LiveLongAgeWell

I am on break! (but not from working, just from entering posts)

Yes, I’ve been very busy recently with setting-up a medical company, and I  haven’t had the time recently to devote to my LLAW postings. (Since LLAW is a totally free blog—no charge ever to subscribers, and never any advertising—I don’t feel so guilty.)  I am of course keeping up with all the latest medical news, and when I have time again to devote to posts, they will again magically appear.

For those of you with dreams of life extension, there was good news last week. It has been known for many years (since the 1930s), from fruit fly, worm, and mice studies, that long-term calorie restriction extends  life spans in many of these animals. Some mice, who from birth have been fed 30% fewer calories than normal mice, have had their life spans increased by up to 30- or 40%. But before you go on a radical diet (or worse, put your kids on such a diet), be aware that many strains of mice and rats do WORSE on such a diet. Still, the fact that many animals aged so much better has tickled the fancy of anti-aging researchers.

A big step up from rodent studies, and before human trials, is primate research. Monkey studies are very expensive to carry out, and life span research, as you might imagine, take many years to complete. Still, twenty years ago, a long-term rhesus study was started at the University of Wisconsin, and now there are preliminary results supporting the value of calorie restriction in suppressing diseases. The rate of tumors and cardiovascular disease was cut by half for the calorie-restricted monkeys, and none of the these monkeys developed any signs of diabetes (which affected about 40% of the normally-fed monkeys). Further, the calorie-restricted monkeys had less muscle and brain shrinkage, and also looked younger than the normally-fed group.

Identical ages; one on right fed long-term low calorie diet.

Since these monkeys normally live about 27 years (and up to 40 in some cases), this 20-year-old study is only about half-way completed, and life span comparisons will take some time yet. But (and here’s your chance again to be part of a research study if you live in the Eastern United States), the so-called CALERIE study is beginning in several U.S. medical centers, which attempts to see if a 25% reduced calorie diet (of course nutritionally balanced) will show positive changes in humans.

Scientists don’t know why calorie-restriction diets might work. Of course if we have lower cholesterol levels, lower blood pressure, fewer cancers, less diabetes and so forth, it’s not so hard to imagine a longer life span, but other factors are also suspected. It is thought that semi-starvation shuts off some of our genes that are directed towards reproduction, and turns on genes that promote better maintenance of our current bodies (our organism senses there is not enough food to share with other, new people, so to best preserve the species, our bodies work harder to preserve our own bodies).

Realistically, a calorie-restricted diet on a long-term basis is not easy to maintain, so many biotech researchers are trying to mimic this semi-starvation effect through medication. Many of the efforts involve resveratrol, an “anti-aging” component found in red wine. This sort of medication would have an incredible market potential as you can imagine, and I believe that within ten years we will a FDA-approved pill we can take that will replicate this semi-starved state.

But for now, I think anyone interested in trying a severely calorie-restricted diet should talk to their regular physician, as well as to an endocrinologist and a nutritionist to see if it’s a good idea, as there are risks. These potential, yet unknown risks and a constant feeling of deprivation might not be worth it, and you might well wait for more human trial results or some proven pill to be released. Failing that, there are studies showing that periodic short fasts—by stressing your body much as exercise stresses your muscles, yet makes you stronger—might offer some of the same benefits. It may be that some form of alternate-day fasting may be as good as full-time calorie restriction. Again, talk it over with your doctors, and if you decide to try something like this, get regular blood tests and physical exam monitoring to see how you are doing.

Finally…..I want to mention to my subscribers that only about 1/2 of the LLAW posts are sent out (I know there is too much mail)…but if you care to read other posts, on other topics, you need to go the the LLAW website itself. Thanks for your interest.

Several weeks ago I detailed some problems with the common over-the-counter pain reliever acetaminophen (otherwise known as paracetamol, and the biggest U.S. brand name is Tylenol). The issue is that this medication, even in what many consumers feel is a safe dose, can lead to permanent liver damage.

Just today there was a big FDA meeting in Maryland, and a number of  recommendations were made (likely to be accepted by the full FDA) which will soon limit your choices for OTC and prescription pain relievers. The committees voted to limit the maximum pill size from 500 to 325 milligrams for acetaminophen, and lower the accepted maximum daily dose to well under the current 4000 milligrams. Further—and significant for many people in chronic pain—it looks like Percocet and Vicodin, two exceedingly popular drugs that mix acetaminophen with a stronger narcotic, will be banned. Read more details here

Normally I publish a post on Monday or Tuesday, and again later in the week. This week has been particularly busy for me, so…sunless tanning, part III of the sunscreen series, will be posted later in the week rather than today. In the meantime, if you are lucky enough to have sun where you are, I suggest you put on a good sunscreen and get outside!

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.”

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.

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!

Last post I explored how the most popular anti-aging website on the planet, RealAge.com (27 million visitors!), might not be your best source of medical information, as they are supported, handsomely, by several drug companies. Some of the content and marketing material might be biased towards taking medications when something simpler, like exercise (or just getting off the couch more) could be just as effective, cheaper, and without side effects.

Nicholas Kristof

I suggest you read a short piece by Nicholos Kristof, a New York Times columnist, from March 18 entitled “The Daily Me” (a popular piece; for several days the most emailed article from the Times). The gist was that as paper newspapers go bankrupt and disappear—today a major Chicago paper declared bankruptcy, and a week ago the largest Seattle paper went online only—we will get more of our news online. No shock; you might say, that’s fine, but research shows a problem, and it could adversely effect your medical news.

Mr. Kristof discusses research that as people gather their own news online, they predominantly visit sites with news and opinions that they already agree with…few people visit sites that present information or opinions that disagree with their current thinking. The long-term tendency then is for less broadly-informed people; individuals more polarized towards their pre-existing biases. This effect could as well pertain to medical news as we more and more get health information from blogs and sites that are most comfortable, and avoid conflicting opinions or difficult advice. Some of the most attractive sites are those developed with big corporate money. There, sometimes the information (even when written by an M.D.)  may be a rehashed press release—another piece in the marketing pie.

So be careful as you read medical news online. Take into consideration corporate “sponsors” or “partners” (look for the “about” page or similar). Check out sites that might not have sponsors or advertising, and strive to get more balanced medical news by always looking for fresh sources and a variety of input.

Finally, relating to medical experts, I suggest Kristof’s column from this week “Learning How to Think”. Here he notes how many media “experts” actually are not, and that the more famous the media expert, the more likely they are to be wrong! Absolutely fascinating.  It seems TV and the media in general seek out “experts” with strong convictions and black-and-white opinions. Great for sound bites and boosting viewership, but the less famous experts—less splashy and well-known—tend to explore the nuances of an issue (more boring), but are more likely to be right. Kristof covers financial experts who were so wrong about the current crisis, but, might this also apply to famous medical experts? Think about that next time you see a doctor endorsed by Oprah.

Several LLAW readers have told me they took the RealAge® online test, which is supposed to measure your biologic age. After you answer about 150 questions, it spits out your “real age”, and a number of health hints tailored to your answers.

Last week the New York Times created a stir when it revealed RealAge sells the data generated from visitors’ answers to various pharmaceutical company “partners”. If a site visitor had checked “Yes” to any number of  questions during the age test, then…expect to start getting emails from your new drug company partners! Sites like patientslikeme.com do the same.

I looked at RealAge® about a year ago (I’m suspicious of any website that is trademarked), and in taking the test, I noticed a number of questions geared towards signing me up and becoming their partner. For example, if I said “Yes” to questions like “Would I like to improve my overall health” or “Would I like to stay on top of the latest health research, etc.”  (Well, of course I do!! I’m writing a health care blog!!)

But still I felt squeamish about leaving so much personal personal health data—and financial information, like income—along with my email address, so I left the site. But many others have completed the test; something like 27 million! Wow.

If you are a RealAge® member, I urge you to read the Times article to see what’s happening with your personal information. Here are my favorite quotes from this article:

Pharmaceutical companies pay RealAge to compile test results of RealAge members and send them marketing messages by e-mail. The drug companies can even use RealAge answers to find people who show symptoms of a disease — and begin sending them messages about it even before the people have received a diagnosis from their doctors.

While few people would fill out a detailed questionnaire about their health and hand it over to a drug company looking for suggestions for new medications, that is essentially what RealAge is doing.

The blogosphere is hopping with this controversy. You might be interested in checking out these blogs:

theblogthatatemanhattan.blogspot.com
CitizenVox.org
Ourbodiesourblog.org

Next: Dr. Oz, Oprah, medical experts

Several people from last week’s survey (if you didn’t fill it out, you still can on the site), suggested I address more of the psychological issues of aging well. So today let’s cover one small but I think important psychological aspect of aging, an attitude you might be carrying but not be aware of. It’s something artificial, a mind-set that will cut your potential and cause you to age faster.

About when I turned 30, I started to hear some of my similarly-aged friends say things like: “I’m too old to try that” or “Oh no, I can’t do that, I’m too old”. It was like they hit the magic age of 30 or so, and they realized some discrete, all-of-a-sudden drop in their ability to handle certain tasks or enjoy some activities or sports they used to easily engage in, or in their ability to interact with younger people anymore.

That was a strange concept for me, because as I grew up, I don’t recall anyone in my family ever saying—including my grandfather who at age 90 started going to the golf driving range—anything like that. My grandfather it seemed was always open to most any new adventure or activity no matter what his age. Maybe he lived in some perpetual state of denial, but up until he died suddenly at age 94, he was mentally and physically healthy, active, and always seemed happy. I also observed that characteristic in my best-aging older patients…the ones who seemed happiest also seemed the most open to new activities and ideas…they didn’t let their chronological age inhibit them.

It seems to be almost a self-fulfilling prophecy: those who think or believe that their age limits them from doing something they might want to do, find that indeed, they “can’t”, and worse, this sets in motion a pattern of inability and inaction. Since they “couldn’t” do whatever anymore (say something as simple as enjoying themselves and staying late at an absolutely fun party), that “confirmed” or justified they were really getting older, and they began to limit themselves more and more, aging themselves ever more quickly and prematurely.

Some people don’t necessarily think they can’t do something anymore, but that they shouldn’t do it at “their age”. For example, I have heard sixty-year olds say they don’t think they should be friends with people in their thirties. To me, that seems slightly crazy and certainly counterproductive. I think whatever age you are, you should be happy to have good friends across the entire age spectrum if you can, and each of you can teach and enrich the lives of the others.

So listen to your inner voice and see if this is a factor in your life, or someone close to you. Maybe it’s something learned from your parents, but if you are aware, you can un-learn, and realize that at most any age, you really have the potential to do what you want, and you should.

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