is classified using the Ludwig and Savin scale. This helps to record the findings of a hair examination and is useful for research purposes as well.

Hormonal factors regarding male pattern baldness

There are several hormonal factors that are involved in the development of male pattern baldness. 5-alpha reductase converts testosterone (T) to dihydrotestosterone (DHT). DHT is more powerful than testosterone, causes shortening of the hair cycle and miniaturization of hair in the balding areas. After several years those who have genetically predisposed androgen receptors in balding areas come down with baldness. There are two isoenzymes of 5-alpha reductase, type 1 and type 2. Individuals born without type 2 5-alpha reductase do not develop androgenic baldness.

Aromatase can cause baldness

Another factor for baldness can be an enzyme, aromatase, located in the fatty tissue that converts testosterone into estrogenic hormones. A lack of testosterone can lead to baldness by this mechanism. Many men in their 50’s and 60’s who are overweight or obese are balding because of this mechanism. The other mechanism, as explained above is via DHT in genetically susceptible men. This process starts to occur mostly in individuals who are in their forties.

Treatment of hair loss

Mild cases of hair loss

This may respond to topical treatment with minoxidil that can be used on the scalp as liquid or hair foam. Systemic treatment in men is possible with finasteride (Propecia) or Dutasteride (Avodart). It helps to block the hormonal pathways regarding 5-alpha reductase and DHT that leads to baldness. In aging men in their 50’s and 60’s it may be that testosterone levels are low. Blood tests can test for this: the total testosterone level should be above 500 ng/dL. If it is less, testosterone replacement by bioidentical testosterone cream or by injection should be considered and usually works quite well with respect to regrowth of scalp and body hair.

Moderately severe hair loss

This can be treated with PRP (platelet rich plasma). This treatment modality cures about 30% of hair loss. There have to be enough hair-rejuvenating stem cells around the bald skin to stimulate hair growth. However, when baldness has set in for some time in an area of the scalp with previous hair growth, there comes a point where the hair follicles die off and even stimulation with PRP will not help. When dermatologists used extracellular matrix (called “A cell”) in combination with PRP the success rate for hair growth in a bald area jumps up to 70 to 80%. The A cell material recruits stem cells from the blood that create hair follicles in the bald skin starting hair growth again.

Severe hair loss

A cell and PRP treatment are not sufficient for this. It requires more invasive treatment: the bald skin usually does not contain any hair follicles. So, what can one do in such cases? Dermatologists detected that dense hair from the back of the head (nuchal area) is transplantable to a bald skin area. It will usually grow very well there. In the beginning of doing hair transplants little discs were transplanted and this looked at times like checkered hair growth in the previously bald area. Newer research showed that miniaturized transplants with perhaps three hair follicles harvested under the microscope from the dense area and transplanted into the bald area give a smooth, natural looking appearance. These are “follicular unit hair transplants”. Nowadays hair transplant physicians will only do this type of hair transplant procedure because of the superior cosmetic result.

There Is Help For Hair Loss

Conclusion

Baldness is no longer a stigma in today’s society, particularly with males. So many men just shave off whatever hair they still have and live with baldness. However, other men and women want something done about the bald scalp; they can do so in various stages, first treat topically with minoxidil, then by trying PRP or PRP with the A cell treatment. Finally follicular unit hair transplants can restore a full head of hair where there was baldness before. In women with crown baldness follicular unit hair transplants can be very useful. This elegant method gets rid of this annoying crown baldness, and women who went for this procedure seem to be very happy with the results.

More info on hair restoration.

More info on hair loss.

References

Oct

2015

Depression Needs Treatment

By Ray Schilling | Alzheimer’s disease, Cancer, depression, Diabetes, Medical Condition, Parkinson’s disease, Vitamins and supplements

Depression is common and depression needs treatment. 10% of all men and 20% of all women have a period of depression in their lives. In people with medical illnesses depression is more common: 20% to 40% (Ref.1).

First, the peak age for depression is usually the age of 25 to 44. There are special groups where depression is also common. In adolescents 5% are affected with depression and 13% of women tend to get depressed after delivery, a condition called postpartum depression.

Second, in any age group with depression there is a risk of suicide, but with adolescents this is particularly true.

Third, about 10% to 15% of people with general medical illness are developing depression, such as patients with Parkinson’s disease, stroke, Alzheimer’s disease, cardiac disease, HIV infection, end-stage renal failure and cancer.

Causes of depression

Officially it is not known what causes depression. That is what medical textbooks say. However, other books like Datis Kharrazian’s book “Why isn’t my brain working?” offers several scenarios that can cause depression and he has examples of cases that were cured of depression (Ref.2). He points out that deficiencies in two major brain transmitters can cause depression: serotonin and dopamine.

Serotonin

First of all, serotonin is produced in the midbrain from the amino acid tryptophan in two biochemical steps. It is important to realize that these biochemical conversions require iron, vitamin B6, vitamin B12, niacin, folic acid and magnesium as cofactors. But you also need the “large neutral amino acid transporter” (LNAA) to transport tryptophan through the blood/brain barrier into the brain.

Dopamine

Furthermore, dopamine is a neurotransmitter that is produced in the frontal lobes of the brain. Notably, it is also necessary for learning. The brain synthesizes dopamine from tyrosine, which has to be manufactured in the liver from the amino acid phenylalanine. You need to have a healthy liver to produce tyrosine, which needs to be transported through the blood/brain barrier into the brain; similar to tryptophan this requires the “large neutral amino acid transporter” (LNAA). People with hepatitis, fatty liver, insulin resistance or diabetes may have problems with the LNAA transporter, which can cause dopamine deficiency (Ref.2). But they may also have low serotonin, if tryptophan did not enter the brain because of a transportation problem. This will happen with sugar overconsumption, as insulin resistance develops and affects the LNAA transporter resulting in both low serotonin and dopamine (Ref.2).

Inflammation

Finally, in the 1990’s researchers confirmed that inflammation is also a possible factor in the causation of neurological disease including depression. Ref. 2 points out that gut issues can become brain issues as inflammatory substances can leak trough a leaky gut into the blood stream and trough a leaky blood/brain barrier into the brain. Hypothyroidism can activate brain inflammation and lead to an imbalance of the neurotransmitters. Gluten sensitivity is also an important cause of depression through the inflammatory connection, but few physicians recognize the full impact of this.

Tests for depression

There are no laboratory tests that would define depression. However, every patient should receive a blood test to check for hypothyroidism, a common cause of depression. When the tests confirm hypothyroidism, the physician can easily treat this with thyroid hormone replacement.

Otherwise the physician diagnoses depression by doing a mental status examination, history and review of symptoms. A good start is to ask: “In the past 2 weeks how little interest or pleasure in doing things have you had?” and “Have you been feeling down, depressed, or hopeless in the past 2 weeks?” (Ref.3).

There are detailed psychometric questionnaires available such as the Beck Depression Inventory that can assist the physician to establish the diagnosis.

Myths of depression

One of the myths regarding depression is that it would be contagious. As a matter fo fact, a study on 2000 high school students showed that depression was not infective. The contrary was true: human interaction with friends who had a “healthy mood” improved depression. By the same token, when you constantly compare yourself with your Facebook friends, and you are not in the best mood, your mood may worsen and you could become depressed.

Treatment of depression

Despite advances in the treatment of depression the response rate with antidepressant therapy has a limit of 60% to 70%. According to Ref.4 inadequate dosing and misdiagnoses account for the fact that 30% to 40% of treated people with depression have treatment failures. Typically the first antidepressant involves a selective serotonin reuptake inhibitor (SSRI), but newer trials have shown that the older monoamine oxidase inhibitors (MAOIs) have a higher success rate when treating depression initially (Ref.4).

For example, a good antidepressant for mild to moderate depression is St. John’s wort, which is recommended by Ref. 5 as having less side-effects as other antidepressants.

In treating resistant depression the psychiatrist often employs other combinations of antidepressants. In addition the health professional recommends to add cognitive/behavioral therapy, which makes the overall treatment more successful. It goes without saying that complicated cases of depression belong into the hands of an experienced psychiatrist.

Suicides

Unfortunately a mental disease like depression still has a stigma attached to it. As a result many people are in deep denial about the fact that mental disease exists. Friends who do not understand depression may inadvertently say things that make the symptoms of the depressed person more severe and distance themselves at a time when they would need support from friends. The end result is that the patient feels lonely, misunderstood and that suicidal thoughts enter the mind. Men often resist seeking treatment for depression, women are better in seeking professional help and getting effective treatment.

Need for a psychiatrist to help prevent suicides

This is where a psychiatrist needs to intervene. If this does not happen, people start attempting suicide and finally commit suicide. In the US committed suicides have a gender ratio of male to female of 3:1 to 10:1. These situations become very difficult. The family needs to step in and talk to the patient. It is best to accompany the patient to the hospital for an assessment. You may want to go to the hospital in your private car or by ambulance. Don’t be shy to call 911 for an ambulance. Better to be cautious than have a major crisis that ends in completed suicide.

Alternative depression treatments

There are alternative treatments for depression.

Magnetic therapy for depression: This therapy is also called transcranial magnetic stimulation (TMS) and was approved for Canada and in 2008 by the FDA. But it is not as powerful according to Ref. 3 as unitemporal electroconvulsive therapy.

Bifrontal electroconvulsive therapy (ECT): Electroconvulsive therapy with two pedals applied to the front of the skull appears to have the best results in terms of treating depression.
Omega-3 fatty acids (EPA and DHA) are powerful anti-inflammatory agents, which will take care of the inflammatory component of depression. Both fish oil and krill oil in combination give the optimal response as outlined here.

Vitamin D3 and light box therapy

Vitamin D3 is also anti-inflammatory and will contribute to an improvement with existing depression, but it also helps prevent the development of depression when taken in regularly as a supplement.
Light box therapy: The observation of seasonal affective disorder (SADS) can develop as a result of lack of light. This has led to the discovery that light boxes are helpful for treating depression and also for prevention of depression due to seasonal affective disorder.

The patients should use a light box for 30 minutes every morning during the fall and winter months. The box should emit at least 10,000 lux. Improvement can occur within 2 to 4 days of starting light therapy, but often it takes up to 4 weeks to reach its full benefit.

Avoid alcohol and too much sugar

It is known for a long time that alcohol is a depressant; it can actually cause depression and in persons with bipolar disease it can trigger a flare-up of that disorder as well.
Finally it matters what you eat: sugar and too much starchy foods (high glycemic index carbs) lead to insulin overproduction and insulin resistance. This causes inflammation, and this will cause depression. As mentioned earlier it also lowers the two key brain transmitters, dopamine and serotonin.

The solution is an anti-inflammatory diet, the Mediterranean diet without sugar and high glycemic index carbs; only low glycemic index carbs are part of this diet. This will normalize insulin production and eliminates inflammation.

B vitamins, electroacupuncture and exercise

Vitamin supplements: Folate and vitamin B12: Up to 1/3 of depressed people have folate deficiency. Supplementation with 400 mcg to 1 mg of folic acid often helps. Vitamin B12 should also be taken to not mask a B12 deficiency (Ref.5). Folate and vitamin B12 are methyl donors for several brain neuropeptides.
The symptoms of depression often improve with electro acupuncture, as shown in many studies. This treatment ameliorates the symptoms of depression and seems to work through the release of neurotransmitters in the brain (Ref.6).
Exercise on a regular basis helps to equalize the mood and seems to exert a slight anti-depressant effect on the person who engages in regular physical activity.

Depression Needs Treatment

Conclusion

I have attempted to show the complexity of depression and what we know about its causes and treatment. Very likely there are several causes for depression and further research will hopefully bring more clarity to this. Over the years psychiatrists have developed treatment modalities, both conventional and unconventional, by trial and error. The physician and patient need to use common sense: if a treatment is working, stick to it and use it. If it does not work, move on and try something else. More complex cases should be referred to a psychiatrist who has the most experience with patients that are difficult to treat. Do not neglect life-style factors and alternative depression treatments as they can often help to stabilize depression significantly. We all must be vigilant about suicide risks in depressed patients and act by calling 911, if necessary to intervene.

More info on depression: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/depression/

References

1. Depression, Major: Fred F. Ferri M.D., F.A.C.P., Ferri’s Clinical Advisor 2016, by Elsevier, Inc.

3. Goldman-Cecil Medicine “Major depressive disorder” 2016, by Saunders, an imprint of Elsevier Inc.

Oct

2015

Tissue Repair With Extra Cellular Matrix

By Ray Schilling | extra cellular matrix, regenerative medicine, scar tissue, wound healing

Are you ready to learn about futuristic medicine consisting of tissue repair with extra cellular matrix? On September 5, 2015 I watched an interesting documentary on Discovery Channel while working out on the treadmill in the gym. This gave me the idea that this would be good material for a blog. After a little research on the Internet I found the full extra cellular matrix story, which you can read about below.

An amputated finger grows back

Lee Spievak, a man who loves flying model aircraft had an injury to his his right middle finger. A rotating model airplane propeller chopped off the end of his right middle finger. His surgeon felt that there was nothing much that could be done. But his brother who works in regenerative medicine knew about a powder made from pig’s bladder tissue, which Dr Stephen Badylak from the University of Pittsburgh, had pioneered. His brother sent a sample of powder (extra cellular matrix, ECM) to Lee Spievak who sprinkled some on the open wound (the stump).

New tissue forming with extra cellular matrix powder

Within two applications he saw that new tissue was forming. In a matter of 4 weeks it sealed up, the wound and a new finger grew to the same length as before. In the course of 4 months his nail, skin, his feeling and even his fingerprint were back to normal.

This story happened in Cincinnati in 2005. In this news story it is explained why the ECM powder worked so well: it prevented the wound from closing and it stimulated the body to heal.

A large thigh muscle defect grows back

Marine Sergeant Ron Strang was severely wounded by a roadside bomb in Afghanistan where a large part of his left quadriceps muscle (left thigh) was ripped off. After several surgeries the surgeons decided that Ron was a good candidate for part of a trial that is ongoing involving about 80 Veterans with similar injuries. Dr. Steven Badylak from the University of Pittsburgh suggested with the next surgery to put extra cellular matrix from pig bladder into the remaining quadriceps muscle to see whether it would regrow part of it.

Surgery with addition of extra cellular matrix from pig’s bladder

The surgery followed by physical exercise was so successful that Sergeant Strang is now able to run and do all the activities he wants. There is still a scar, but in comparison to the initial injury where a big chunk of muscle was missing, the remaining scar was insignificant.

Dr. Badylak explains in the video of the link that the insertion of the sheet of extracellular matrix immediately recruits the patient’s own stem cells, which makes new muscle cells, new nerve tissue, new skin, whatever the body needs to heal what’s missing in the injured area.

Dog gut growing into a dog aorta

Dr. Badylak from the University of Pittsburgh had a veterinary medicine degree before he studied medicine and became a surgeon. From the beginning his interest was in regenerative medicine.

After he saw the success with Lee Spievak’s finger regeneration, he thought that there must be a way to regenerate other tissues. He started doing experiments on dogs where he removed part the arch of the aorta and replaced it with a piece of gut from the same dog to see whether the dog would survive and whether the gut would be strong enough to withstand the pressure from the outflowing blood in the aorta. He figured that the tubular structure of the gut would be a better template than the synthetic aorta pieces that are still in use by thoracic surgeons. To his surprise the first dog (his own dog named Rocky) survived and did well.

Dog experiments to understand how extra cellular matrix works

He accumulated data on a total of 15 dogs. All of them survived and did well. He could not understand what had happened, so he reexamined one of these dogs where he got histological samples and analyzed them under the microscope to see what was going on. What he expected was the typical findings of the gut transplant, but instead he found a new aorta with all of the histological findings of aortic tissue. There was a transformation of a piece of gut into aortic tissue!

Next Dr. Badylak repeated the surgical procedure, but this time he inserted a piece of gut from a cat, removed the lining of it (the mucosa) and the muscle layer, (the muscularis),. The remainder was only the extra cellular matrix, a thin tubular structure of ECM.

Aorta scaffolding made of extra cellular matrix survives in dogs

When he was done, he was wondering whether the body would reject the catgut ECM. After all, it came from another species. Normally with whole organ transplants one can expect rejection of the foreign tissue. None of that happened. The experiment went flawlessly: the transplant survived like all the others and again the ECM had turned into dog aorta. It was possible to integrate the extra cellular matrix into the aorta without any scar formation! None of this fitted any conventional medicine model; it was the blueprint for the regenerative medicine model.

Dr. Badylak recognized that this was a huge step forward, and he would need easy access to ECM material. He got it from the pig slaughterhouses dotting the Indiana countryside surrounding Purdue. There would never be a shortage of tissue for preparing the scaffolding of the ECM for various applications.

Repair of tissue defects with extra cellular matrix in various body regions successful

By now the surgeon had proven that the gut or ECM transplant was switching off an inflammatory reaction, which suppressed scar formation, and simultaneously promoted regeneration. But the missing puzzle still was how the body generated the aortic tissue.

Dr. Badylak tested whether the procedure would work for large veins, smaller arteries and Achilles tendons. He did this all in dogs and using pig’s ECM. The answer was it worked all beautifully with no scarring and perfect healing results. Control dogs did not get the ECM, but were only operated on and then repaired conventionally in their Achilles tendons. They developed a limp from scar tissue. This is what often happens in humans as well with conventional surgery. But none of the dogs that had 3 cm cuts and then received a treatment with pig’s ECM developed a limp or scarring. They healed perfectly.

Large company supports Dr. Badylak’s work

In 1992 DePuy licensed Badylak’s ECM-derived “biologic scaffolds” for all orthopedic applications. DePuy is a big company that makes supplies for hip and knee replacements and much more. This was an ideal support for Dr. Badylak’s work.

In 1999 the FDA approved pig’s bladder ECM for human applications. This included the use of pig’s ECM for shoulder rotator cuff tears in patients. The FDA also approved it for abdominal hernias and for esophageal reflux damage. In addition the FDA approved it to induce the regrowth of the outer lining of the brain following brain surgery.

He could now continue his research and find out what the missing puzzle was. How did the body use the pig’s ECM and repair tissues?

Stem cell recruitment by ECM

Dr. Badylak was visiting a colleague of his in Los Angeles, Dr. John Itamur who had previously repaired a rotator cuff tear on a patient 8 weeks earlier using porcine ECM. The same patient had an unrelated shoulder injury. This required surgery just adjacent to the previously repaired rotator cuff. The surgeon decided to take a small biopsy to see how the healing tissue looked. This was when Dr. Badylak came for a visit. The microscope showed a surprise: the scaffolding had disappeared as expected. But there were a lot of new cells there. They did not look like inflammatory cells, muscle cells or nerve cells; they were stem cells. Dr. Badylak read several papers that told him that ECM breaks down into so-called crypteins. These peptides have powerful stem cell recruiting properties.

Experiment show how extra cellular matrix recruits stem cells

In 2003 he started groundbreaking experiments in mice that proved this theory to be correct. He X-rayed a group of mice to kill all of their bone marrow stem cells. Then he injected stem cells tagged with a fluorescent marker. They repopulated the bone marrow with these tagged stem cells from the same strain of mice. Now he removed a piece from the Achilles tendon and repaired the defect with pig ECM. Stem cells tagged with a fluorescent marker were flooding the Achilles tendon repair area. Even months after the Achilles tendon repair with ECM the new Achilles tendon was still filled with some of these tagged cells showing that some of them had matured into regenerated tissue.

Video showing would healing with extra cellular matrix and the final outcome of dog Rocky

Here is a link that contains a video about Sergeant Strang and his severe leg injury (repair of a rectus muscle tear). You may wonder how Rocky, the initial dog did who had an aortic segment replaced by a piece of gut. Rocky lived for another 8 years and was healthy until the very end.

Tissue Repair With Extra Cellular Matrix

Conclusion

You saw how the observation of a healing finger turned into experiments on dogs. Aortic defects and Achilles tendon defects healed without scarring. You learnt how pig’s or cat’s ECM were in use as scaffolds and that the body absorbed this. They recruit stem cells from the host’s body that subsequently do the healing. The exciting news about ECM is that it promotes healing, recruits stem cells, but also suppresses inflammation and scar formation.

We already hear that ECM is used in hernia repairs, rotator cuff repairs for shoulder injuries, and also in hair transplants, where Acell material is mixed in to improve the transplant success.

It is being used in lower esophagus surgery in cancer cases and with reflux esophagitis.

What will be the next application for ECM? We do not know everything, but it is a promising step into the future of regenerative medicine!

Oct

2015

What Stress Does

By Ray Schilling | alcohol, Cardiovascular disease, fractures, heart attack, High Blood Pressure, Hormones, Infectious Disease, Inflammation, Insomnia, Sleeep, Stress management, Stroke, telomeres

I like to discuss what stress does. We all are stressed out at times. Some people are stressed all the time and this is called chronic stress.

Acute stress

Let’s say you were in a minor rear-ender accident. It is annoying, but at least you had no injury. But you have to deal with the insurance company, get the repair done and maybe get a car rental during the time of repair. Yes, you may have a few days where you feel that your hands are shaky and your heart pounds, or your sleep may not be restful. But when everything is done things are back to normal. This is an example of acute stress with a shorter running time. It has a limited severity, is an inconvenience, but it does not really affect your body on the long-term.

Chronic stress

Let’s assume the car accident was more severe and you received a personal injury with a broken leg. You end up in hospital and the orthopedic surgeon fixes the fracture with a surgical plate. The leg has to be in a cast for several weeks, and you have to use crutches. Every day you feel reminded of the car accident, because it is awkward to walk with crutches. After weeks you notice that you have gained weight. Your doctor is also worried about you because your blood pressure showed higher readings. You do not sleep as well, waking up frequently and having nightmares about another fictitious accident. On top of that you came down with the flu. What happened here? The stress reaction released cortisol, which weakened your immune system and may be responsible for catching the flu.

High blood pressure and increased alcohol consumption

On the long-term cortisol can also contribute to high blood pressure, but so can alcohol consumption. You may have increased your alcohol intake in the evening to relax more, but with the chronic stress and the cortisol increase this can cause high blood pressure. The weight gain that you noticed has to do with the fact that you cannot work out any more because of your healing leg fracture and you having to use crutches. Inadvertently you may also eat a bit more rich food; a lot of people do that as food can be used as comfort food.

Disbalance of melatonin and cortisol with stress

And why do you sleep less well? Chronic cortisol elevation leads to lower melatonin levels, as these two hormones are natural opponents. A high melatonin level leads to a low cortisol level and vice versa. With relaxation methods you can lower cortisol and the melatonin level increases normalizing your sleep. Chronically elevated cortisol can also lead to weight gain as sugar is converted into fatty acids that are stored as subcutaneous fat. Muscles can melt down when cortisol is high giving the appearance of spindly arms and legs.

Causes of chronic stress

Holmes and Rahe tested a stress scale in 1970, which has become the standard ever since. You get a certain amount of points for a stressful event, e.g. 100 for the death of a spouse; 45 point for retirement; 23 for trouble with the boss etc. Add up all of the points that are affect you right now; if the total score is less than 150 points there is only a minor risk of getting medical problems from the chronic stress; for 150 to 299 points the risk of illness is moderate and for 300 and more points you are at a significant risk for illness.

Physical illness and mental illness from stress

There is physical illness and mental illness that chronic stress can cause. Physical illness can be high blood pressure, hardening of the arteries. The long-term risks from this are possible heart attacks and strokes. But chronic adrenalin and noradrenalin elevation associated with chronic stress can burn part of your brain cells in the hippocampus and medial prefrontal cortex. This can lead to memory loss, spatial memory loss and aggression. Mental illness caused by chronic stress can be anxiety, depression, social isolation, panic attacks and panic disorder. Psychosomatic symptoms can include headaches, back pain, abdominal pain and difficulties concentrating.

Job stress and cancer

Perhaps one of the best examples of job stress and cancer is a study where the amount of breast cancer was correlated to the amount of stress. I discussed this in another blog. Briefly, women with a less responsibility had the lowest rate of breast cancer, but they too had some stress as there was a higher breast cancer risk after 15 years on the job versus only 5 years on the job. The same study showed that women with high responsibility had the highest breast cancer rates.

How stress leads to higher breast cancer rates

A hormone disbalance can explain this based on high cortisol levels associated with chronic stress. If cortisol is high, the cortisol binding globulin (CBG) increases; this in turn also binds more circulating progesterone, as progesterone attaches to CBG. CBG is a transport protein for both cortisol and progesterone. The end result is that estrogenic compounds get the upper hand, a condition called estrogen dominance. I have explained under the above link that this was the real reason for the increase in breast cancer in the stressed women. Similar mechanisms are causing other cancers to occur more frequently with chronic stress.

Chronic stress and cardiovascular disease

High stress jobs were found to cause a 2.2 to 2.4-fold increase of strokes and heart attacks due to cardiovascular disease when compared to low stress jobs. This was based on a British Medical Journal study in October 2002. As I discussed above under a brief description of chronic stress cardiovascular disease is often what develops as part of chronic stress. People who are under chronic stress feel that they do not have enough time to prepare good, healthy food at home. They tend to eat out more often. Even well educated people just swallow a quick hamburger and other processed foods.

Bad fats lead to heart attacks and stroke

This increases the bad fats like trans fats and omega-6 fatty acids in their system causing inflammation of the blood vessels as explained in this blog. The LDL cholesterol and triglycerides get elevated, sugar from sugary snacks oxidizes the LDL cholesterol and your coronary arteries and brain arteries get clogged up. This sets anybody on the downward pathway, and it is now only a matter of time when the chronically stressed person will develop a heart attack or stroke.

Chronic stress extremes: PTSD and burnout in soldiers

Dr. Thierry Hertoghe gave a lecture during the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas (Dec.10 to 14, 2014). The title was: “Burnout: A multiple hormone deficiency syndrome”. Burnout is the extreme of chronic stress. He said that burnout is a common condition where several hormones are affected, with the cortisol axis being the main one, but other hormone glands being stressed as well. As a result endocrine glands age prematurely. Symptoms are fatigue, exhaustion, gastrointestinal problems, anxiety, depression and aggressiveness. The underlying hormone abnormalities are a lack of cortisol, thyroid deficiency, growth hormone deficiency, testosterone and estrogen deficiency and oxytocin deficiency. Burnout is common in teachers and there is a questionnaire that has been developed for teachers (teacher’s burnout scale) to monitor them whether they are heading this way.

Burnout or PTSD

Soldiers who return from combative situations often suffer from burnout or from PTSD. The teacher’s burnout scale already mentioned can monitor their burnout severity. In suspected cases laboratory tests that measure hormone levels give concrete answers about hormone deficiencies. Treatment protocols were discussed in detail. Multiple bioidentical hormone replacements are necessary, possibly for prolonged periods, if not life long. In addition supportive counseling sessions from a counselor or psychiatrist will help to tone down increased brain activity and help regain the internal balance. Why is this important? It is important, because hormones are necessary on a cellular level and regulate the energy metabolism of every cell in the body. Also, by recognizing what is going on and helping the affected individuals, a lot of pain and suffering can be prevented.

Accelerated aging from telomere shortening

Chronic stress has been shown to cause telomere shortening. So does a lack of sleep (insomnia), smoking and alcohol overconsumption, all conditions that can be associated with chronic stress. What can we do about this? Learn what shortens telomeres and ultimately your life. Cut out what you can and take supplements that lengthen your telomeres.

Positive thinking combats stress

Negative thoughts are draining you of energy. You want to stay optimistic within what’s reasonable. Be thankful for all the good things in your life. Minimize what’s negative, but think about positive solutions to get rid of energy draining parts in your days. Do this persistently until it becomes part of your life and you will have extra energy that you didn’t waste in negative thinking or needless, anxious anxiety. Worrying does not get us anywhere, but it depletes our energy.

Relaxation methods counter stress

Self-hypnosis is a simple way to allow your whole body to relax. However, the various forms of yoga will do the same thing for you. Meditation is another way of finding peace and tranquility. Prayer is know to help people in sickness and in health. All of these methods will re-energize you. They calm your brain, help you to cope with stress and rebalance your hormones at the same time.

Building social ties and mutually supportive relationships will also build you up. It makes you feel that you belong, you have your place in society, you help others, and they support you.

Constant overdrive has physical consequences

We need some stress to get us going, but we do not need “distress”. Dr. Hans Selye, the father of the general adaptation syndrome due to stress, gave a lecture about this topic in Hamilton, Ont. in 1977, which I attended. I vividly remember how he projected a picture of his skeleton showing bilateral hip replacements. He said that chronic stress could lead to arthritis. In his case, he said, he had developed end stage arthritis in his hips requiring total hip replacements on both sides. To illustrate further that stress leads to physical consequences, he explained that one person may develop a heart attack, another a stroke, a third could get arthritis. Constant overdrive has physical consequences.

What Stress Does

Conclusion

Stress can be deadly, particularly if it lingers on and becomes chronic. But we can reorganize our lives to minimize stress. Some people may decide to seek a less stressful occupation. Others may elect to stay at that job, but develop hobbies, learn how to relax and take relaxation classes to combat job stress. The key is to start thinking about what stress you may be under and then develop a plan to counter it so you can allow yourself to rebalance your life.

Sep

2015

Testosterone

By Ray Schilling | Alzheimer’s disease, andropause, Anti-aging medicine, Cancer, Cardiovascular disease, fractures, heart attack, Hormones, Men's Health, Osteoporosis, Prevention, Stroke

One of the driving hormones in a man is testosterone. We also know that with age this hormone level falls. The lesser known fact is the importance of monitoring testosterone levels in aging males. This way they have the choice of intervening with the aging process. Here are the facts about the male hormone and about replacement of it when it is low. I will also discuss the anxieties of the medical profession to deal with this. Some feel uncomfortable about hormone replacements.

Androgen receptors contained in key tissues

Androgen receptors are situated in the key organs like the brain, heart, muscles, bones, kidneys, fat cells, genitals, hair follicles and skin. They respond to all male hormones, called androgens, like testosterone, dihydrotestosterone (DHT) and DHEA. DHT is produced by metabolizing testosterone with the help of an enzyme, called 5α-reductase in the adrenal glands. This is responsible for hair loss in males and some females. There is a genetic factor for this. It is important that the man continues to have all tissues stimulated by his male hormones when he ages or the key organs mentioned are going to suffer.

A lack of the male hormone as the man ages (around 55 to 65) leads to a slowdown in thinking, osteoporosis in the bones, muscle atrophy (melting in of muscle tissue), and a lack of sex drive. Mood swings can turn the male into the “grumpy old man”. The skin gets thinned and is more brittle.

Animal experiments have shown that the development of fatty streaks in blood vessels happens at a higher rate in castrated animals. The more encouraging finding in these animals is the fact that this condition is reversible by replacement of the male hormone. In healthy males of a younger age all organs are working well. The problems starts when males age and the hormone regulation in the brain slows down, which ultimately leads to andropause in males, the equivalent of menopause in women. When the physician replaces testosterone in an aging man who has low testosterone levels, the stimulation of androgen receptors in key organs, which I mentioned before return organ function to normal.

Reluctance of physicians to prescribe testosterone

In the past medical students were taught that testosterone is causing prostate cancer. This was based on old observations by Dr. Huggins, a Canadian born surgeon who practiced in Chicago, that orchiectomy improved the survival of advanced prostate cancer patients by a small percentage. Dr. Lee pointed out that Dr. Huggins neglected to realize that testicles make both the male hormone and small amounts of estrogen.

History of hormone ablation therapy for prostate cancer

When an orchiectomy was done (because of the belief that the male hormone production was the culprit) inadvertently the real cause of prostate cancer (an estrogen surplus) was also removed thus improving the survival of these patients somewhat. Nowadays we have more sophisticated testing methods. Dr. Abraham Morgentaler (Ref. 1) has compiled a lot of evidence about the importance of testosterone in men. He proved, based on a lot more modern references that it is not testosterone that is the cause of prostate cancer. We know now that estrogen dominance is responsible for prostate cancer and that this develops as stated above because of the low testosterone and low progesterone during the male menopause (also called “andropause”).

Rebuttal of Dr. Huggins’ research

Dr. Morgentaler, a urologist from Harvard University has taken prostate cancer patients and put them on testosterone. To his and everyone else’s surprise testosterone treated prostate cancer patients improved, their prostate cancer either disappeared or become much less aggressive, which can be measured with the Gleason score based on its microscopic appearance. The result was that they did better, not worse on male hormone replacement.

Older physicians still hold on to the belief that testosterone would make prostate cancer worse

Unfortunately the history of male hormone production, orchiectomy and prostate cancer as explained led to confusion among the medical profession. We now know that testosterone is innocent with respect to prostate cancer, testicular cancer or any other cancer. But some of the old-timers among the physicians doggedly hold on to their false belief from the past. If a man asks one of these physicians for testosterone replacement he may not only be told that he/she could not do that, but will also receive a tirade of false statements about testosterone.

No blood clots with male hormone replacement

We dealt with the myth of prostate cancer that is not related to treatment with the male hormone. There is another myth that older physicians often cite: that testosterone would supposedly be causing blood clots. At the University of Texas Medical Branch at Galveston (Texas, USA) a large study was done involving 30,572 men, ages 40 years and older. All had venous thromboembolism and received an anticoagulant drug or an intravascular vena cava filter following their diagnosis. Because they also had a low testosterone level physicians gave them testosterone replacement therapy. In addition, they followed them and monitored them for further venous thromboembolism. None were found in any of the men. The conclusion of the investigators was that filling a testosterone prescription was not associated with any clotting condition.

Aging and testosterone

A longitudinal study showed that testosterone has been declining in the male population over a period of 20 years. Partially there is a relationship to aging. Otherwise estrogen-like substances or xenoestrogens, which are environmental factors, contribute to it as well. Although age is a factor, there is so much variation from man to man, that it is best to just measure testosterone and determine whether the mail hormone level is above or below 500 ng/dL. This seems to be the most reliable indicator in determining whether a man needs hormone replacement, apart from symptoms due to testosterone loss. These are: increased risks for prostate problems and/or cancer, cardiovascular disease, loss of bone density, a rise in cholesterol and urinary dysfunction. Dr. Randolph describes this in detail and also discusses who needs bioidentical testosterone replacement.

The aging male and hormone replacement

A New England Journal of Medicine study from September 2013 explained that apart from testosterone the male body needs a small amount of estradiol, the female hormone. The enzyme aromatase within the fatty tissue achieves this. But the physician must prescribe testosterone replacement as the bioidentical testosterone, so that a small amount of it converts into estradiol by the action of aromatase. Synthetic male hormone compounds with chemical side chains do not provide this small estrogen metabolism.

After a review of the hard facts about prostate cancer risk, it is now clear that older men get prostate cancer because testosterone in their blood is low and their body weight elevation. The extra fat converts androgens by the aromatase into estradiol. This leads to estrogen dominance. This causes breast cancer and uterine cancer in women, prostate cancer in men. When the total testosterone level in a man is lower than 500 ng/dL it is a sign that he needs male hormones to protect his prostate from prostate cancer.

Cardiovascular disease and testosterone

The cardiovascular system has a lot of androgen receptors on its cell surfaces. It is important that the man continues to have the proper stimulus from androgenic hormones (testosterone, dihydrotestosterone and DHEA). This will allow him to have proper contractility of heart cells. It will also allow for relaxation of smooth muscle cells in the arteries to control blood pressure. With a lack of male hormones there is hardening of the arteries, loss of muscle cells in the heart muscle and increase of blood pressure. So far researchers have only noticed an association of low testosterone with diabetes, high blood pressure and heart attacks. It has not been proven that it is the cause (so webmd.com says). But careful replacement with bioidentical testosterone helps patients to get rid of their symptoms, have the energy to exercise and feel better.

Is it safe to replace missing hormones in a male?

Long-term studies have already shown that hormone replacement saves lives, but the medical profession is slow to accept this (Ref.1). Here is a link that explains this a bit further.

If a man who is low in male hormones wonders whether it would be worthwhile to go on testosterone therapy, here is the clear answer: would you like to have a 47% lowered risk of dying, a reduction of 18% in heart attacks and 30% reduction in the risk for a stroke? This is what a 14-year follow-up study published in the European Heart Journal in August, 2015 found.

The same is true for cardiovascular disease as stated above: if the total testosterone level in a man is lower than 500 ng/dL it is a sign that he needs testosterone replacement therapy to protect his cardiovascular system to prevent heart attacks and strokes.

Loss of bone density with a lack of testosterone

Older men can get osteoporosis, which can lead to compression fractures in the spine. In addition fractures can also occur in the hip, the ankle or wrist. Current thinking is that with the lack of male hormones there is also a lack of estradiol via the aromatase pathway in fatty tissue. This small amount of estradiol is able to prevent osteoporosis all his life until testosterone drops with older age. Once again it is important to monitor his male hormone level and replace with bioidentical testosterone when it is lower than 500 ng/dL.

Rise in cholesterol

With obesity there is a metabolic change, called metabolic syndrome. This leads to an elevation of LDL cholesterol, which is a direct risk for hardening of the arteries. In an obese older man with low male hormones there is a double risk. First, there is the low testosterone and secondly the metabolic syndrome, if he is overweight or obese. As a result the heart attack and stroke rates in obese men with low testosterone are much higher. In obese men with normal male hormone levels there are less heart attacks and strokes. Men with obesity need to lose weight by changing their diet to healthier eating habits and starting a regular exercise program with swimming and walking. At the same time those with a testosterone level of lower than 500 ng/dL should have bioidentical testosterone replacement.

Urinary dysfunction

A hyperactive bladder, dribbling, hesitancy and leaking bladder can all be part of male hormone deficiency. But this is not that easy to diagnose. A full consultation by a urologist may be necessary to assess various other causes that could hide behind these symptoms. Part of the work-up though is to measure the total testosterone level and replace what is missing.

Alzheimer’s disease

Alzheimer’s disease can be due to a lack of male hormones. It is therefore important to measure the total testosterone level in a man. If it is lower than 500 ng/dL, as mentioned before , it means he needs male hormone replacement therapy. This will prevent Alzheimer’s disease.

Burnout

According to Dr. Thierry Hertoghe, an endocrinologist from Belgium, there are several hormones that can be missing in a person with burnout: a lack of cortisol, thyroid, growth hormone, testosterone/estrogen, progesterone and oxytocin. The middle-aged manager with burnout would have other hormones missing apart from testosterone. The physician needs to order blood tests to measure whether other hormones are missing. Whatever is low needs replacement with bioidentical hormones.

Some details regarding testosterone measurements and delivery

The deeper you delve into male hormone replacement, the more details there are to consider. First, there is a sex hormone-binding globulin that is mostly produced by the liver and circulating in the blood. It is like a storage form of testosterone and only 1 to 2% of the total testosterone is unbound. This is called the free or bioavailable testosterone. Some physicians measure just that portion of testosterone.

Hormone replacement in a man

Second, when it comes to replacement of testosterone in a man who is deficient for testosterone, there are several delivery systems, which some people find a little confusing. There are testosterone gels with less than optimal absorption. Another application are creams that compounding pharmacies provide. The patient absorbs these creams usually quite well. But some men do not absorb either creams or gels. They need testosterone injections or testosterone pellets. The goal is to replace testosterone in a manner that there is a fairly equal amount of testosterone available circulating in the blood at all times. Some men achieve that only with testosterone pellets, others with testosterone cypionate injections. For this reason blood test that determine the levels of free testosterone are necessary at intervals of about 3 months.

Testosterone

Conclusion

Testosterone is a key hormone in the male that requires monitoring, particularly when he is aging. A knowledgeable physician or naturopath needs to take a careful history of his symptoms. If blood tests show that the total testosterone is less than 500 ng/dL the physician needs to replace with bioidentical testosterone.

References

Ref.1: Dr. Abraham Morgentaler: “Testosterone for Life – recharge your vitality, sex drive, and overall health” McGraw-Hill, 2009

Sep

2015

Obesity Shortens Life

By Ray Schilling | Cancer, Cardiovascular disease, Diabetes, heart attack, Heart Disease, High Blood Pressure, Inflammation, Mortality, Nutrition, Obesity, Smoking, Stroke, Weight loss

This article is about the fact that obesity shortens life. Of all the factors that definitely shorten life, obesity stands out like a giant. Let’s review a couple of facts regarding obesity:

Americans who were born between 1966 and 1985 became obese at a much earlier age than their parents
Obesity occurs at a younger age than in the past. 20% of people born between 1966 and 1985 were obese in their 20s.
The longer you are obese, the higher the chance of getting seriously sick or dying prematurely from complications of associated diseases like diabetes, heart attacks, strokes, kidney disease, liver disease and cancer.
Severely obese people live up to 20 years less than non-overweight people.
Obesity causes about 300,000 deaths in the U.S. annually

Change of metabolism

Obesity shortens life. Obesity leads to a change in metabolism, which is known as metabolic syndrome. The liver changes its metabolism slightly producing more triglycerides, LDL cholesterol and clotting factors, which increases the risk for heart attacks, strokes and pulmonary emboli. The pancreas produces more insulin, which gives rise to reactive hypoglycemia. This means that 2-3 hours after a meal you become hungry as your blood sugar declines from the extra insulin. You are craving a sugary drink, a donut or other starchy food (pizza, fries, bread etc.). Unfortunately, these types of foods reinforce the metabolic syndrome: the liver changes the sugar into LDL cholesterol and triglycerides.

Excess sugar oxidizes LDL cholesterol

Excess sugar will oxidize the LDL cholesterol, which causes atheromas (hardening of the arteries). Protein is being caramelized, which is called “advanced glycation end-products” or AGEs. This reference clearly explains how to counter this: increase your consumption of fish, legumes, vegetables, fruits, low-fat milk products and whole grains; also reduce your intake of solid fats, full-fat dairy products, fatty meats, and highly processed foods. There are other hormone changes that take place in obese people.

Death statistics due to obesity

In this study 849 autopsies were performed over 10 years, of which 32.3% were of obese persons. Leading causes of deaths in obese people were: malignancy (31.4%), infection (25.9%), ischemic heart disease (12.8%), pulmonary embolism (6.2%) and liver disease (2.9%). Table 2 of this link shows the causes of death in non-obese individuals as well: malignancy (32.5%), infection (23.8%), ischemic heart disease (10.4%), pulmonary embolism (2.9%) and liver disease (0.7%). The figures do not look all that different except that liver disease and pulmonary embolism are significantly more often the cause of death in obese patients than in normal weight patients. What you do not see in these figures is that obese people get these conditions at a much younger age as a result of complications from the associated diseases like diabetes, high blood pressure, cardiovascular disease, osteoarthritis, kidney disease and liver disease.

Diabetes

The metabolic changes with regard to the metabolic syndrome include insulin resistance.

As obesity worsens the balance is lost where the body can compensate and type 2 diabetes develops with increased blood sugar values and symptoms of diabetes. Surprisingly with regular exercise and changes in food intake (adopting a low glycemic index diet) this can be treated successfully. Usually this change is also associated with some weight loss, which helps to stabilize the metabolism. If nothing is done to to change diabetes, there is a high risk for heart attacks, strokes and subsequent secondary conditions like diabetic nephropathy, retinopathy, diabetic neuropathy and vascular complications.

Uncontrolled high blood pressure

High blood pressure is part of the metabolic syndrome. Unfortunately in obesity it is often difficult to control and may require several different antihypertensive medications in combination to control it. One way to quickly get the blood pressure under control is to make a concentrated effort to reduce a few pounds of weight; this can be achieved by cutting out refined carbs and sugar and starting an exercise program of walking and swimming.

Smoking

Smoking continues to remain a problem. Men as a group are now smoking less while women are increasing their smoking rates. Smoking causes various cancers, but also increases death rates from heart disease and strokes. In connection with obesity it is clear that the obese smoker has the highest risk of dying prematurely. This is depicted in this link based on the original Framingham study.

Disabilities and nursing homes

Obese people get disabled earlier, ending up in nursing homes. This poses a huge problem there for the staff. Back injuries and disabilities in the caregivers of nursing homes have increased significantly in the last few decades.

Osteoarthritis

80% of hip replacements and 90% of knee replacements are due to osteoarthritis. Obesity is the strongest modifiable risk factor that leads to osteoarthritis and subsequent surgery. There is a lot of morbidity and mortality associated with total knee and total hip surgeries. Part of this is the susceptibility to clot formation from the changes in metabolism associated with the metabolic syndrome. This often leads to pulmonary emboli and higher death rates following surgery when compared to surgery in people with normal weight.

Heart attacks and strokes

As there is an increase of the amount of heart attacks and strokes in overweight and obese people it is important to reduce your BMI when you realize that it is creeping up. Regular exercise along with a Mediterranean diet helps to improve this. Avoid processed foods that often have hidden sugar and refined carbs in them. Also cut out sugar. Use stevia, a natural sweetener, if you want to sweeten your food or drinks.

Nonalcoholic fatty liver disease (NAFLD)

In the past nonalcoholic fatty liver disease was rare. Now with the increase of obesity it is common. It can lead to liver cirrhosis with hepatic failure, a common cause of death. But after several years of liver cirrhosis, liver cancer may develop within the cirrhotic liver. Physicians saw this condition only rarely in decades past.

Obesity shortens life: Kidney disease

With obesity there is a negative effect on the kidneys from the metabolic syndrome. Hyperinsulinism affects the capillaries of the filtration units, called glomeruli. They start to proliferate and undergo a form of degenerative change, called glomerulosclerosis. This decreases the filtration capacity of the glomeruli and the kidneys as a whole. After a few decades of this process kidney failure can set in. When an obese person develops diabetes, this will also have a negative effect on kidney function and accelerate the deterioration of kidney function. The end result is kidney failure, which requires dialysis or a kidney transplant.

Cancer and obesity

Obesity shortens life. Chronic inflammation that is worsened by the metabolic syndrome leads to higher rates of various cancers. A prospective study of more than 900,000 US adults was conducted for 16 years. In 1982 when the study was started none of the participants had cancer. After 16 years 57,145 of the study participants had died of cancer. Those in this study who had a BMI of 40.0 or more had cancer death rates that were 52% higher for males and 62% higher for females when compared to normal weight men and women.

Higher cancer rates in people with obesity

It was noticeable that the digestive tract showed higher cancer rates in the obese: esophagus, liver, gallbladder, pancreas, colon and rectum; other more frequent cancers were kidney cancer, multiple myeloma and non-Hodgkin’s lymphoma. There were also trends of higher cancer death rates with regard to cancer of the stomach and prostate in men and breast cancer, uterine cancer, ovarian and cervical cancer in women. The authors concluded that due to the rising obesity rates in the US population cancer rates in men will soon reach the 14% level and in women the 20% level out of the total death rates.

Treating obesity

Treatment of obesity requires a multifaceted approach. I have discussed this in detail in this blog. Briefly, the diet of the obese person needs to be closely looked at. Sugar and starchy foods need to be eliminated. Low glycemic foods like vegetables, lean meat and salads should be encouraged. A regular exercise program needs to be instituted, starting with swimming and walking. Later a gradual transition into gym type activities could be contemplated.

Weight loss surgery has been successfully applied in some obese patients with a BMI that is greater than 30.0 up to a BMI of 39.9. In a 5-year follow up after LAP-band surgery no surgical complications were reported and the mean percentage weight loss was 15.9±12.4%.

Obesity Shortens Life

Conclusion

Obesity shortens life. Obesity is a condition that has been gradually developing since the 1980’s. When you look at the food intake changes rationally it is not surprising that this is happening. Sugar consumption, high-fructose corn syrup consumption and the consumption of processed food have to be cut down, if not cut out completely. You can forget shopping at the middle section of any grocery store, where all that processed food is located. Go to the vegetable section and buy a lot of food from there. Low fat dairy products, eggs, and low-fat meats as well as salmon and other seafood are foods that are healthy. There is one problem though and that is the feeding of antibiotics to chickens, turkeys and beef cattle. This leads to superbugs and changes your gut flora.

Eat organic foods

I suggest you buy organic meats. I eat organic food and have cut out wheat also as wheat underwent forced hybridization in the 1970’s. All of the wheat in the world now is this type of wheat that is too rich in gliadin, which causes leaky gut syndrome and autoimmune diseases. For this reason, I avoid all wheat.

Gradually shed your pounds

I see no reason why obese people could not gradually shed their pounds and regain their stable metabolism. Those with diabetes will be able to shed that diagnosis as they shed their pounds. The kidney and liver function will also stabilize when you shed enough pounds. The goal should first be to reach a BMI of 25.0 to 30.0, which is the overweight category. The next goal would be to aim for shedding even more pounds until you reach a BMI of fewer than 25.0. If you say this is too tough to do, I am saying: giving up is not an option. Cherish your health!

Sep

2015

Ageless Aging

By Ray Schilling | Anti-aging medicine, Arthritis, Cancer, Cardiovascular disease, fractures, heart attack, Hormones, Inflammation, lifestyle, Menopause, mitochondria, Nutrition, Osteoporosis, Prevention, Vitamins and supplements

We have been exposed to a lot of clichés about aging, which makes it more difficult to dispel rumors and to clearly focus on what can and what cannot postpone aging and the associated disabilities. Here I will attempt to summarize what is known about this topic.

The American Academy of Anti-Aging Medicine (also known as A4M) has published a book where all of this is discussed in detail (Ref.1). But there are yearly conferences as well in Las Vegas and other places where further details regarding anti-aging are discussed. Since 2009 I have been attending the conferences in Las Vegas regularly every year.

Based on this knowledge let me start by reviewing the tools of anti-aging that can be used to slow down the process of aging significantly.

Mitochondria

At the center of anti-aging is the preservation and metabolic optimization of the mitochondria. Each of our cells contains little particles called mitochondria, which is where our energy metabolism takes place. Mitochondria function like mini-batteries.

The citric acid cycle builds up ATP, which is subsequently hydrolyzed into ADP and orthophosphate releasing energy for cell metabolism.

Old people who shuffle when they walk and have difficulties climbing stairs have lost significant amounts of mitochondria and simply run out of energy. The key to prevent this from happening is to preserve our mitochondria. We inherited them from our mother, because only the head of the sperm, which does not contain mitochondria entered the ovum when the egg cell that was destined to become you was fertilized. Subsequently the mitochondria from mother’s egg have provided all of the mitochondria in the cells of our body.

Preserving mitochondria

There are supplements that specifically preserve mitochondria: PQQ (=Pyrroloquinoline quinone) helps mitochondria to multiply. A typical dose to take every day is 20 mg. Mitochondrial aging is slowed down by ubiquinol (=Co-Q-10, 400 mg per day is a dose that I recommend). Co-Q-10 repairs DNA damage to your mitochondria.

There are simple lifestyle changes that you can make: eat less calories as this will stimulate SIRT1 genes, which in turn stimulate your cell metabolism including the mitochondria.

Resveratrol, the supplement from red grape skin can also stimulate your mitochondria metabolism. 300 to 500 mg of trans-Resveratrol once daily is a good dose.

Build in regular exercise into your day – and I mean every day– as this will also stimulate your mitochondria to multiply similar to the effects of PQQ. Lipoic acid is an anti-oxidant that counters the slow-down of mitochondrial metabolism. I recommend 300 mg per day.

L-arginine is an amino acid that is a precursor of nitric oxide (NO). Red beet is a rich source of nitric oxide, which is directly released into your system. There are also commercial products for NO. This keeps the arteries open, prevents high blood pressure and also hardening of the arteries and has a direct effect on preserving mitochondria.

Researchers from the McKusick-Nathans Institute of Genetic Medicine of the Johns Hopkins University School of Medicine in Baltimore, MD found that mitochondrial DNA content varies according to age (less mitochondrial DNA in older age), sex (yes, women have more than men) and mitochondrial DNA; it even has an inverse relationship to frailty and a direct relationship to life expectancy. This paper was published in February of 2015.

Each mitochondrion has its own mitochondrial DNA contained in 2 to 10 small circular chromosomes that regulate the 37 genes necessary for normal mitochondrial function.

In multi ethnic groups it was apparent that mitochondrial DNA content was dictated by the age of a person.

Frailty was defined as a person who had aging symptoms including weakness, a lack of energy compared to the past, activity levels that were much lower than before and loss of weight. When persons with frailty as defined by these criteria were identified, they were found to have 9% less mitochondrial DNA than nonfrail study participants.

Another subgroup were white participants; when their bottom mitochondrial DNA content was compared to the top mitochondrial DNA content, the researchers found that frailty was 31% more common in the bottom DNA content group. This means that white people are more prone to frailty and they should take steps early on to prevent this from happening.

Slowing down hardening of our arteries

It makes sense that young people who do not have signs of hardening of their arteries have better blood supply to their cells and thus supply their mitochondria with more oxygen and nutrients than frail, older people. The same is true for people who exercise regularly.

Vitamin D and vitamin K2 have been shown to lower calcium in the blood vessels and to retain calcium in the bone preventing osteoporosis. This is particularly useful in postmenopausal women. This October 2014 publication mentions that apart from vitamin D and vitamin K2 resveratrol and inositol are additional factors helping to prevent heart disease and osteoporosis.

This September 2013 publication confirms that a deficiency for vitamin K2 is common in the general population. This deficiency leads to osteoporosis and calcification of the arterial wall and causes heart attacks, strokes and bone fractures. Supplementation with vitamin K2 at 200 micrograms per day every day is recommended to prevent this from occurring.

Sugar and starchy foods

You need to understand that starchy foods equal sugar, once digested. As a result a refined cereal breakfast=sugar, pasta=sugar, bread=sugar, donuts=sugar, potatoes=sugar and so on. It has to do with the glycemic load. When you cut out sugar and starchy foods (meaning that the glycemic index of the foods you eat is below 50) you will shed 30 to 50 pounds of weight within 3 to 5 months, if you are overweight or obese. You will feel a lot more energy. Your blood vessels will be cleaned out as the oxidized LDL cholesterol will disappear and the HDL cholesterol will mop up what cholesterol deposits were there before.

It is certainly good for you, if you are not into the sugar and candy stuff, but the seemingly harmless pizza and all the other starchy foods mentioned above are of concern as well. All of the high -glycemic carbs stimulate the pancreas to produce insulin. This in turn produces inflammation in tissues including the brain. Alzheimer’s disease is one of the complications of this.

Where does this leave us? For decades we have been told that saturated fats and cholesterol in our diet were the culprits and we replaced them with sugar that is part of a low-fat diet. We need to pay attention to the glycemic index and cut out high glycemic foods. However, it is OK to eat some carbs from the medium glycemic food list and most of our carbs from the low glycemic food list. With regard to fat it is important to consume only the healthy fats like olive oil, coconut oil and omega-3 fatty acids. As you make these adjustments to your life style you will also prevent many cancers, as you normalize the body’s metabolism and help prevent chronic inflammation, which can cause arthritis and cancer. Finally, pay attention to stress management. The body and the mind work together. Uncontrolled stress leads to heart attacks and strokes.

Cut down on processed foods

Processed foods contain the wrong type of vegetable oils that are composed of omega-6 fatty acids. This disbalances the ratio of omega-6 fatty acid versus omega-3 fatty acids. This is typical for all the processed foods, but also fast food places in the industrialized world. The consequence of this disbalance is the formation of arachidonic acid and inflammation of tissues. This causes high blood pressure from inflammation of the arteries, arthritis from inflammation in the joints and can irritate the immune system to the point of causing autoimmune diseases. The end result after decades of exposure to a surplus of omega-6 fatty acids are disabilities from end stage arthritis, as well as heart attacks and strokes from inflammation of the arteries due to the hardening of the arteries.

The remedy for this is to cut out all processed food and stick to the basics of preparing your own food from healthy ingredients with no food preservatives.

Use olive oil for salads and coconut oil for cooking. Take omega-3 supplements to restore the omega-6/omega-3 fatty acid balance.

Replace hormones with bioidentical ones

When I watch postmenopausal women, many look prematurely aged with sagging skin in their faces. Had they replaced their missing hormones when they entered menopause, the bioidentical hormones used for replacement therapy would have helped their skin to remain younger looking, hardening of the arteries would have been postponed and osteoporosis in the bones would also have been prevented.

With men it is now known that testosterone is vital for prevention of prostate cancer, but it is also important to prevent heart attacks, strokes and dementia as they age.

I would recommend that you see a naturopath or an anti-aging physician to have your hormones checked and if necessary start replacement with bioidentical hormones.

Ageless Aging

Conclusion

Slowing down aging and avoiding disabilities from aging are now a possibility, if we manage our lives in a way that the biochemistry of our bodies remains the same and our mitochondria continue to function, even when we get older. I discussed the details of how to do that above. I have also written a book on the subject of anti-aging, which deals with these topics in more detail.

I hope that you incorporate at least some of these steps in your life to prevent suffering from disabilities as you age and to avoid premature aging.

References:

Ref.1: Ronald Klatz, MD, DO and Robert Goldman, MD, PhD, DO, FAASP, Executive Editors: “Encyclopedia of Clinical Anti-Aging Medicine & Regenerative Biomedical Technologies”. American Academy of Anti-Aging Medicine, Chicago, IL, USA, 2012.

Aug

2015

Problems With The Western Diet

By Ray Schilling | Cancer, Cardiovascular disease, Diabetes, Fitness, heart attack, Heart Disease, Inflammation, lifestyle, Nutrition, Prevention

Lately there have been various news reports cautioning us about the Western diet. We eat too much processed food, we eat too much sugar and we have to be careful with how much fat and what kind of fat we eat. Take this story from the CNN. Half the world lives in big cities. And this number will reach 70% in the year 2050, if the urbanization trend continues at the same rate. With it comes the consumption of fast food. The wealthier people are, the more meat they eat. This is exactly what is bad for us. Too much meat can cause gout, particularly when paired with alcohol. First it is time to explain some more about the Western diet. “The biggest features of a Western diet are overconsumption of over-refined sugars, highly refined and saturated fats, animal protein and a reduced intake of plant-based fibers,” says Ian Myles. He is located at the U.S. National Institute of Allergy and Infectious Diseases. This statement is specific enough: we are eating too much fat, red meat, salt and sugar, and too little fiber.

Too much fat

In processed foods we get too many omega-6 fatty acids, which have been shown to cause clogging of arteries and causing heart attacks and strokes, if not balanced with enough omega-3 fatty acids. But many processed foods still have hidden trans fats, which distribute free radicals in your system; this in turn causes hardening of the arteries again. Free radicals also age you faster. A candy bar with palmitic acid and fructose for instance, leads to a slow grade inflammation. The immune system mistakenly takes palmitic acid for the gut bacterium E.coli and mounts an immune reaction. This low-grade inflammation causes inflammation in the blood vessels, but also weakens the immune system. The sugar part of the candy bar oxidizes LDL cholesterol leading to clogging of arteries, which causes heart attacks and strokes.

Too much red meat

Grain fed and antibiotic treated regular beef changes the gut bacteria and can cause super bugs. The change of the gut flora can lead to inflammation in the gut lining and something called “leaky gut syndrome”. We carry almost 2 pounds of gut bacteria in us at any given time. But residual antibiotics from regular beef and chicken reduces that amount and changes the composition of our gut flora.

You can read in this blog that the changes taking place from consuming regular beef changes your liver metabolism and leads to accelerated hardening of the arteries, which in turn causes deadly heart attacks and strokes. On the other hand, grass fed beef or organic beef do not do this. To prevent leaky gut syndrome, heart attacks and strokes from developing you can take probiotics every day, which should include these two species: Lactobacillus acidophilus and Bifidobacterium bifidus. This keeps your gut flora stable and does not allow your food to undermine your health.

To much salt and sugar

Too much salt is often in processed food to prolong the shelf life. But we humans are very sensitive to overdoses of salt. Our kidneys have to work overtime to get rid of the excess salt. We need to drink enough water to allow the kidneys to produce urine, which will eliminate the excess salt. Persistent excessive salt intake will also cause high blood pressure. High blood pressure can cause heart problems, strokes and aortic aneurysms. Restaurant food often contains too much salt and sugar.

Too little fiber

The more food is processed, the less fiber it will contain. If you go for the pizza, it may taste good, but where is the fiber? If you eat bread and butter, where is the fiber? You may say that you like a donut. I ask you again: where is the fiber? The end result is that toxins that normally would have been bound to fiber in the colon and were eliminated in the stool are now interacting with the wall of the colon causing colonic polyps and colon cancer. It may not only be fiber as plant-based diets rich in fruits, non-starchy vegetables, legumes, and whole grains were shown to be associated with a lower risk of the most common cancers. That’s the reason why people who consume a Western diet have higher rates of cancer in general. They lack fruits and vegetables.

Polyunsaturated fatty acids

The recommendation in the 1980’s until about 2010 of a low fat diet to prevent heart attacks and strokes has failed miserably. It turned out that polyunsaturated fatty acids are of the omega-6 type, which gets metabolized into arachidonic acid and causes inflammation. The immune system gets suppressed from the chronic inflammation and the person becomes more prone to infections. As low fat diets are typically high in carbohydrates, there is a calorie surplus causing weight gain. Dr. Fife explains in his book that polyunsaturated acids interfere with the insulin receptor feeding into insulin resistance, which makes it even more difficult to control the metabolism and leads to more weight gain (Ref.1). The end result is what we have observed over the last few decades, a relentless obesity wave in the civilized world. It is a direct result of the Western diet.

Cancer caused by the Western diet

Breast cancer, colon cancer and prostate cancer are cancers that are related to the Western diet. But there are likely many other cancers that are also caused by it.

We know that free radicals cause cancer, such as from trans fats and rancid polyunsaturated fatty acids found in processed foods. Cancer is more common in obese people and people with diabetes.

Habits that make us eat more

There are habits that make us eat more like snacking and falling for so-called “fitness food” which contains dubious ingredients. It may come as a surprise, but married people can also fall prey to unhealthy habits together, forgetting about working out and sneaking in “skinny cocktails”. Read what Cynthia Sass, registered dietician had to say about this on CNN.

Solution to the Western diet

You may expect me to say that you should modify this or that in the Western diet. Modification does not work. You have to get radical here! The real solution is to abandon the Western diet altogether. Replace it with the Mediterranean diet without sugar and starchy foods. It is not that as bad as you can see from 1 week of recipes that my wife included in my book: “A survivor’s Guide To Successful Aging”.

You can eat cooked organic spinach, a piece of meat with slices of Avocado for breakfast. Cooking is done mostly with coconut oil or olive oil. Alternatively you may enjoy an egg or egg white vegetable omelette with lots of greens, mushrooms, onions and salsa and avocado on the side. Add to this caffeinated or decaffeinated coffee with stevia. Alternatively, a bowl of rolled oats, flaxseed and nuts with fresh fruit and organic milk, goat milk or yoghurt would make an excellent, sustaining breakfast. I am mentioning all of this to show you that you can get away from your familiar pancakes with maple syrup, sausages, waffles, toasts and muffins etc.

Food needs to be prepared form scratch with organic ingredients. GMO foods need to be avoided as the final judgment on these is decades away, and you do not want to become a human guinea pig.

Problems With The Western Diet

Conclusion

The only way to “improve” a Western diet is to eliminate it and replace it by the Mediterranean diet. Throw all the processed food into the trash where it belongs! Avoid omega-6 fatty acids (polyunsaturated fatty acids), which have been shown to weaken the immune system and cause insulin resistance. The best fats are omega-3-fatty acids from marine oils (fish oil), coconut oil and olive oil. Forget all the other oils that are heavily advertised. They are not healthy.

I stick to organic foods although they are more expensive. Don’t forget that apart from a good diet you need to engage in a regular exercise program in order to prevent heart disease and cancer. And don’t stress out over the changes that you are about to make. Remember to manage your stress and relax!

References:

Bruce Fife, C.N., N.D.: “The Coconut Oil Miracle”, 5th edition,2013, Penguin Books, NY 10014

Aug

2015

Tools To Turn 100

By Ray Schilling | alcohol, Alzheimer’s disease, Cardiovascular disease, Fitness, heart attack, Heart Disease, Mortality, Nutrition, Smoking, Stress management, Vitamins and supplements

A Swedish longevity study that went on for 50 years gave me the idea to blog about the factors that can help you to turn 100 and still have your mental capacity and good health. Let me introduce you to this study.

Researchers at the Sahlgrenska Academy in Göteborg, Sweden (which is the same as the University of Gothenburg) decided back in 1963 to follow a group of 855 Gothenburg men born in 1913 until they would either die or turn 100. The idea was to find out what killer diseases are in the way to reach such a ripe old age and if they would survive, what was it that made them to reach this age.

Think of it as a race to turn 100. The researchers had checkpoints along that journey: various surveys were conducted at the age of 54, 60, 65, 75, 80 and 100 to consider the factors that lead to longevity. 27% (232) of the original group reached the age of 80, and 13% (111) made it to 90. Only 1.1% of the men made it to the age of 100.

What were the causes of death for the other ones who did not make it? 42% of deaths after the age of 80 were due to heart attacks, 20% due to infectious diseases, 8% due to strokes, 8% due to cancer, 6% due to pneumonia and 16% due to other causes. 23% of the men over 80 were diagnosed with Alzheimer’s or dementia.

What else did the researchers find out? Factors that made people survive were refraining from smoking, maintaining a healthy cholesterol level and limiting coffee consumption to not more than 4 cups per day.

Another marker for longevity was either paying high rent for a condominium or own a house; in other words, a certain amount of wealth seems to be associated with longevity. Passing a fitness test at age 53 riding a bicycle was another peculiar finding of the study. This one points to the importance of fitness and clarity of thought as markers for longevity. There was a genetic factor also, as those who had a mother who lived to a ripe old age also survived longer than others who did not have this longevity advantage. However, researchers stressed that overall this genetic factor was of minor importance, the other factors that are under our control were much more important.

Two of the men who were 100 years old dropped out of the study: one because of dementia, the other one for personal reasons. Here are some of the facts about the other seven: none of them smoked; 2 lived at home, 5 in assisted living facilities. All of them wore hearing aids; all of them had good spatial and temporal cognition. All of them were slim, had good posture, but all used walkers to prevent falls or assist them walking. They were all able to read and watch TV, and most of them wore glasses.

Dr. Wilhelmsen who was part of the entire 50-year research effort said about the centenarians: “All of them were clinically healthy, satisfied with their circumstances and pleased to be living where they were.”

Other research about marriage, health and life expectancy

There is some peculiar research that found that men who are married are healthier than single men. This study came from the University College in London and was based on a group of 10,000 British people who were born within one week of each other on March 1958.

Being married or living common-law was beneficial for men compared to single men. One biomarker was the metabolic syndrome (a cluster of obesity, high blood pressure and diabetes), which was found to be 14% higher in non-married males while in females it did not matter whether they were married or not: they had the same low rate of metabolic syndrome. The longer men were married, the healthier they were. This was not so for the single male. Women, who married in their late twenties or early thirties, were much healthier in their later midlife compared to women who never married.

Harvard has published some interesting facts on men and marriage. A survey of 127,545 American adults showed that married men live longer than the unmarried males of the controls. A review of studies in the early 2000 suggested that when men were married to a well educated woman this may be causing heart attacks in the men. Quite peculiar, isn’t it? But this was refuted in a larger 2009 study, which found that married men live longer and are healthier when the partner is well educated.

Unhappiness and stress were singled out as a cause of high blood pressure, which leads to heart attacks later. Harvard reveals several other facts that are important with respect to longevity: cancer mortality is higher in unmarried men than in married ones; married men are at a lower risk of developing depression. They were found to have higher rates of satisfaction with life in retirement than their peers who never married. Marriage protects cognitive function and leads to a reduced risk of Alzheimer’s disease. Marriage is also associated with improved blood sugar levels and better outcomes with respect to cancer treatment or when hospitalized for other reasons.

General factors leading to longevity

We heard now several interesting points that seem to be linked to longevity. But what is it exactly that is behind some of these observations?

1. Diet

The Mediterranean diet is the gold standard as it has been shown to lead to the lowest mortality rates among diets.Note that longevity increases even more when sugar and starchy foods are avoided. And yes, a Mediterranean diet cuts down the risk for Alzheimer’s disease.

2. Exercise

It has been shown in many studies that regular exercise will reduce all diseases by about 50%! This is better than any medication; this is simply a must, if you are at all interested in living longer and healthier. Not only will your heart benefit from that, but your mind will thank you and not enter into dementia.

3. Alcohol

This has been drummed to death, but the limit is 1 glass of red wine for women and 2 glasses of wine for men. Personally I do not believe that this is true. I have explained in a blog that the same heart protective effect can be achieved by 250 mg of resveratrol as supplement and avoiding alcohol altogether will prevent a number of cancers.

4. Smoking

Originally the Framingham Heart Study has shown that smoking is an important risk factor for heart attacks and strokes. Hundreds of other studies have verified this. Despite this fact women as a group are now repeating the experiment that has already been completed for men: smoking causes lung cancer and many other cancers as well as cardiovascular disease. I see young women thoughtlessly walking around town puffing their lives away.It shows you how powerful cigarette commercials are. Sometimes it is frustrating to watch this as a health care provider!

5. Stress management

This means seeking ways to reduce stress like meditation, self-hypnosis, yoga and others. This also means building social ties and mutually supportive relationships. It makes you feel that you belong, you have your place in society, you help others, and they support you.

6. Avoiding iatrogenic disease

Physician-caused illness is getting more common. Medications have become stronger and often have more potent side effects. For instance, if a physician treats a gluten-induced rash called dermatitis herpetiformis with a drug called Dapsone, the patient can get severe anemia, violent abdominal cramps and bloody diarrhea. A strict gluten-free diet would probably have helped the patient to clear up the rash. All of the symptoms that the patient had to suffer as a result of Dapsone were from this “iatrogenic disease”, which simply means they happened as a result of the doctor’s malpractice that had caused a medication-induced disease.

7. Avoiding exposure to free radicals

Many different agents like substances from pollution, radiation, rancid unsaturated oils and others contain free radicals that damage tissues and cause inflammation. Antioxidants like vitamin C, E and resveratrol can stop this as is reviewed here.

8. Using vitamins and supplements

As already indicated this will help to reduce free radical exposure by the use of antioxidants; reduce inflammation by using omega-3 fatty acids, Co-Q-10, vitamin C and E, resveratrol and others.

9. Avoid accidents

As you are aware, accidents can kill. Wear seat belts, drive safely, and stick to speed limits, particularly in curves. Also don’t drink and drive, don’t use your phone and don’t text and drive. The use of street drugs is also a common cause for accidents.

10. Use bioidentical hormone replacement

When we experience the change of life, called menopause in women and andropause in men we can allow nature to knock us off the planet or use scientific knowledge. It has been proven that it is perfectly safe not to use Big Pharma’s hormone concoctions that the body cannot recognize. Synthetic hormones cause iatrogenic disease as proven in the Women’s Health Initiative. Bioidentical hormones, however simply replace what is missing in menopause and andropause.

The reason this is important is that our system has hormone receptors on the surface of all body cells. In order to have normal function, we depend on bioidentical hormones to assist cell metabolism. For instance the heart muscle in a man has testosterone receptors as has his brain. In women estrogen receptors and progesterone receptors are contained in the cells. Using the right mix of bioidentical hormones based on saliva hormone tests or blood hormone tests can help the treating physician or naturopath to rebalance the body’s natural hormone needs with bioidentical hormone creams applied to the skin.

Tools To Turn 100

Conclusion

Tools to turn a hundred years old and still be fairly alert and fit are listed above. It is important that we start thinking along those lines, because it is only prevention that gets us safely there. If you allow yourself to constantly live it up and run your health down, how can you expect to turn 100? In the last 50 years the life expectancy has risen at least 20 years (85 years now, 65 years then). Now we are seeing a downward trend in the obesity and overweight population and the diabetics. They are the ones vulnerable to iatrogenic disease and mortality. They also are at a higher risk to die from heart attacks and strokes and they are more likely to get Alzheimer’s disease. Also, single men would do well to see their physician more often to check out their health status and perhaps change detrimental lifestyles that married men would not get into, because their wives talk to them. If you can switch from a curative approach in healthcare that usually does not work too well anyways to a preventative approach, you have a good chance to make it to 100. I talk to you then.