LiveLongAgeWell

Likely all of us—who either write or read this blog—hope to live into our 90s and still be healthy, happy, and productive. And fortunately, this is a very doable goal. Every once in a while though, it’s good to know or at least read about living role models, people who have successfully negotiated into their 90s, still strong and productive (here in Brazil for example we have Oscar Niemeyer, a working architect, still designing big works, and he just turned 100).  These folks are a reminder that if we take care of ourselves and with with a little luck, getting older doesn’t have to be bad. With the right mindset it can be a continuing adventure, just with new challenges that we can deal with, even laugh at.

Now, I’m not necessarily endorsing this method for any of you, or for myself, but as I observed some of my oldest and healthiest patients in California, I noticed many of the sharpest and healthiest were those who put off retirement until much beyond age 65. Of course, they were all doing work they loved…

This past week I read two stories about oldsters like this, and I suggest you take a few minutes to read at least one of their stories. The better one, the first, in the Japan Times, is an interview with a 97 year-old physician still working in Tokyo. I like these of his points in particular: always make plans for the future, avoid obesity, find life guides and role models, share what you know, stay attuned to art and music, and always take the stairs.

The second story is about the 90 year-old science writer for the San Francisco Chronicle. Seems like his newspaper will fade away before he does, but my guess is, if his employer goes bankrupt, he will adapt, like all wise old people do, and start a science blog.

For a long time scientists have suspected that the progressive, degenerative neurological disease Parkinson’s can be triggered by exposure to pesticides. Animal studies have shown exposure to the common pesticides paraquat and maneb will damage the brain’s dopamine producing neurons, and a lack of dopamine in the brain can lead to the rigidity and tremors seen human Parkinson’s disease.

A recent report from UCLA studied people in California’s agricultural Central Valley who lived close to crops exposed to the pesticides paraquat and maneb (and a matched “control group” who lived far away from the treated crop fields) and found that the people living close by had a 75% increased risk of developing Parkinson’s. Those pesticides are commonly used on a number of vegetables including soybeans, potatoes, lettuce, and corn. This is another reason to seriously consider buying organic when you can. Especially if you have a worrisome family history for any neurological problems, the cost difference should be well worthwhile. On the positive side, keep in mind, as mentioned in a previous post, that caffeinated coffee seems to markedly decrease the risk of Parkinson’s disease.

And, while the UCLA study was only directed at the association between pesticides and Parkinson’s disease, I suspect further research will show an association between chronic pesticide exposure and other neurologic disorders….it seems logical that if pesticides cause damage in the dopamine-producing neurons, that they also cause damage elsewhere in the nervous system, and increase the risk of other degenerative neural disorders. Maybe dementia, or the tremor commonly seen in many (not all) older people…for example the little shake when some grab a cup of coffee…that is harmless but serves as one marker indicating that yes, this person seems to be getting “old”.

OK, now here comes a link that will make the cost of your subscription to LLAW worthwhile (hehe…drDave just wanted a little chuckle to himself there)—it’s my favorite list of veggies and fruits with the highest pesticide content, with lower pesticide alternatives (if you don’t or can’t buy organic)…print and consult this list.  You just might live longer and better!

http://www.organicconsumers.org/organic/pesticide-residues.cfm

To finish the week…vitamin D and the racial health gap

You probably know that in the U.S. at least, African-American individuals suffer from a greater incidence of many health disorders, and at an earlier age, such as colon and breast cancer, and more aggressive forms of prostate cancer, and there are various theories why. Now it’s been found that darker-skinned individuals have lower levels of vitamin D, and perhaps that’s  one of the major reasons for the health gap.

Darker-skinned people, and people who live farther from the equator—especially during the winter—can easily suffer from low vitamin D levels, and more and more data is showing how important vitamin D is for our health (click on the “Pick A Topic” cloud on the LLAW right sidebar, and you’ll find a number of posts about vitamin D). While the current recommendation for D is from 200 to 600 units a day, most likely in a year or so these will be raised, maybe to 1000 units per day. Check out and click on Pick A Topic to see more about the vitamin that probably deserves so much praise. Keep posted here for the latest updates. Have a great weekend!

p.s. If you want to read even more about vitamin D this weekend (or whenever), check out this non-profit source:

http://www.vitamindsociety.org/about.php

Continuing the theme of last Friday’s post “do married people live longer?”, today a light and simple idea for couples looking for ways to keep their relationships fresh. A healthy, low-stress primary relationship goes a long way to keeping you physically healthy. First though, since many LLAW readers are outside the U.S., let me define “date night”.

“Date night” is a pre-set “date” time, typically one evening per week, that couples—often who have been together for some years—use to re-ignite or at least help maintain some fun and passion in their relationship. The two don’t have to be actually married, but the common theme is that the partners are often so busy with their independent work and home lives that without this pre-arranged time, they might not get out of the house alone together for fun and entertainment.

Researchers have found however that “date night” for many couples can be, every week, every time… pretty much the same…out to the same restaurants or movie theaters or with the same group of friends. Now some recent studies, based on neurotransmitters, suggests a better way to approach “date night”.

These days neuropsychologists look at either brain scanning or brain chemistry to try to explain and understand human emotions, and love and passion are prime targets for research. Already widely known is that couples’ relationships shift over the first several years, and the original excitement and passion is usually replaced by a (hopefully) still loving connection, but typically the newness and passion cools over time.

The neurochemical explanation is that when we are first in love, the brain is flooded with the neurotransmitters dopamine and norepinephrine, the same transmitters that fill our brains when we engage in new activities and adventures that are exciting, or daring, maybe a bit risky. Working with that data, a social psychologist from the State University of New York devised a number of experiments with couples in various situations.

He found that one big key to keeping a relationship exciting and the good neurochemicals flowing is to inject novelty and challenge into shared activites. Make an active effort to avoid the same places or the same people each week. Shake it up as much as you can. Rather than Chinese food, pick Moroccan, rather than biking in the park, try rafting or hiking on new trails, rather than hooking up with the couple from work, invite that new lesbian couple for drinks or dinner. Take risks, shake it up, constantly. Some things will work out, others will fail and that’s a good thing. It shows you’re willing to live a bit on the edge, and that helps keep your brain chemistry in good working condition. When you experience novelty in outside activities, the right neurotransmitters will keep flowing, and you’ll probably continue to see newness in your partner too.

Monday’s post will be “Date night success for married people”…
but today let’s examine one pearl of “conventional wisdom”: that married people live longer and are healthier than single people.

Fortunately this “marriage” benefit is not so rigid, as it allows for unmarried couples too; just living as a couple, or at least living with another person, is said to help you live longer. The reasons are uncertain. It could be that close daily social interaction itself is good for our hearts and brains, or that when we live with another person we are less likely to engage in damaging behaviors like laying on the couch all day or drinking too much or smoking. Probably it’s a combination of various things.

There is also good evidence that living with a pet is better than living alone. (I suspect it’s better to live with a pet than with another human with whom you don’t get along. I believe the stress from a nasty human relationship is worse than any benefit….yes, dogs and cats can be our best friends…)

Armed with the conventional wisdom then, I found this Psychology Today blog post very interesting. Written by a University of California psychologist, she argues that the basic research (the RAND study)—the foundation of the accepted dogma that marriage protects you—is biased and not true.

Dr. DePaulo’s examined the RAND study along with even longer-term data, and found that the most scientifically correct conclusion is: what is best for your health is not singleness or the married state, but consistency… that you either STAY married or STAY single.

She says the other studies had it wrong in their conclusion that people who were “single” died sooner. The reason lies in the RAND definition of “single”. They defined single as anyone who was not married at the time of the research. This means that their “single” group included not only people who had never married, but anyone who was also divorced, separated, or widowed. And there is plenty of data—and I saw this many times in my medical career—that people (especially men) who are divorced, separated, or widowed suffer more medical problems.

So the major study showing that being married was healthier than singlehood used a definition of “single” that included an less-healthy mix of separated, divorced, and widowed people. Another longer-term study of single vs. married, the Terman Life-Cycle Study which began collecting data in 1921, found that either consistent marriage or consistent singleness was the best for health.

I recommend you check out the Psychology Today blog, and if you have an opinion, email me or leave a comment. I am not against being in a couple; far from it, but I think we should, like this UC professor, look at the potential medical benefits more honestly. Next…one hint how to stay coupled.

I have a regular disagreement with a doctor friend of mine. I tell him that most research supports that people who drink a little alcohol each day live longer, and he says no, sorry, that can’t be… (or if he’s in a good mood, he might concede: “yes, but only if it’s red wine”). And I always respond: no, actually, even people who drink a little gin or vodka or whatever each day live longer and with less risk of early death. It’s always the same argument.

So I was happy to see this recent publication of a large, impartial research project (part of the U.S. Health and Retirement Study) from a reliable institution; the University of California San Francisco, which followed 12,519 adults age 55 and over during a four year period with one question: who was more likely to die—of any cause—during the four-year period—those who didn’t drink any alcohol, those who drank “moderately” (one drink per day), or those who drank “heavily” (three or more drinks per day).

They found that people who had one drink per day enjoyed a 28 percent lower risk of dying during the four-year period. The researchers controlled for other factors like race, smoking, obesity, socioeconomic status and so forth to make sure that what made the difference was only the alcohol intake, and not some other factor(s), like that people who could afford a little alcohol each day also were thinner, or had better diets, or wore their seatbelts more, etc.

The study further concluded that people who drank three or more drinks per day increased their risk of dying during the four years by 11%. Those who drank just a little bit—averaging one drink per week—did not show a lower death risk like those who had one drink a day. In this study, the people who drank a little bit, or we might say moderately (one drink per day),  survived the best.

Alcohol and health though is a complex and controversial topic, and it brings out lots of passion and guilt, fear, danger…all of that, in doctors as well as in the general public. Floating around is the concern regarding addiction, and for all of us, that needs to be considered.

If you care to read more about this, and how cancer risk compares with heart risk and alcohol, I suggest you might start with this recent WebMD article.

Now I’ll ask my doctor friend—the one with whom I argue this issue—and see what he thinks about this UC San Francisco study. I suspect he won’t believe it. If you remind me, I’ll tell you what he says.

ps….yes, Buzz the poodle is better

Due to the Easter holiday, no post today….beyond that…my little toy poodle is sick and I had to find a vet who was working today, which is not an easy venture here in Brazil on “Santa Sexta-Feira” (Holy Friday)…everything is shut down.  Looks like this weekend I’ll be playing nurse for my dog. (I will do my best.)

Have a good weekend, and hope to see you Monday with a new post!

I noticed an interesting research report a few days ago, a Spanish university study showing that THC—the active ingredient in marijuana—had an effect in killing brain cancer cells. And since brain cancer is one of the worst, any good news is worth a look. Senator Ted Kennedy is fighting this disease right now.

The Spanish study focused initially on mice with artificially induced brain cancers, and THC introduced into the tumors caused the cancer cells to basically consume themselves to death (a process called autophagy), and apparently left the normal cells intact. The researchers then tried the treatment on two human brain cancer patients, with supposedly good results (however, if the patients had actually been cured or put into remission, that would have been huge medical news).

There were reports about THC being effective against brain cancer in 2004 and there have been sporadic positive reports that THC may promote brain neurogenesis (growing new brain cells), and could even help fight Alzheimer’s disease. It seems that many of these studies though haven’t been replicated, which is essential in testing any potential medical advance. Many times one medical study can be flawed in any number of ways.

I suspect though that over the past decade, in the United States at least, it would have been politically difficult to get funding—let along publish—for any study that might show a benefit from THC or cannabis. Let’s hope that now, going forward, objective research can be carried out in what we might call politically sensitive areas (stem cell research comes to mind). Only then can we can learn, for example, if these early studies showing positive effects of THC on the brain are valid or not.

Last post we discussed research showing that people who eat more red meat have a higher risk of cardiovascular disease and cancer. During this ten year study, those who ate the most (red) meat had a significantly higher risk of dying of any disease.

Still, many people enjoy eating red meat, and there are some nutritional benefits. Red meat is a great complete protein and vitamin B12 source, both of which are difficult to obtain from vegetables (but fish for example provides both).  This study and others have shown that those who eat “white” meats such as poultry and particularly fish, have a lower risk of heart disease and cancer, so switching from red to white is the first thing to consider for meat eaters. Here are some other measures red meat eaters can take to diminish the risks:

1. Eat smaller quantities less often. Try to limit to two- to three times per week and keep to about 6 ounces per serving (the size of a deck of cards).

2. If you eat processed meats (like hot dogs and bacon), look for nitrate-free products, as nitrates are a known carcinogen (be aware though that nitrate-free meats need more careful refrigeration, as nitrates are normally used as a preservative to decrease bacterial growth).

3. Don’t char meat! Cooking meats at high temperature—especially on a grill—giving a black crust, forms many carcinogenic substances. Cook (thoroughly to avoid bacterial problems) at more medium temperatures.

4. Look at the sell-by date when you buy. Buy the freshest you can, avoiding oxidized, brown-tinged pieces.

5. Buy the leanest cuts to avoid saturated fat, known to increase the risk of breast and colon cancer. Bison, leaner than beef, is a good alternative. The fat in meat is where any pesticide residue or hormones are concentrated.

6. Consider buying organic, grass-fed beef. It may be safer as you avoid any risk of extraneous chemicals, and it is said grass-fed beef contains a higher concentration of the healthy omega-3 fatty acids.

7. At the same meal you have red meat, make sure you also eat several different vegetables, which may counteract the cancer-causing properties in the meat. Cruciferous vegetables such as broccoli, kale, collard greens, mustard greens, cabbage, cauliflower, and Brussels sprouts have especially been shown to be cancer-fighters.

8. Consider drinking a glass of red wine along with a red meat meal. Red wine is full of cancer-fighting polyphenol compounds, and some data suggests these might minimize absorption of the carcinogenic substances in the saturated fats of meat.

We have heard nutritional experts for years saying: “eat less meat, especially less red and processed meat” A week ago a large study from the National Cancer Institute was published, and the results should wake-up those of us who eat (probably too much) red meat. The study strongly suggested we have a higher cancer and cardiovascular disease risk, and, bottom line, may die sooner. Fortunately, there are some measures meat eaters can take to minimize the risk and damage (and there is very good news for “white” meat eaters). First let’s look at the cold hard numbers, then, let’s try to get some balance on the issue.

The researchers studied over 500,000 people during a ten-year period, 1995-2005. All of them completed an extensive dietary questionnaire diet (I suggest you take a glance at this almost unbelievable survey form [pdf]). The study also analyzed the individuals’ health habits (like smoking and exercise) and diseases, and at the end of the ten year period, the main question was: did eating red meat significantly raise the risk of death from cancer and heart disease? The answer was a clear yes.

Shockingly, men who ate the most red meat had a 31% increased risk of dying from any disease during the ten-year period compared to men who ate very little red meat. For women, the numbers were even worse: a 36% higher risk of dying for those who ate the most. Most of the deaths were due to a higher rate of cancer and cardiovascular disease in the heavy meat group.  Those eating the most processed meats (like sausages, hot dogs, bologna) showed, for men, a 16% higher risk of dying during the ten-year period, and again, worse for women at a 25% higher risk.

One issue that complicates the data is that those who ate lots of red meat were also more likely to smoke, and on the other side, those who ate less meat were more likely to eat more fruits, grains, and vegetables. While the researchers tried to factor those issues out of the study—and only examine the difference in meat consumption—it’s impossible to separate out the various other factors.

The possibility exists, for example, that it’s not so much the heavy meat consumption that’s responsible for the increased deaths, but the lack of fruits, vegetables, grains, and the increased cigarette use in the heavy meat group. Most likely it’s a combination of factors: more red meat and less of the good things in the diet, and probably the minimal-meat eaters were tuned in to many other healthy habits than were the heavy-meat eaters. Maybe the serious carnivores were more likely to eat things like fast food, or French fries… The bottom line is that it’s very difficult to study only the difference between those who ate lots of meat and those that did not, and this study didn’t do that either.

Next post I’ll write briefly about “white” meat, and list a number of ways red meat-eaters can minimize their risks. Humans evolved—rather successfully—as omnivores, eating many types of animals and plants. It’s a contentious issue. I have heard people say, in effect, I don’t care if I die sooner; I want to enjoy eating meat. And, since the risk of death for each of us is 100%, it’s a question we need to answer for ourselves, not only for meat, but in many aspects of our lives.