Archives for June 2016

Jun
25
2016

Prevent Unhealthy Aging

We know that stress can age you prematurely, but what do we need to do to prevent unhealthy aging? This is exactly what this review by cardiologist Dr. Joel Kahn has done. It points out that the right lifestyle makes the difference.

Studies showing how to prevent unhealthy aging

Several studies have shown how to avoid getting heart disease, cancer and diabetes.

2001 Harvard lifestyle study

Kahn reported that in 2001 the Harvard School of Public Health published a study where 84,941 healthy female nurses had been followed who were free of heart disease, cancer and diabetes at baseline. But only 3.4% of the 84,941 women managed to stay healthy after 16 years of the study. The secret? Their body mass index (BMI) was less than 25.0, their diet was high in polyunsaturated fat and fiber, low in trans fat and low in glycemic load, they engaged in regular moderate exercise with a minimum of 30 minutes per day; they did not smoke and they drank ½ an alcoholic drink per day. Their risk to get diabetes was 91% lower than the rest of the study. This shows you how powerful lifestyle choices are; it shows us how to prevent unhealthy aging.

INTERHEART study

In 2004 an international study (the INTERHEART study) reported in the Lancet the lifestyle of 15,152 cases that developed heart attacks in 52 countries with 14,820 controls who did not have heart attacks. The researchers found 9 risk factors that accounted for 90 to 95% of the heart attacks. They were smoking, cholesterol risk ratio elevation, diabetes, high blood pressure, abdominal obesity, stress, low intake of fruit and vegetables, high alcohol intake and lack of physical exercise. Obesity counted as a risk factor when the waist circumference measured more than 35 inches in a woman or more than 40 inches in a man. Lifestyle changes could eliminate all these 9 risks.

2006 Health Professional Study

The 2006 Health Professional Study spanned over 16 years in a group of 40 to 75 year old doctors without a heart attack at baseline. It noted that male doctors who were lacking the 5 heart attack risk factors had 87% less heart attacks than controls without health lifestyles. What were the lifestyle factors? A body mass index (BMI) of less than 25, being a nonsmoker, being physically active for more than 30 minutes a day, having not more than moderate amounts of alcohol intake and having a diet that was more than 40% plant based.

2007 Swedish study

In 2007 a Swedish study reported on 24,000 women after menopause that had no heart attacks initially. After 6 years of follow-up 308 women developed heart attacks. An analysis showed what the risk factors were for those who developed heart attacks. Those who did not have these risk factors reduced their risk of getting a heart attack by 92%. What lifestyle factors were protective? Four factors were identified: a low-risk diet (consisting of high vegetable and high fruit intake, whole grains, legumes, fish and moderate alcohol intake), not smoking, walking or biking 40 minutes daily and a low waist circumference.

2008 Harvard study (follow-up to 2001 study)

In 2008 the Harvard University released a study that was a further follow-up of the Health Professional study with more than 43,000 men and also the Nurses’ Health Study with more than 71,000 women. The question here was what would prevent the development of strokes? The investigators found that in both groups stroke risk reduction by 50% was achievable with the following 5 lifestyle factors: no smoking, keep the BMI below 25, exercise at least 30 minutes daily with moderate activity, don’t exceed a modest alcohol intake and have a diet intake in the top 40% of fruit, vegetables and whole grains. This, too shows us how to prevent unhealthy aging.

2014 study from the Netherlands

A 14 yearlong study from the Netherlands was published in 2014, where almost 18,000 men and women without heart disease at the beginning of the study were followed. More than 600 heart attacks occurred throughout the study. People who stuck to 4 lifestyle habits reduced their heart attack rates by 67%; if they adhered to 5 lifestyle factors they reduced the heart attack rate by 83%. The 4 initial lifestyle factors were: doing an average of 30 minutes of physical activity per day, eating a Mediterranean style diet rich in fruit and vegetables and whole grains, not smoking and having more than one alcoholic drink per month. This gave you a reduced risk of your heart attack rate by 67%. Add one more good habit: sleep 7 or more hours per night on average. This reduces the risk of you getting a heart attack by 83%!

Swedish heart study (more than 20,000 men)

A Swedish heart study with initially more than 20,000 men was going on for 11 years.  The investigators identified 5 lifestyle habits as essential to reduce heart attack rates. Unfortunately only 1% of the study group adopted all 5 lifestyle factors, but they dropped their chance of getting a heart attack or dying of a heart attack by 86%. The lifestyle factors were: a diet rich in fruit and vegetables, legumes, nuts, whole grains and low fat; not smoking, moderate alcohol consumption, thin waistline and more than 40 minutes of physical activity. All of this demonstrates to us how to prevent unhealthy aging.

Preserving health and vitality to prevent unhealthy aging

There is a clear pattern in all of these large studies. A healthy lifestyle preserves your health by keeping your joints and muscles in good working order. When you engage in cardiovascular training every day,  your heart and lungs will work at their best capacity. This keeps your nitric oxide going, which is an important signalling molecule that in turn reduces your blood pressure.

When we remove disabling diseases like strokes and heart attacks and prevent diabetes from developing, life expectancy is increasing. There will be fewer disabilities and less frailty when people remain physically active even in old age. By adhering to good lifestyle habits even Alzheimer’s disease occurs less often.

Prevent Unhealthy Aging

Prevent Unhealthy Aging

Conclusion

The studies cited here show how lifestyle factors can make a significant difference in preventing heart attacks and strokes. In the past even doctors ignored the risk of smoking. A few years back conventional medicine negated that lifestyle factors could make a difference. Now we have more studies than we need to prove that this is so. It is more important that we adhere to as many of the lifestyle factors identified in these studies to make a real difference in our lives. We also need to set an example to the next generation and to our peers. Adopting healthy lifestyle factors has to become a cultural habit for society at large. This will help reduce healthcare costs, but most importantly this will help you and me to live longer, healthier lives. It will help us to prevent unhealthy aging.

Jun
18
2016

High Vitamin D3 Prevents Cancer

In the last few years we learnt a lot about vitamin D3, but the newest thing is that high vitamin D3 prevents cancer.

Researchers at the University of California, San Diego School of Medicine reported that with respect to several cancer types higher doses of vitamin D3 led to less cancer over a period of time.

The cancers investigated were colon cancer, breast cancer, and lung and bladder cancer. People absorb vitamin D3 differently.  The researchers found that the best way to measure vitamin D3 concentration in the body is to use serum 25-hydroxyvitamin D (25(OH)D). In the past people did not pay much attention to this matter. However, several studies including the present study showed that in patients who had a lower level of 20 ng/ml cancer rates were higher.

Comparison of two cohort studies

The researchers used data from two prior studies, a randomized clinical trial of 1,169 women and a prospective cohort study of 1,135 women. The researchers found that the age-adjusted cancer incidence was 1,020 cases per 100,000 person-years in the randomized clinical trial, called “Lappe cohort”. The other prospective cohort study was called the “GrassrootsHealth cohort” where cancer incidence was 722 per 100,000 person-years. The interesting fact was that the Lappe cohort median blood serum level of 25(OH)D was 30 nanograms per milliliter, while the GrassrootsHealth cohort had a higher level of 25(OH)D of 48 ng/ml.

Higher vitamin D levels correlate with lower cancer incidence

This likely explains the lower cancer rate in the GrassrootsHealth cohort. Researchers combined the two trials in order to increase the statistical significance . The striking finding was that above 40 ng/ml the overall cancer risk was more than 71% lower than for the group of people whose level of 25(OH)D was 20 ng/ml or lower. The above ScienceDaily article was based on this scientific study.

Other studies showing high vitamin D3 prevents cancer

AfroAmerican men had less prostate cancer, if vitamin D level was higher

In a 2015 study Afro American men were found to have 71% less prostate cancer, if their serum 25-hydroxyvitamin D level was at least 30 ng/ml or higher.

Prospective study showing high vitamin D levels cancer protective

This 2006 study reported a 14-year prospective follow-up in men where all cancers were counted and blood serum 25-hydroxyvitamin D levels were correlated to cancer incidence. An increase of 25 nmol/L (=10 ng/ml) in predicted serum 25(OH)D level showed an association of a 17% reduction in total cancer incidence, with a 29% reduction in total cancer mortality and a 45% reduction in digestive-system cancer mortality. These investigators stated that it takes about 1500 IU of vitamin D3 increase per day to achieve an increment of serum 25(OH)D increment of 25 nmol/L (=10 ng/ml).

University of Arizona Cancer Center study

A publication from the University of Arizona Cancer Center in Jan. 2016 is more critical of the evidence regarding vitamin D3 and the claim that it lowers cancer rates. The researchers reviewed the cancer literature and found that for colorectal cancer there is a clear inverse relationship between serum 25(OH)D levels on the one hand and rates and mortality of colorectal cancer on the other hand. However, with breast cancer the literature was more divided. Only higher vitamin D levels were related to a lower risk for progression of breast cancer and a lower mortality rate. Randomized, double-blind clinical trials with regard to breast cancer failed to show effectiveness on cancer prevention or reduction of mortality. For prostate cancer conditions were similar with the exception of a study using 4000 IU of vitamin D3 per day, which inhibited progression of prostate cancer.

Mouse model regarding ovarian cancer and vitamin D

In a mouse model using a carcinogen to induce ovarian cancer there was an inverse dose-relationship between vitamin D3 and ovarian tumor development both in tissue culture and in the animal.

How high vitamin D3 prevents cancer

Immune stimulating effect of vitamin D3

Several studies have attempted to speculate how vitamin D3 may prevent cancer. Chirumbolo summarized the literature and noted that vitamin D3 has been shown to function as an immune cytokine stimulating the immune system non-specifically.  Vitamin D3 is also anti-inflammatory and counters insulin resistance and inflammatory kinins in obesity. Flavonoids with their antioxidant activity are also cancer preventing. We know that low levels of vitamin D have an association with higher cancer frequency. This means,. it is important to use vitamin D3 as supplements in our diet.

Chinese study describing action of vitamin D3 in detail

This Chinese study examined the effects of vitamin D3 on cancer prevention. It found that vitamin D3 combines three specific actions in one. Vitamin D3 is anti-proliferative meaning that it stops uncontrolled cell division. Secondly, it has an apoptotic (cell death) effect, which means it supports the removal of cells that are dying. If they are dying, but not removed, cancer can occur from these cell remnants. The third effect of vitamin D3 is that it has differentiating effects in several malignant cell types. When cancer cells are non-differentiated (=more immature cells) cancer can multiply quickly. Mature cells find it more difficult to turn cancerous. This is an effect that controls the speed by which cancer cells divide and how quickly cancer metastasizes.

High Vitamin D3 Prevents Cancer

High Vitamin D3 Prevents Cancer

Conclusion

There still is some confusion about the effects of vitamin D3 regarding cancer prevention. In colorectal cancer the statistics are clear: vitamin D3 can significantly prevent colorectal cancer to a large extent. There are also preventative effects in breast cancer and prostate cancer. But individuals may have to take at least 4000 IU of vitamin D3 or more. This is particularly true in higher latitudes where sunlight exposure is lower in the wintertime. Also, people absorb vitamin D3 differently. For this reason it is important to at least check your serum 25-hydroxyvitamin D levels on a few occasions. This will tell you whether your vitamin D3 supplementation is sufficient. Aim for levels in the 50-80 ng/ml, which is health promoting.

Apart from cancer prevention vitamin D3 is also important for prevention of cardiovascular disease. This is particularly true for diabetes, osteoporosis and Alzheimer’s disease.

Jun
04
2016

Genetic Screening For Better Health

Dr. Matt Pratt-Hyatt gave an overview about genetic screening for better health at the 23rd Annual World Congress on Anti-Aging Medicine on Dec. 13, 2015 in Las Vegas. The title of the talk was: ”Genetic Screening: A Tool for Better Health with Age”. He showed that with more sensitive genetic screening techniques minor genetic changes can be detected. These are a lot more common than previously thought of. Matt Pratt-Hyatt, PhD is Associate Laboratory Director for the Great Plains Laboratory in Lenexa, KS.

Specifically, Dr. Pratt-Hyatt explained that single nucleotide polymorphisms, frequently called SNPs (pronounced “snips”) were the most common type of genetic variations among people. These genetic changes in the DNA often cause disease. Different types of genetic testing can identify the gene defects of SNPs. One of the questions is how aging can be better managed when genetic defects are known.

When it comes to our genetic material there are over 3 billion base pairs, all contained in 23 chromosomes. These are home to 20,000-25,000 genes, most of which are normal.

A gene has three regions all of which can have mutations. In the middle there is the coding region; one end is the regulatory region for transcription initiating; at the other end the transcription termination signals are located. Minor mutations in any of these regions can have major implications for the health of the individual or they can stay silent SNPs. SNPs are classified into missense mutation or nonsense mutation. This description just shows how intricate and complex the process of mutations can be!

There are three types of sequencing that are common:

Three types of genetic screening for better health

  1. Sanger sequencing
 utilizes certain dyes that correspond to specific nucleotides of the DNA. The benefits of Sanger sequencing is that it can cover one gene completely. It can find previously unknown mutations. But the disadvantage of Sanger sequencing is that you cannot process a large number of genes.
  2. The Florophore-base detection looks at multiple SNPs in a single run. This method is cheaper than whole genome sequencing. But one of the disadvantages of Florophore-base detection
is that only a limited number of SNPs can be processed per run. It also can miss new mutations.
  3. Benefits of next generation sequencing 
are that it can look at 1000s of SNPs per run. It is much more accurate than previous technologies. A drawback
though is that the equipment is much more expensive.

The physician does not have to order all of these tests, but can make the choice of the appropriate one for the patient. The following are some applications with regard to how genetic screening can be useful for better health.

Detoxification as part of genetic screening for better health

Since the 1970’s and 1980’s it has become clear that there are many steps in the detoxification process in the liver. It involves major enzyme systems that are controlled by the P450 genes. We know several genetic defects that run in different families. These effects are very important for drug detoxification and metabolism.

The P450 detoxification system in the liver

Any mutation in one of the P450 controlling genes will lead to accumulation of the drug that is normally detoxified by this enzyme system. Without discontinuing or lowering the drug there can be toxicity at higher levels. When people age, they often have spontaneous mutations of the P450 detoxification system. The physician who prescribes medications should take this into account. Common drugs that cause problems with the P450 controlled detoxification are antidepressants, the blood thinner Coumadin, the antibiotic erythromycin, the asthma medication Theophylline and many others.

Patient with atrial fibrillation

Here is an example of how important this knowledge is in an elderly patient who was sent to the hospital with an irregular heartbeat. The electrocardiogram allowed a diagnosis of atrial fibrillation. The doctor treated the patient with a cautious loading dose of 0.5 mg of Coumadin in an attempt to thin the blood of the patient. This would prevent a blood clot or a stroke due to the arrhythmia. Normally a small dose like this would not do much in terms of blood thinning. It would take several days of small doses of Coumadin dose like this to achieve blood thinning.

Defect of gene controlling P450 system

Unbeknown to the physician, this patient was different as he had a defect in the Cyp2c9 gene, a subtype of the P450 system. Very quickly the patient developed bleeding gums and bruising of the skin in various locations. When blood tests were taken, the INR, a measure of the clotting system, was 3.7, a value that should not have exceeded a level of 2 to 3. Genetic testing confirmed a homogenous mutation of the Cyp2c9 gene that explained the toxicity of Coumadin in this case, one of the many drugs that is detoxified by the P450 system.

Mental health as part of genetic screening for better health

Many mental illnesses can be caused by defects in various parts of the brain metabolism. This is particularly so when it involves the synthesis of brain hormones. If there are genetic defects, this can lead to the particular brain metabolism that is associated with depression or schizophrenia. Even dementia, Alzheimer’s disease and Parkinson’s disease can be caused by genetic defects. Methylation pathway defects are another source of possible genetic defects, which can affect multiple metabolic pathways. This is the cause of many diverse conditions like autism, diabetes and some hereditary cancers. The reason it is important to be aware of such genetic aberrations is that often vitamin B2, B6, niacin, vitamin B12 and the minerals magnesium and zinc can stabilize a person with methylation defects.

Cholesterol as part of genetic screening for better health

People with obesity have problems with their lipid metabolism, diabetes, high blood pressure and often heart disease and strokes. Changes in cholesterol metabolism are at the center of these problems. Cholesterol is one of the building blocks of cell membranes, and cholesterol is one of the normal components in the blood as long as the subfractions are properly balanced (LDL and the HDL cholesterol). Unfortunately many people have minor or major defects of the biosynthetic pathway of cholesterol. There are 5 genes that control the acetyl CoA biosynthesis. 21 genes involve the main cholesterol biosynthesis pathways. Over 10 genes control cholesterol metabolites. Historically these genes were detected because of various familiar gene defects that caused problems with the biochemical processes surrounding cholesterol. Familial high cholesterol levels (familial hypercholesterolemia) is one of these common conditions.

Patients who have this condition will often have high cholesterol and also often have a family history of gall bladder surgery for gallstones and a history of premature heart attacks or strokes. Early diagnosis and careful clinical intervention can improve the outlook for many patients.

Genetic Screening For Better Health

Genetic Screening For Better Health

Conclusion

Modern medicine cannot help all of the genetic conditions. But you can work around many minor genetic abnormalities. In addition, if the physician knows the genetic defect, it is possible to avoid drug interactions. It is encouraging that newer test methods have now shown success, as they are more affordable than in the past. As time progresses the price of these genetic tests will come down even further. Mental health, detoxification pathways and the metabolic syndrome of obesity are practical applications where genetic tests have significance.