LiveLongAgeWell

Over the last several years as more studies come out regarding vitamin supplementation and health, I have been decreasing the number and milligram “dose” of the vitamins I take. For example, I used to take vitamin E (as the more difficult to find, but more valuable “mixed tocopherol” form) 200 IU once per day, and now I take that same amount but three times a week. The one vitamin supplement though I recently added is vitamin D3, a single 1000 IU pill on most days.

Just this month another report about vitamin D and its possible “brain protective” effect appeared in the Journal of Alzheimer’s Disease. The author suggests people over 60 have their vitamin D level checked, and strongly consider vitamin D3 supplements or…get more sunshine.  This is not the first researcher to suggest vitamin D is “neuroprotective”. Earlier this year there was a large U.S. study showing that people with low vitamin D blood levels were more than twice as likely to have dementia as people with high blood levels. Of course, this doesn’t prove that taking vitamin D will cut your risk for dementia, but it seems likely, and for me, I think the potential benefits of daily 1000 IU of vitamin D3 far outweighs any risks.

I was surprised to see a report in the June American Journal of Medicine. The author examined health habits on over 15,000 adults over two different time periods: 1988 through 1994 and 2001 through 2006. The question was: are people practicing a healthier lifestyle now than they were 15 to 20 years ago? The answer is that currently, more people are doing worse when it comes to good health habits!

Yes, more people in the current study are obese (36 percent now vs. 28 percent in the older study), fewer people are exercising regularly (now 43%, and it was 53%), and even worse, the percentage of people who eat five or more servings of vegetables and fruits daily dropped from 42% to the current level of only 26%.

All this despite a flood of health information in the media, including blogs like this. Maybe people are becoming overloaded with health information and just… tune it out? Perhaps the constant flood of data, combined with contradictions from study to study, leads people to think: why bother? What do you think?

I guess the only good news from this is that if YOU choose to live a reasonably healthy life (in short: eat a good diet, exercise and keep your weight under control), you will  look better and better as you get older compared with the growing number of people who are all also getting older, but who aren’t taking care of themselves like you are.

Yes.

Last post I presented evidence that the act of chewing gum can temporarily improve short-term memory and test-taking performance (click to read).

These brain benefits are based on relatively new research, including functional MRI scans, but other well established research has demonstrated that chewing gum can improve your oral health; the condition of your teeth and gums. If you have healthy gums and good oral health, you are less likely to get sick.

People with poor dental nutrition, meaning untreated cavities and inflamed gums, are more likely to suffer from cardiovascular disease. The current thinking is that some heart and blood vessel disease, including atherosclerosis, is an inflammatory process, and if your gums and teeth are not in top condition—meaning they are chronically infected—your oral tissues will be slowly leaking toxic, infectious products into your bloodstream. These toxins then are slowly irritating, inflaming the walls of your blood vessels and leading to more vessel damage and making you more prone to heart attacks and strokes.

As an otolaryngologist, I saw tens of thousands of mouths over 25 years, and usually I got a fantastic clue as to how healthy someone was just by looking at their teeth and gums. Not always, but usually, if the gums were in good shape, so was the person, and if the person had bad oral hygiene, their body was not in such great shape either.

Saliva is a good thing; in general the more the better. One of the causes of chronic gum infection and inflammation is dry mouth. Typically the more saliva you make, the healthier your mouth, and one reason chewing gum is healthy is because it stimulates saliva production. Saliva dilutes the acidic environment in your mouth that follows a meal—it washes away and neutralizes the acid and food particles that lead to chronic infection and dental plaque. The calcium and phosphate in saliva can strengthen your dental enamel. Further, low-grade gum irritation makes you more prone to diabetes, and if you already have diabetes, gum infection will make your blood sugar more difficult to control. Finally, a dry mouth makes bad breath more likely.

Even the normally conservative American Dental Association has endorsed certain chewing gums, and you can see which those are by clicking here. They typically contain tooth-friendly sugars like xylitol or sorbitol. The recommended “dose” is that you chew for up to 20 minutes after a meal. It’s particularly a good idea after you eat out—for example after lunch at work—and don’t brush until hours later.

Look for a gum with “Whitening” on the label. They cost more than regular gums, but are worth it. The only side effect I can think of is the act of chewing gum can in some people strain the TMJs (temporo-mandibular joints), so watch for any pain in front of your ears, and discuss any concerns with your dentist. Otherwise, give gum a try. It’s cheaper than most all medications, and a lot safer. It potentially can improve your oral health, your general health, your mental health, and your social life…as we get older, breath becomes more of an issue, and whatever we can do to combat bad breath and allow people to come physically closer, the better.

Recently I’ve written about prescription drugs (like modafinil) that will likely improve your mental performance, but, like most drugs, there are possible side effects. Since these drugs are so new, there may be really serious ones that show up only after years of use. So today let’s talk briefly about something much milder—chewing gum—which might improve your mental performance, and certainly with much less risk.

I have been particularly interested in this subject because here in Brazil—and this is also true in many European and Asian countries—that the outcome of one big test, one written exam, will determine if someone gets into college or not. I have a friend here who is taking a written test that will determine if he gets an important job. There’s no interview, just this one test, so it’s lots of pressure.  I wanted to give him a little help, but didn’t want to suggest drugs such as modafinil. So I encouraged that he chew gum right before and during the test. There is research evidence that it could help him perform better, and you might consider this even if you don’t have to take tests anymore, but at times need a little mental boost.

Earlier in the decade there were studies that chewing gum improved performance on memory tests involving word lists, but the most recent study came from Baylor University in Houston. Researchers there looked at 108 students aged 13 to 16, and gave half of them sugar-free chewing gum to use in math class and while doing homework, and the other half went without gum. After fourteen weeks, they all took the Texas Assessment of Knowledge and Skills test, and the gum chewers slightly outperformed the non-chewers (by 3%, but they felt this was statistically significant).

Teachers noted also that the gum-chewers needed fewer breaks during class, seemed to pay better attention, and were quieter (they must have been careful and courteous chewers).

There have been other studies, using “functional MRI” scans, suggesting that gum chewing temporarily stimulates mental activity. These studies suggested that the mechanism is increased blood flow to the areas of the brain having to do with memory and focus such as the hippocampus and pre-frontal cortex. Other researchers have suggested that chewing temporarily lowers anxiety by releasing nervous tension, allowing one to perform better. This makes sense, and likely it is a combination of factors that allow students to perform better.

So while the mental boosting effect is not great, chewing gum might give you a little boost when you need it. Try it and see if it works for you; there’s not much to lose. But beyond possible mental benefits, gum chewing can be good for you in other ways, and we will cover that in the next post.  Have a great weekend!

I was surprised and slightly amused to see acai (properly spelled, with accents açaí, and pronounced ah-saa-EE), the blue Amazonian berry, so heavily promoted as a weight loss aid—and a frequent subject of spam emails—because here in Brazil, where it comes from, acai is more likely seen as something that will make you fat, not thin. Still, acai as a supplement has become a huge industry in the United States, with a marketing frenzy spurred by high-powered endorsers like Dr. Oz and Oprah. What’s the truth….will it help make you thin, or fat, or neither?

I initially heard of this “healthiest fruit in the world” —a reputation it carries in Brazil—on my first trip here in 2001, and since it was exotically blue, tasty, and apparently full of antioxidants, I have eaten it frequently. Acai is a grape-sized fruit from an Amazonian palm tree (another part of the same tree is sold as “palm hearts”), usually sold in frozen packs of blue pulp. Typically it is prepared as a thick smoothie, mixed with banana and the sweet caffeine-rich syrup of another Amazonian berry, guaraná. It’s fashionable to cover the whole bowl with granola.

Acai indeed has the reputation as being mysteriously healthy, full of antioxidants, and the science indicates that it is, but exactly how heavily it’s loaded with antioxidants is controversial. Some studies indicate a medium level, some higher; it depends on which “system” of oxidation in the body or test tube is being tested. It seems likely though that the basic antioxidant content is quite high, somewhere around that of a blueberry.

Interestingly, the value of antioxidants in the body is a hot topic now…are they helpful or could they be in some cases harmful? A recent study regarding vitamins C and E and exercise suggest that antioxidants, at least as pill supplements, might actually weaken our own body’s natural system of mopping up oxidative damage, and antioxidant pills might weaken these defenses. So a new theory is that these supplements might make our own natural antioxidant systems lazy, and in the long run, lead to more oxidative damage, more aging.

But it is much too soon to reach any conclusions; almost certainly, other studies with different formulations of vitamin E, different dose schedules, etc, will give different results. Most scientists seem to agree however that the antioxidants you consume in foods like tea, red wine, colorful vegetables, legumes, coffee, chocolate, etc, are beneficial as far as cutting risk of heart disease, some cancers, and possibly dementia.

Back to acai. Besides whatever natural antioxidants it contains, it is full of the best form of (monosaturated) fatty acids, similar to olive oil, and has lots of fiber. But as a weight loss aid? No proof at all, and no good evidence either. Don’t waste your money. Acai in body creams as a wrinkle reducer? Again, no evidence; better to spend your money on a visit to a dermatologist, a prescription for topical retinoic acid, and a good sunscreen. Still, I’ll continue to eat my acai mixed with banana and guarana, but I’ll rely on the gym and lots of walking to keep my weight in line…certainly not acai, green tea, or any supplement.

Here are several excellent articles that may interest you… The first two cover recent LLAW topics (red meat and mind drugs), and these links will give you a totally different slant on each subject. The third article, and the shortest,  regards a totally different subject: creativity.

From The New Yorker, titled Brain Gain, is a long piece that first describes how college students are taking advantage of mind drugs (easily found on-campus) to ultra-perform. Then, in true New Yorker style, the author dives into several people at the forefront of cosmetic neurology, and the “transhumanist” movement (who believe we humans have the potential to live a very long time).

And if you are looking for even more motivation to cut down on your red and processed meat consumption, I suggest this relatively short article in the New York Times: Paying a Price for Loving Red Meat by Jane Brody.

I subscribe to an American Medical Association news feeder that every day sends me a digest of the latest medical news, and I have noticed for the last few months, the news is dominated by public health policy and health care economic reform in the United States.

So let me suggest a topic far away from those subjects… from a founder of the company IDEO, which helped design the Apple Computer.

Getting older is much more fun if you constantly keep your “creative juices” flowing, no matter your age; believe me, you will help keep your brain in good form, and this brief and entertaining piece from the IDEO group gives six hints to help us achieve that! Love it!

In honor of our mothers, let’s consider some advice many of them have given—perhaps your own mother said “eat your carrots…you’ll see better at night”—now let’s just update that with the latest information. It’s a nice coincidence because a few days before Mother’s Day, the journal Ophthalmology came out with a report on the best (nutritional) advice to prevent macular degeneration, the progressive loss of function in the retina of the eye and the most common cause of adult visual loss. (Click on this link for a “macular degeneration simulator”.)

One reason macular degeneration is so worrisome is that it’s so common: 10% of people over 65 are affected, and that rises to 30% for people over 75. Your risk is higher if you have a history of smoking, and with a close relative with macular degeneration, your lifetime risk rises to 50%. So it’s good to know there is something you can do to help diminish this threat as we get older besides a carrot-a-day…

Here’s what the analysis of the diets of over 4000 people in the Age-Related Eye Disease Study suggested to keep your vision good as you get older:

1. Eat a low-glycemic index diet. The glycemic index is a rating of how foods spike your blood sugar once they are absorbed, and the less the spike, the better. Slow absorbing foods are best. Particularly bad are white bread, starchy foods such as potatoes, and sugary pastries. Best are whole-grain breads, nuts, proteins, and vegetables.

2. Try to get a wide range of antioxidants from fresh fruits, vegetables, nuts, and perhaps eggs. Especially good are green leafy vegetables, spinach, kale, broccoli, and when you buy lettuce, stick to the dark green romaine style rather than the wimpy pale “head lettuce” or “American lettuce”. Other good sources of the vision-beneficial antioxidants are eggs, beans (especially black), and again, nuts and whole grains.

3. Try to get lots of vitamin C from citrus fruits.

4. Omega-3 fatty acids are great for your eyes (as well as your brain), and you can best get those from fatty fish, such as salmon.

So go ahead and eat a carrot-a-day, it’s great advice, but if you are really concerned about keeping your vision intact as you get older, and particularly if you have a positive family history, there are plenty of other dietary measures you can take. Don’t wait…add to your shopping list: oranges, broccoli, spinach, whole-grain bread, romaine lettuce, nuts, and salmon!

You probably have a friend, or perhaps a boss, like Bristol (name changed)….let me summarize Bristol—she’s very bright, but she consistently has a negative, pessimistic reaction to, well, seems like everything. I really like Bristol, but I’m constantly amazed: how can someone find something bad in almost every bit of news I give her? Now maybe I have an answer.

In the most recent issue of Veja (no link since it’s by subscription; only in Portuguese…most similar to Time magazine in the U.S.), there was an article of a British/Brazilian university study which identified a gene that appears to control optimism and pessimism. Several hundred people were put through DNA analysis along with a battery of psychological testing, and the results were clear: if a person has two “long” versions of this particular gene, they are prone to optimism, if they have the “short” gene version, they are much more likely to look at the world in a negative way, pessimistically.

This gene in question helps control transport of the neurotransmitter serotonin from nerve cell to nerve cell, and speaking generally, the more serotonin that travels the gap from nerve cell to nerve cell, the happier a person tends to be. It’s the basis for the most popular form of anti-depressants, SSRIs, otherwise known as “selective serotonin reuptake inhibitors”, which increase the amount of serotonin in that nerve gap, the synapse. So the people with the two long form genes have more serotonin available to bridge those nerve gaps, and probably look at the world in a more positive way.

With this gene information, I will try to be even more understanding with Bristol, or perhaps mention to her again the idea of seeing a physican to at least consider “up-regulating” her serotonin levels with medication. Of course, medication and the issue of behavior being genetic or environmental…all of these are hot and controversial topics. As science identifies more genes influencing more behavior types, I suspect the controversy will become even more intense, more polarized, as people debate how responsible individuals are for their own behaviors, and if  “problem” behaviors should be “fixed” with medication. What do you think?

Last Friday’s post was somewhat directed towards dense research (aging theory, anti-inflammatories, vitamin D, avoiding diabetes) so today, let’s go lighter, simpler, and to a topic that probably is more important than the heavy science issues, at least concerning your mind and memory.

I have a theory that much unnecessary (I might say, premature) aging occurs just because you think you should age in a certain way, at a certain rate. Maybe you observed such aging changes in your parents or contemporaneous friends, and now you feel this is how it should be for you too. But it doesn’t have to be. In many areas, if you really believe that you can maintain your abilities as you get older, you can. I’ve seen it many times. Certainly not in all aspects of aging, but it’s true in many: your mindset is most important. It’s not so complicated.

And this recent simple research from North Carolina State University, published in Experimental Aging Research, is directed towards that theory. Basically, two groups of older individuals were given memory tests to see how well their minds were functioning. Before and during the tests, half of them were essentially told (or in subtle ways reminded): “you are old”, and the other half were not biased with that rubbish at all…they just were allowed to do the memory tests.

The study found that those older people who were subtly told: “we are young researchers doing memory tests on you old people” did much worse on the tests than the older people who just took the test without any such biased and unnecessary comments. So as you, and we, all get older, we will be subjected to such biases and comments (be ready so you can reject them), and if you just believe in yourself, you’ll do much better…

I could only find a short abstract of the study (I couldn’t get access to the full report), so I suggest you read the following press release from North Carolina State University, which sums up the details of the study very nicely:

Thinking your memory will get worse as you get older may actually be a self-fulfilling prophecy. Researchers at North Carolina State University have found that senior citizens who think older people should perform poorly on tests of memory actually score much worse than seniors who do not buy in to negative stereotypes about aging and memory loss.

In a study published earlier this month, psychology professor Dr. Tom Hess and a team of researchers from NC State show that older adults’ ability to remember suffers when negative stereotypes are “activated” in a given situation. “For example, older adults will perform more poorly on a memory test if they are told that older folks do poorly on that particular type of memory test,” Hess says. Memory also suffers if senior citizens believe they are being “stigmatized,” meaning that others are looking down on them because of their age.

“Such situations may be a part of older adults’ everyday experience,” Hess says, “such as being concerned about what others think of them at work having a negative effect on their performance – and thus potentially reinforcing the negative stereotypes.” However, Hess adds, “The positive flip side of this is that those who do not feel stigmatized, or those in situations where more positive views of aging are activated, exhibit significantly higher levels of memory performance.” In other words, if you are confident that aging will not ravage your memory, you are more likely to perform well on memory-related tasks.

The study also found a couple of factors that influenced the extent to which negative stereotypes influence older adults. For example, the researchers found that adults between the ages of 60 and 70 suffered more when these negative stereotypes were activated than seniors who were between the ages of 71 and 82. However, the 71-82 age group performed worse when they felt stigmatized.

Finally, the study found that negative effects were strongest for those older adults with the highest levels of education. “We interpret this as being consistent with the idea that those who value their ability to remember things most are the most likely to be sensitive to the negative implications of stereotypes, and thus are most likely to exhibit the problems associated with the stereotype.”

One of the hottest topics in medical research regarding aging is that many problems—from some cancers to atherosclerosis to Alzheimer’s disease and even some aspects of aging itself—can be in part caused by inflammation, which we might describe as a low-grade infection in the body over many years. This chronic irritation gradually results in damage to various organs such as the brain and the lining of our blood vessels, and might be one of the major factors in determining who among us will lose our mental capacity as we get older…the more the chronic inflammation, the greater the long-term damage, the higher the risk for dementia.

So for the past several years at least, the conventional wisdom has been that drugs that decrease inflammation also lower the risk of dementia, and much hope has been directed towards the non-steroidal anti-inflammatory drugs (NSAIDs) such as over-the-counter ibuprofen and naproxen (U.S. trade names like Aleve, Advil, Motrin).

Indeed, it was almost exactly one year ago that the esteemed journal Neurology published a huge study of veterans (about 250,000 people) over the age of 55, and found that during a five-year period, NSAID use appeared to lower the risk of developing Alzheimer’s by 24-40%. Considering the grand theory of inflammation, this all made sense. But now a University of Washington study, spanning 12 years, showed the opposite result—those who used NSAIDs most heavily (which, we would think, should markedly cut the inflammatory effect), had a 66% higher risk of developing Alzheimer’s than those who didn’t use NSAIDs.

The authors of this new study suspect the reason for this contradiction is that the earlier research studied younger people, and the latest study looked at people over 75. So perhaps NSAIDs only have the protective effect for younger people, and if you are above 75, NSAIDs markedly raise your risk? Is it perhaps that NSAID use by younger people delays the onset of Alzheimer’s, but ultimately raises the risk? This is still a very messy and complex topic, which won’t be resolved soon. What is certain is that much new research will come out over the next decade, and maybe by then the issue will be resolved.

The news about vitamin D just keeps getting better and better. In fact, it’s hard to find much news that is negative about this vitamin. The latest work comes from studying Costa Rican children with asthma, and those with the lowest vitamin D levels had a much higher risk of severe asthma.

Want to avoid diabetes? (who doesn’t?)  It seems likely that most cases of diabetes in people 65 or older are preventable… it’s not just fate, or family history. Nine out of ten cases can be avoided if you “live right”. According to a recent report in The Annals of Internal Medicine, people who follow some basic health principles regarding diet and exercise have a 89% lower risk of developing diabetes.

Here’s how to do it…see the details in MedPageToday, and of course, consult your physician for your specific situation:

1. above average physical activity
2. healthy diet regarding fat and fiber intake
3. don’t smoke, or have quit 20 or more years ago
4. light to moderate alcohol use, vs. not drinking at all
5. avoiding obesity
6. keeping your waist under 34.6 inches (88cm) for women, and under 36.2 inches (92 cm.) for men