The Most Important Principles for Staying Young: The World Has Death on the Run

8 Feb

Our basic premise is that your body is amazing.  You get a do over. It doesn’t take that long, and it isn’t that hard if you know what to do.  In these notes, we give you a short course in what to do so it becomes easy for you and for you to teach others. We want you to know how much control you have over both the quality and length of your life.

You know from past articles that I believe most of you will be able to live well beyond age 100 with all your faculties intact. We’ve gone from a life expectancy of 47 in 1900 to 77 in 2000 to 83+ today.  You may have heard that life expectancy just declined for the second year since 1970.  Do not be fooled. This decrease was caused by people not taking care of themselves, gaining weight, earning diabetes, and by drug abuse and overdoses. But for those who take care of themselves, life expectancy now exceeds 95. The good news is we’re making progress on not just illness treating, but on life-extension, too, and I expect you to be able to live past 110 by the year 2030.  Let me give you an example of how science is learning to make your repair systems work much better…

Prevention is critical, no doubt. But it’s not the only way to approach aging. Your goal should be to nurture your body so that it can repair itself expeditiously when it breaks. Accidents and illness happen. Stuff breaks. Cars, computers, and relationships all have their own breaking points. And to suggest that stuff will not break either through acute injury or from wear and tear over time would be misleading. While it’s obviously important to keep your biological systems from breaking down, the real secret to longevity isn’t whether or not you break; it’s how well you recover and repair when you do.

As with a car, you’ll get a lot more mileage out of your body if you perform routine maintenance. Aging is essentially a process in which your cells lose their resilience; they lose their ability to repair damage because the things you might never have heard of (until now), like mitochondria and telomeres, aren’t working the way they should. But it’s within your power to boost that resilience and keep your vehicle going an extra couple hundred thousand miles. And here is one indication research is progressing fast enough that you may have adjuncts to help you repair your mitochondria (your energy factories in each cell) even before 2030.  Yes, you may get the energy you had when you were 20 or 30 back again—that level. Imagine having that amount of energy daily. Scientists tended to view mitochondria as low-IQ biological drones that take glucose and turn it into ATP—the tiny molecular batteries that fuel your body. This is clearly an important role. Complex life forms like you couldn’t exist without mitochondria.

And recently, the view of mitochondria’s role in biology increased in importance.  When we are old, we lack at least one thing that mitochondria need to perform and communicate optimally: nicotinamide adenine dinucleotide (NAD).  NAD is a coenzyme found in all living cells. It is critical for enzymes that fuel reduction-oxidation reactions, carrying electrons from one reaction to another in the production of energy in your mitochondria.  Cellular NAD+ concentrations decrease during aging.  Without sufficient NAD, mitochondria can’t make the ATP energy our cells need. Researchers focused on the aging process are talking seriously about boosting this NAD with it’s precursor, NR (nicotinamide riboside); at an conference on aging that I attended last year, two-thirds of the researchers said they were taking NR already although human trials have only just begun.

Here are some data on that one supplement… NR may help you repair your mitochondria and you gain more energy. In a recent Nature article, Dr. Auwerx and colleagues showed that animals with Alzheimer’s lack sufficient NAD. Mitochondrial energy output is reduced, and damaged mitochondrial proteins are not recycled. Knowing that NR increases NAD levels, they gave the vitamin (NR is a form or niacin) to animals. The result was reduced amyloid deposits, higher energy levels, and improved memory. NR didn’t cause these improvements by directly attacking the pathology of Alzheimer’s disease. Rather, it improved mitochondrial function. That resulted in more efficient and healthier systems overall. This reduced Alzheimer’s disease, at least in animals. A recent article in the journal Circulation titled, “Nicotinamide Riboside Preserves Cardiac Function in a Mouse Model of Dilated Cardiomyopathy,” indicates this benefit of NR on mitochondrial energy function may also affect the heart muscle. This study showed that mice with heart problems have lower NAD levels. This includes dilated cardiomyopathy (enlarged heart) and cardiac hypertrophy caused by constriction of the transverse aorta. They also confirmed that low NAD levels are typical of humans with heart diseases.

So we now know that NR can improve the health of mice with at least two age-related conditions—memory impairment and inability of the heart to pump adequately—presumably by restoring NAD levels to improve mitochondrial function.

And we know that NR increases NAD levels in people. As stated above, cellular NAD+ concentrations decrease during aging. But what is new in addition to Dr. Auwerx work on Alzheimer’s and the Circulation study on cardiac function is that modulation of NAD+ usage or production can make the animal’s RealAge younger and prolong (in animal studies so far) life span substantially (by 20 to 80 percent). We don’t yet have evidence that it increases human health and lifespan, or if it fights or prevents specific human diseases.  But, we should know soon. Several human trials are underway—you can find those trials at clinicaltrials.gov.  Search for nicotinamide riboside for more information. In the meantime, you’ll understand that restoration of mitochondrial function is just one of 14 areas where aging research is progressing quickly. We’ll talk about some in this column in the next several years. And that research and that progress is why I am so optimistic about your (and my) chances of living a lot longer with great health.

All these developments are wonderful news from a human standpoint, but also economically. Think of all the potential genius and innovation the world never sees because disease robs it from us. By preserving these lives, this research can enhance everyone’s life.

But you got to make it to 2030 or so to benefit from these aging research advances, so we’ll continue to present in this column the medical news and our action tips based on that research for doing just that.  I’m not talking immortality—a five-alarm fire can happen or you can step in front of an RTA (Cleveland Metro) bus. Stuff happens. And, yes, I have thought a lot about how people will react when they realize they can actually be 150 years old in a youthful body that will have an extremely young RealAge. And, yes, I really have no clue how individuals and society will handle these transformations. But that is one of the things I’m looking forward to finding out. We’ll just have to live through the changes to figure them out.

Thanks for reading. Feel free to send questions to: AgeProoflife@gmail.com

Dr. Mike Roizen

PS: Please continue to order the new book by Jean Chatzky and myself, AgeProof: Living Longer Without Running Out of Money or Breaking a Hip. 

 

NOTE: You should NOT take this as medical advice.

This article is of the opinion of its author.

Before you do anything, please consult with your doctor.

 

You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week).  The YOU docs have two newly revised books: The patron saint “book” of this column YOU Staying Young—revised and YOU: The Owner’s Manual…revised —yes a revision of the book that started Dr Oz to being Dr Oz.  These makes great gifts—so do YOU: ON a Diet and YOU: The Owner’s Manual for teens.  

Michael F. Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. His radio show streams live on http://www.radioMD.com Saturdays from 5-7 p.m. He is the co-author of 4 #1 NY Times Best Sellers including: YOU Staying Young.

Carpal Tunnel Syndrome – OVERVIEW (Part 1)

5 Feb

Carpal tunnel syndrome (CTS) represents a collection of signs and symptoms resulting from the compression or pinching of the median nerve as it passes through the carpal tunnel at the wrist. In this overview, you will see why CTS can be a challenging ailment to diagnose and treat.

SYMPTOMS: Numbness, tingling, and pain. Less commonly, burning and/or sharp pain in the index to the thumb-side half of the fourth finger, palm-side only. Loss of grip strength (such as unscrewing a jar) may occur but usually later in the course of the condition.

PATHOPHYSIOLOGY: Compression of the median nerve inside the bony carpal tunnel occurs when the pressure inside the tunnel increases, often due to overuse with subsequent swelling. There are multiple epidemiologic factors including genetic, medical, social, vocational, avocational, and demographic with a complex interplay between some or all these factors. However, definitive causative factors remain obscure and unclear in many cases.

EPIDEMIOLOGY: About one to three people per every 1,000 will develop CTS in a given year, and estimates show about 50 people per 1,000 currently live with CTS in the general population. However, the incidence may rise as high as 150 cases per 1,000 subjects per year, with prevalence rates greater than 500 cases per 1,000 subjects in certain high-risk groups. The incidence and prevalence is similar in developed countries like the United States, the United Kingdom, and the Netherlands, but CTS is almost unheard of in some developing countries. The female-to-male ratio for CTS is three-to-ten females to one male. Carpal tunnel syndrome seems to peak at age 45-60 years old with only 10% of CTS patients under the age of 31. The condition is not fatal, but if left untreated, severe cases can lead to complete, irreversible median nerve damage and a loss of much hand function.

CLINICAL PRESENTATION: A patient’s history is often more valuable than the physical examination when it comes to CTS. Patients may report the above-listed symptoms, which may worsen at night and interrupt sleep. Symptoms may also increase in intensity during activities like driving, crocheting, and painting. Frequently, CTS affects both hands, but it’s usually worse in the dominant hand. Patients may have difficulty “mapping” their symptoms well and may feel numbness, tingling, pain, and/or weakness in the whole arm and/or forearm. It’s often prudent to look for additional compression elsewhere in the course of the median nerve in the neck, shoulder, and/or elbow. Less commonly, the patient may experience whole hand hot/cold sensitivity with color changes and/or sweating, which may indicate autonomic nervous system involvement. The use of CTS questionnaires can help diagnose and track progress during care. This discussion will continue next month – stay tuned!

The Elderly & Back Pain – Is Chiropractic Effective?

1 Feb

Around the world, low back pain (LBP) is a leading cause of disability and ranks sixth in terms of “overall disease burden.” Chronic low back pain (cLBP) has a profound socioeconomic impact on individuals, families, and communities—so much so that the World Health Organization has identified LBP as a major disabling condition.

Older people tend to have greater physical disability caused by LBP compared with younger individuals, and old age is often associated with non-recovery and poor outcomes. One study found that more than a quarter of older people in the United States had cLBP upon entering retirement and that baby-boomers (those born between 1946 and 1964) account for 51% of all costs (over $10 billion) associated with cLBP.

So the question of the month is: how safe and effective is chiropractic care for older patients with cLBP? To help answer this question, researchers searched multiple sources for studies that included patients over 55 years of age with cLBP (more than three months of LBP), that utilized some form of manual therapy, that included tools that measured pain and disability, and that utilized a randomized control trial design. Researchers excluded data from experiments in which subjects had prior back surgeries, had pelvis-only pain (e.g. tail bone pain), or had received only a single treatment without follow-up.

Though only four studies met these stringent criteria, the authors did conclude that manual therapies, which include spinal manipulation delivered by doctors of chiropractic, can improve pain and function in older patients with chronic low back pain with very few adverse side effects.

This study supports the benefits of chiropractic care for the aging population and emphasizes the need for effective treatment options for cLBP with a low risk for serious adverse effects. With the size of the senior population expected to double over the next several decades, Chiropractic care will surely continue to play an important role in improving the quality of life of the elderly.

Do Coffee Drinkers Live Longer?

29 Jan

There has been great debate over the years about the pros and cons of drinking coffee.  The confusion is justified, as one study will report on the negative affects while the next will highlight its beneficial attributes. So here we go again, but this time, the focus is on whether or not the compounds found in coffee can help you live longer.

In a 2017 study published by the International Agency for Research on Cancer and the Imperial College London, researchers surveyed 520,000 people from ten European countries and concluded that drinking coffee does appear to promote a longer lifespan. According to the study, other significant health benefits associated with coffee consumption include lower mortality rates from liver and digestive disease in both men and women; decreased mortality from cancer, circulatory disease, and cerebrovascular disease (stroke) in women; and a reduced suicide rate for men. Coffee consumption also lowers inflammatory markers and other negative biomarkers in the blood, giving us some insight on how the compounds in coffee may promote longevity.

The other study, this one funded by the National Cancer Institute, included a diverse set of subjects, as the survey included more than 185,000 adults from various ethnic backgrounds. The authors of this study also concluded a link between coffee consumption and living longer.

Regarding the dosage of coffee required to achieve the most benefits, the European study found the more coffee consumed, the better. They observed that participants who consumed three cups a day had better protection against all-cause death than those consuming less, especially when compared with the non-coffee drinkers. Also, because the researchers surveyed people from many different parts of Europe, it didn’t appear to matter what brand of coffee the particpants consumed, how it was prepared, or the serving style.

The United States-based study echoed many of the same findings as it reported that individuals consuming two to four cups a day had an 18% lower risk of early death in comparison with the non-coffee drinkers, regardless of the ethnicity, coffee type, or preparation style.

Not to burst your bubble about the health benefits of coffee, but moderation is still recommended regarding your daily indulgence. Nutritionists also warn that adding heavy cream and sugar may nullify many of the health benefits of black coffee plus add unnecessary calories to your diet.

Look for future research to focus on determining which compounds found in coffee provide the most benefit and if they can be consumed as a supplement for people who are not coffee drinkers.

What You NEED to Know About Whiplash

22 Jan

Whiplash injuries are very common and are primarily associated with car and rear-end collisions in particular. This is what happens when you’re rear ended…

  1. At 0-50 milliseconds (ms): As the car is initially propelled forward, the seatback pushes the torso forward while the head remains in its original position, which straightens or flattens out the cervical curve.
  2. At 50–75 ms: As the torso accelerates forward, the head/neck moves backwards forming an S-shaped curve with flexion of the upper cervical region and extension of the lower cervical region, stressing the ligaments in back (upper) and front (lower) cervical spine regions.
  3. At 150-175 ms: The torso is at its maximum forward position in reference to the neck and the head/neck is forced into peak extension (backward bending). The head may contact the head restraint or ride over it if of the torso slides up the back a reclined seat. This can further damage the ligaments in the front of the cervical spine.
  4. At 200-600 ms: The head and torso are then thrown forward by the rebound off the seatback, hyperflexing the neck (and mid- and/or low-back) and potentially causing further injury to the ligaments in the back of the spine. Depending on whether or not a seatbelt is in use, the head may strike the steering wheel and/or windshield causing further injury.

It may seem logical to think that if we can anticipate an impending MVC, then less injury will occur. Unfortunately, this doesn’t hold true because the total length of time it takes for the sequence described above to occur is about 600 ms and we cannot voluntarily contract our muscles in less than 800-1000 ms. Therefore, you simply won’t have time to brace yourself for impact.

If cervical rotation occurs at the time of impact, such as looking into the rearview mirror, then the risk for injury may increase. There is recent evidence suggesting that it is difficult to avoid rotation of the cervical region during a collision because the diagonal path of the chest restraint promotes trunk rotation in the later stage of whiplash as the torso rebounds forward.  Nonetheless, looking straight ahead at the time of impact may reduce the degree of injury in some collisions.

To achieve the best long-term outcome, treatment should emphasize movement and exercise as soon as possible. In addition to treatments performed in the clinic, doctors of chiropractic commonly recommend whiplash patients to perform home exercises, home cervical traction, and other self-help methods with the objective of returning to a normal lifestyle as quickly as possible.

Migraine Headaches and Nutrition?

18 Jan

According to a World Health Report, migraines are the nineteenth most common patient complaint worldwide with an 18% of women and 6% of men in the United States experiencing at least one migraine headache episode each year.

There is evidence that patients with migraines have an energy deficit disorder associated with their glucose intake. As such, adopting a strict ketogenic diet (in which ketones are the primary source of energy for the body in place of glucose) does appear to benefit patients with migraines.

A 2017 study set out to determine if it was the absence of glucose or the increase in ketone bodies that made the difference for patients. In the study, researchers provided four female migraine patients with a specially designed ten-gram beverage containing a specific type of ketone  called B-hydroxybutyrate or bHB twice a day for four weeks.

After one month, their migraine frequency rate dropped 50% to eight days/month on average without any serious side effects.  The patients also lost weight, presumably due to consuming less glucose in their diet. An additional benefit of higher levels of ketones in the body is that they have an anti-inflammatory effect.

A larger double-blind, randomized, placebo-controlled trial is now underway with a group of 90 patients that will last three months The goal of the study is to determine if this nutritional supplement is capable of reducing migraine headaches without the significant side effects and associated disabilities that are currently associated with many migraine medications.

Chiropractic care often includes nutritional counseling as an important part of caring for the whole person. In fact, there is research supported evidence that spinal manipulation alone has a very positive benefit for migraine headache patients as noted in the 2010 and 2014 UK studies regarding the effectiveness of manual therapies. Based on the outcome of this large-scale study, the use of ketone-based supplementation for migraines may become a new standard.

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