Integrated Health and Aging
An important principle of the emerging laws of health and healing is that anything helpful should help more than one system of the body at a time. So a diet that might help mitigate the effects of aging in the skin should also have beneficial effects on the major organs of the body.
So I was encouraged to see a new report indicating that cardiovascular health and a healthy lifestyle are associated with maintaining the health of our brains as we age. This is, of course, intuitively obvious, but it is always nice to see such things confirmed by empirical research.
The new report is from a multi-Institute collaboration of the National Institutes of Health (NIH) published online in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. The chair of the committee was Hugh Hendrie, the Scottish-born professor of psychiatry from the University of Indiana, and the committee members were many of the most eminent people in the fields of aging and Alzheimer’s disease.
What is encouraging about this new report is that many of the factors associated with cognitive decline as we get older are eminently remediable: we have within our reach a set of potential interventions that could significantly reduce our personal risk of developing cognitive problems later in life. These are the things that we need to work on if we want to reduce our risk of developing cognitive decline later in life:
- Hypertension: There is excellent evidence that inadequately treated hypertension correlates strongly with cognitive decline.
- Physical activity: There is good evidence that elders who exercise regularly are less likely to experience cognitive decline. This is over and above the general improvement in quality of life that accompanies regular exercise. The earlier in life that we start, the easier it is to continue.
- Increased mental activity throughout life, including learning new things and going through higher education may benefit the health of the brain.
- Moderate alcohol use and the use of vitamin supplements also seem to be brain protectors, though the report does not specify which supplements.
- Social disengagement and depressed mood are both associated with poorer cognitive functioning, so it is important to be alert to signs of depression, and to maintain a social network. I discuss this in more detail in my book Healing Meaning and Purpose.
There are doubtless some genetic and environmental factors about which we can do little. But the idea that we now have a list of things that we can do to protect our brains is very exciting.
This report also signals another important change. In recent years we have seen the growth of Positive Psychology, the study of how to improve ourselves rather than the constant focus on psychopathology. This report calls for the research community to study health maintenance of the brain with the same energy that it has brought to bear on the study of diseases of the brain. To which I would add, that we must not just focus on how to maintain the health of the brain, but how we can enhance it’s function so that we can all reach and exceed our full potential.
Technorati tags: aging, Integrated health, Positive Psychology, healthy lifestyle,
The Four Percent Solution
In this week’s edition of the Journal of the American Medical Association, is a study of 11,701 American over the age of 50, who participated in a national health survey in 1998 funded by the National Institute on Aging. The researchers analyzed participants’ outcomes during a four- year follow-up and examined the health characteristics that seemed to predict death within four years.
These were the questions that were asked, and this is a bit like golf: you want to have the lowest score possible. Zero would be best. The score is supposed to tell you your chance of dying within the next four years.
1. Age: 60-64 years old = 1 point; 65-69 = 2 points; 70-74 = 3 points; 75-79 = 4 points; 80-84 = 5 points; 85 and older = 7 points.
2. Male or Female: Male = 2 points.
3. Body-Mass Index: Less than 25 (normal weight or less) = 1 point. (BMI = weight in pounds divided by height in inches squared, multiplied by 703.)
4. Diabetes: 2 points.
5. Cancer (excluding minor skin cancers): 2 points.
6. Chronic lung disease that limits activities or requires oxygen use at home: 2 points.
7. Congestive heart failure: 2 points.
8. Cigarette smoking in the past week: 2 points.
9. Difficulty bathing/showering because of a health or memory problem: 2 points.
10. Difficulty managing money, paying bills, keeping track of expenses because of a health or memory problem: 2 points.
11. Difficulty walking several blocks because of a health problem: 2 points.
12. Difficulty pushing or pulling large objects like a living room chair because of a health problem: 1 point.
Score:
- 0 to 5 points = less than a 4 percent risk of dying;
- 6-9 points = 15 percent risk;
- 10-13 points = 42 percent risk;
- 14 or more points = 64 percent risk.
So what should we make of this?
The first thing is that the study is just looking at the physical aspect of life. It asks nothing about diet or family history. It also says nothing about psychological and spiritual factors that can buttress health and well-being.
So what should it mean if somebody gets a high score? Does it mean that they should expect the end and stop reading long novels? Absolutely not! A high score should be a very good indicator that you should have a talk with your health care provider and get to work on all the reversible factors on the list. And as I have pointed out before, a positive psychological outlook and regular spiritual practice have been shown to extend the length and quality of your life.
It is not given to us to know the length of our lives and plenty of people live on and on despite breaking all the rules while others die young despite a lifetime of temperance. I had an aunt who smoked heavily throughout her adult life, yet lived to be well over ninety, while one of my former students died of lung cancer in his thirties, having never smoked a single cigarette.
Genes and lifestyle are important in determining our life span, but so are the quality and integrity of our relationships, our own sense of meaning and purpose, the clarity of the subtle systems of the body and our spirituality.
So use this study not as a death sentence, but as a wake-up call.
Technorati tags: health quiz, aging, longevity
Appetite Suppression
Appetite is a complex phenomenon controlled by many neurochemical and hormonal signals, as well as psychological and social factors.
An article by a group of investigators lead by Gilles Mithieux from the French research body, INSERM, published in the journal Cell Metabolism, may explain why many people on high protein diets, like Atkins, report a reduction in their hunger pangs.
The study was done in rats that were fed a high protein diet. It was found that this diet increased the activity of genes involved in glucose production in the animals’ small intestine. This increased glucose production was sensed by the liver and then chemical signals were relayed to the brain indicating that the stomach was full, and thus causing the animals to reduce their food intake.
Previous research has indicated that high protein diets do not seem to do anything magical to metabolism, but may work by reducing the overall intake of calories. The same effect on intestinal glucose production can be achieved with a low carbohydrate diet, showing us that both types of diet are probably working by the same mechanism. There are some interesting points here:
1. This study re-affirms the importance of calorie reduction as the key to weight loss, and it answers the “how” question: how do some of these diets work?
2. It illustrates something that is not widely known: glucose is produced in many parts of the body and glucose is a key regulator of appetite. The vast majority of the glucose circulating in your blood has come from the liver, and not directly from what you eat. It is only if you soak yourself in simple carbohydrates, as might happen if you drink something containing a lot of sugar, that your blood glucose may rise. But in most people who have healthy metabolism, the body rapidly corrects the elevated glucose.
3. The types of genes being stimulated to work in the intestine cannot be stimulated indefinitely. Eventually they will stop responding. You can only fool the body for a limited amount of time. That would explain why so many people who lose a lot of weight on one of the popular diets, find that the weight does not stay off. The lesson must be to make small but significant dietary changes, with the emphasis on keeping your food intake balanced. (You might like to have another look at my entry from January 6th)
Technorati tags: appetite, diet, high-protein
