Apr
20
2019

Some Reasons For Variations In Cancer Rates

It can be confusing to see that various countries have big differences in cancer rates, but here I am giving some reasons for variations in cancer rates.

The following countries have high cancer rates: Denmark, France, Belgium, United States, Hungary, Ireland, New Zealand, Australia.

These countries have low cancer rates: Niger, Yemen, Oman, Nepal, Mauritania, Gambia, Cape VerSe, Bhutan. These are only samples; it is not a complete list.

Short life expectancy in many low cancer rate countries

People in many low cancer rate countries do not live long lives because of parasitic infestations, bacterial infections and AIDS. Life expectancy in Gambia, for instance is only 61.15 years. People in Yemen suffer from malnutrition and the life expectancy is only 64.95 years. One can make an argument therefore that people do not live long enough to get a lot of cancer. Cancer is a disease of the older population, as DNA mutations, shorter telomeres, and loss of mitochondria in older cells cause many cancers.

These three countries have various cancer rates

Low cancer rates in India

India is one of the countries with lower cancer rates when compared to the US. Scientists have pointed out that 40% of Indians are consuming vegetarian diets without meat; (red meat consumed in high amounts like in the US is carcinogenic). India has some of the highest spice consumption in the world. We know that curcumin, for instance, has cancer-preventing qualities. You could say that Indians inadvertently treat themselves with herbal, non-toxic chemotherapy (curcumin and others spices) before a cancer even occurs. On the other hand India is a nation with high consumption of refined sugar, which is a factor that can cause cancer over a long period of time. The life expectancy in India is only 68.56 years, which skews the statistics towards lower cancer rates when one compares India to countries with a life expectancy of 80.0 years.

Why is Denmark a high cancer rate country?

The biggest factors are a reliable cancer reporting system, but also a high smoking rate among Danish women and high alcohol consumption in the Danish population. See below what these factors do.

Why is Oman a low cancer rate country?

A study done in Oman showed that a lot of people do not know that certain risk factors could be changed to lower the present cancer incidence. Cigarette smoking, passive smoking, excessive alcohol consumption, reduced intake of fruit and vegetables, increased consumption of red meat and processed meats, infection with HPV, being overweight, less physical activity and an age above 70 are all risk factors for cancer. At the present time Oman still compares favorably with the US, as there is less obesity in Oman. But the average person still eats fairly healthy with an emphasis on fruit and vegetables.

Increasing cancer rates in Oman

The cigarette consumption per year per person in Oman is 271.1 versus 1016.6 in the US. The life expectancy has increased from 50.47 in 1970 to 77.03 in 2016. Oman is expecting the cancer rate to double by the year 2030 due to the increasing life expectancy and lifestyle factors (more drinking, smoking and gaining weight from junk food). A lot of the differences in the cancer rates between the US and Oman are simply due to lifestyle differences. 

Cancer risk factors analyzed

What do the various cancer risks mean in terms of cancer development?

Cigarette smoking

About 480,000 premature deaths are caused by cigarette smoking in the US. This is due to a combination of cancer, heart attacks and strokes. Smoking causes cancers of the lung, esophagus, larynx, mouth, throat, kidney, bladder, liver, pancreas, stomach, cervix, colon, rectum, but also acute myeloid leukemia.

Passive smoking

Passive smoking is as bad, if not worse than smoking. This reference explains that a passive smoker has double exposure to cigarette smoke, namely to the smoke from the smoker, but also to the direct smoke from the burning cigarette. This means that a passive smoker may have exposure to a higher concentration of carcinogens than the smoker!

Excessive alcohol consumption

Heavy alcohol consumption introduces a cell poison into your body. If you drink more than 8 drinks per week as a woman or more than 15 drinks per week as a man, you are a heavy drinker. It leads to cancer of the mouth, esophagus, throat, colon, liver, breast and prostate. The data on prostate cancer is somewhat weaker.

Reduced intake of fruit and vegetables

Consumption of fruits and vegetables, but also foods high in fibre are known to reduce the risk of cancer. So, when you lower the intake of fruits and vegetables, you have less of a cancer protective effect, which leads to more cancer.

Increased consumption of red meat and processed meats

Another big factor about cancer causation is when you eat foods that contain known carcinogens. Such cancer causing substances are contained in red meat, processed meat like sausages, and salt-preserved foods.

Infection with HPV

Type 16 and 18 HPV virus is the cause of cervical cancer, penile cancer, oropharyngeal cancer, anal cancer, vulvar and vaginal cancer. It can be of concern for all sexually active people.

Being overweight

When a person gets overweight or obese, there is more estrogen production from the fat cells that circulate in your blood.  There is also more insulin production and IGF-1 production, which is a growth factor for cancer cells. Estrogen dominance due to estrogen production from fat cells with a relative lack of cancer-controlling progesterone tips the balance towards cancer development. These are the cancers that are common in obesity: breast (in women past menopause), colon and rectum, endometrium (lining of the uterus), esophagus, kidneys and pancreas.

Less physical activity

Breast cancer and colon cancer are reduced when people exercise regularly. This seems to be because of a reduction in circulating estrogen in women and because of reduced insulin and insulin-like growth factors. Even prostate cancer can be kept at bay with a regular brisk walk.

An age above 70

The medium age for cancer diagnosis is 66 years. This means that half of the cases are below this age, the other half above it.  25% of new cancer cases are diagnosed in the age group of 65 to 74. Age is an independent, but important risk factor for the development of cancer.

Sugar and starchy food consumption

Refined sugar and starchy foods lead to an accumulation of fat. At the same time there is a metabolic change with more insulin production and growth factors appear in the blood. It is these growth factors and an increase in estrogen (via aromatase) from the fat cells that lead to conditions that favor cancer development. Switch to a low-glycemic diet like a Mediterranean diet, and you can reverse this process.

Some Reasons For Variations In Cancer Rates

Some Reasons For Variations In Cancer Rates

Conclusion

It is never too late to reduce your cancer risk. No matter how old we are, it is never too late to live healthier, which translates into a stronger immune system. We can stop smoking, or cut out drinking too much. If we keep a healthy weight and eat a healthy diet we will stop chronic inflammation in our bodies and strengthen our immune system. We need to stay away from ultraviolet light (direct sun exposure). We also need to stay active, no matter whether it is choosing to take the stairs and take daily walks, or whether we exercise regularly in a gym.

Apr
06
2019

Healthier After Age 60

Unhealthy lifestyles have staying power, so what can we do be healthier after age 60? A recent CNN article describes 10 ways how to adopt a healthier lifestyle when you get close to retirement.

The thinking is that 5 years before your retirement at 65 you should perhaps adopt a healthier lifestyle.

2017 study by Dr. King regarding lifestyles before and after retirement

Dr. Dana King was the author of a 2017 study where lifestyles before and after retirement were compared.

Seven factors were examined, namely cardiovascular factors including physical activity, healthy diet, healthy weight, smoking status, total cholesterol, glucose, and blood pressure. Retirees were more likely to have poorly controlled blood pressures compared to non-retirees. 23.9% of retirees had uncontrolled blood pressure versus 15.1% of non-retirees. This difference was statistically significant. There was another significant difference with regard to physical activity. Retirees were 1.85-fold more active than non-retirees. But sadly, the other 5 of the 7 points did not significantly improve. There were no differences in healthy weight, smoking rates, healthy diet, glucose levels or cholesterol control.

Healthier after age 60: how to change your diet

Adopt a Mediterranean diet. This is an anti-inflammatory diet that prevents hardening of the arteries. It lowers the bad LDL cholesterol and also triglycerides. It is also recommended to consume at least 2 tablespoons of olive oil per day. When you cook only with olive oil and use only olive oil and Balsamic vinegar for salads, it is relatively easy to reach or surpass the recommended 2 daily tablespoons of olive oil.

Healthier after age 60: how to change your exercise status

You have more time when you retire. The easiest to get into a routine regarding regular exercise is to get a membership in a gym. In the beginning you may want to see a trainer to show you some routine exercises on weight machines. You start the program off with 30 minutes on the treadmill. Before long you get used to the exercise routine and you feel stronger. But your system also produces much more of the protective HDL cholesterol, which is sensitive to regular exercise. If you have been physically inactive, get some input from your health care provider.

Healthier after age 60: how to change your weight

It is not exercise, but a healthy diet, which controls your weight. Having adopted a Mediterranean diet is a big first step in that direction. But it is also important to cut out sugar and starchy foods (potatoes, rice, bread, muffins, pasta etc.). This will reduce your LDL cholesterol and triglycerides. On the long term you prevent heart attacks and strokes.

Healthier after age 60: how to change your smoking status

It is old knowledge that smoking cuts down on life expectancy. Better quit smoking now than later. It prevents heart attacks, strokes, lung cancer and many other cancers.

Healthier after age 60: how to lower your blood pressure

Regular exercise, weight loss and quitting to smoke will all lower your blood pressure. Some people though continue to have high blood pressure. It is important to seek medical advice regarding this. People with persistent elevated blood pressure need medication to have this controlled in order to avoid getting a hemorrhagic stroke.

Healthier after age 60: how to lower your glucose levels

The diet I described will help you to control your blood sugars. Your doctor can order a hemoglobin A1C, which summarizes your average blood sugars over the past 3 months. Controlling your blood sugar is important to prevent type 2 diabetes. Diabetes reduces your life expectancy significantly. The risks are heart attacks, strokes, blindness, leg amputations, kidney damage and cancers.

Healthier after age 60: how to lower your cholesterol

When I discussed a healthy diet, I indicted that it lowers the LDL cholesterol and triglycerides. This reduces the risk of hardening of the arteries. A regular exercise program increases the protective HDL cholesterol, which reinforces the protection from heart attacks and strokes.

Healthier After Age 60

Healthier After Age 60

Conclusion

Whether we retire or not, we should all strife to achieve these 7 changes of lifestyle that Dr. Dana King has discussed. They were cardiovascular factors including physical activity, healthy diet, healthy weight, smoking status, total cholesterol, glucose, and blood pressure. Each of these factors is important on its own. But when you tackle all of them simultaneously, there is a potentiation of these factors that allows you to get super-healthy. That’s what you want for your life after age 60. It is not too late to start! You want to be healthier after age 60!

Mar
02
2019

Exercise For Different Age Groups

In a health article CNN reported about exercise for different age groups.

Exercise has profound positive effects on the body. First it strengthens the lungs and the heart. Secondly, it conditions your muscles. Thirdly, exercise can protect you from chronic diseases like heart disease, type 2 diabetes and many cancers. Each age group needs different exercises, as follows.

Growing up years

During childhood exercise helps to grow healthy bones, regulate weight and build up self-confidence. In addition the child sleeps better, when exercise is part of the course of the day. Children should try out various sports. They should learn how to swim and how to handle a ball. They should also play in playgrounds together with other kids. Several studies have shown that during the teen years exercise levels decline steadily, particularly for girls. Especially during the teen years regular exercise builds a healthy body image and helps adolescents to manage stress and anxiety. Parents should encourage teens to keep one team sport regularly. For those who are not into team sports, swimming and any kind of sport is a good substitute.

Exercise for different age groups: in your twenties

In your mid twenties you are at the highest performance level in your life. You have the fastest reaction time and your heart pump capacity is the highest. Exercise physiologists measure this by an expression, called VO2 max. This value decreases each year by 1%. Your reaction time also decreases every year. The good news is that you can slow down the decline by exercising regularly for the rest of your life. If you train your body regularly during this time, your lean body mass will be preserved and your bone density will stay dense until your later years. To make it more interesting, vary your training with various sports.

If you are a regular exerciser, talk to a trainer about interval training, which intermittently pushes your exercise limit to the maximum. This type of training releases human growth hormone from your pituitary gland. The effect of this is that you increase your stamina and endurance. It also builds up lean muscle mass, decreases body fat content and provides you with more energy.

Exercise for different age groups: in your thirties

Family life and stress at the job can be a reason that you forget about exercise. But right now there is a particular need to maintain a regular exercise program. You may want to get up early, work out at a gym and go to work from there.

Some employers encourage those who work at a desk to get up every 30 minutes and have a brief exercise break for only 2 or 3 minutes. There are computer programs that show you what to do and all you have to do is copy what you see on the screen. Keep good posture while you sit. When you need a rest room break, you may decide to use the rest room downstairs. This gets you to climb some stairs and use the muscles that were resting when sitting at the desk.

As already outlined for those in the twenties, high-intensity interval training is a tool where you can exercise for only 20 minutes intensely. You do a burst of maximum exercise that brings you up to 80% of your maximum heart rate. This can be done cycling or sprinting and is alternated with low intensity exercise.

Women should do Kegel exercises (pelvic contractions) following labor to prevent incontinence.

Change exercises around to keep them interesting.

Exercise for different age groups: in your forties

This is the time when a lot of people put on extra weight. Resistance training is a way to counteract this by burning fat and preventing the loss of 3-8% of muscle mass per decade. As this link shows, 10 weeks of resistance training increases muscle mass by 3 pounds (1.4kg), increases the resting metabolic rate by 7% and decreases fat by 4 pounds (1.8kg). Exercise machines in gyms or Pilates equipment in Pilates centers will give you this type of training.

Exercise for different age groups: in your fifties

Many people develop joint aches when they are fifty and older. Also, chronic diseases like heart disease, type 2 diabetes and others are starting to get more frequent. In postmenopausal women, where estrogen is on the decline, heart disease is getting more common. Bioidentical hormone replacement can reverse these problems. Strength training twice a week will counter muscle loss that you would get otherwise without any regular exercises. Do weight-bearing exercises like a fast walk where you breathe a bit faster and where you break out into a sweat. This will make your bones and muscles stronger and prevent osteoporosis. Tai Chi, yoga and Pilates are all exercises suitable for this age group.

Exercise for different age groups: in your sixties

This age group is characterized by the fact that multimorbidity is getting more prevalent. People often have mental and physical illnesses. Or they have diabetes and heart disease. They often are on multiple drugs for various conditions. Aging is also a strong risk factor for developing many cancers. But regular exercise can prevent many cancers. For instance post-menopausal breast cancer, colon cancer and cancer of the womb are cancers that can be prevented to a certain extent with regular exercise. Heart disease and type 2 diabetes will also largely improve with regular exercise.

Physical exercise tends to decline in this age group for various reasons. Some reasons are obesity, various diseases that make individuals more sessile and general disability. It is important to resist this trend as much as possible. Take ballroom dance lessons and join the dancing community. Any other dance type (Latin, Bachata, Salsa, Kizomba, Argentine dancing etc.) is good exercise and enjoyable as well. It is a fun way to socialize and exercise at the same time. Aqua-aerobics is a great way to keep your joints and muscles in good shape. People with arthritis will tolerate this. Use brisk walking to maintain your cardiovascular fitness. Do strength and flexibility exercises twice per week to maintain your muscle mass and your balance.

Exercise for different age groups: in your seventies and beyond

Frailty and falls are common in the 70’s and 80’s. Many fractures are happening needlessly. Keep exercising regularly and your muscles will be strong enough to prevent falls. Walk and talk with friends instead of sitting around a table. It is good for your friends to walk as well. If you have several chronic conditions, talk to a physiotherapist or exercise professional what type of exercises you should do. You need some strength, balance and cardiovascular exercises. Enlist the help of a trainer. Sustained exercise is what benefits you most. Think of brisk walks, swimming and aqua-exercises.

Exercise For Different Age Groups

Exercise For Different Age Groups

Conclusion

We are born to stay active. Movement is life. As long as we live, we need to do regular exercise. This way a lot of chronic diseases will be prevented and even many cancers as well. I have summarized that for different age groups there are different activities that are appropriate. But the key in all age groups is to move and keep your lean muscle mass from shrinking. As explained, this will automatically make you also lose a few pounds. Strength exercises (also called resistance exercises) are the key to achieving this. When you get older, you are not exempt from exercising. Now even more than before your well being depends on exercising regularly. You want to prevent osteoporosis, falls and fractures. You want to avoid chronic diseases, heart disease and diabetes, and exercise is one valuable key to achieve this.

Feb
02
2019

Hormones Helping In Menopause

Dr. Filomena Trindade presented a talk about hormones helping in menopause. This talk was part the 26th Anti-Aging Conference of the American Academy of Anti-Aging Medicine in Las Vegas from December 13 to 15, 2018. The exact title of her talk was “Women and cognition: insulin, menopause and Alzheimer’s”. Above the age of 80 Alzheimer’s disease in women becomes much more common compared to men. PET scans of the brain of postmenopausal women in comparison to PET scans of premenopausal women, often show more than 30% slow down of metabolism after menopause. Literature regarding that finding showed that it was mostly the decline in ovarian estrogen production that was responsible for the slow down in brain metabolism. Other factors that lead to Alzheimer’s disease are central adiposity (abdominal) and inflammation in the body.

Brain insulin resistance and Alzheimer’s

Older women with Alzheimer’s have more IGF-1 resistance and IGF-1 dysfunction. Other studies showed that minimal cognitive impairment (MCI) progressing into Alzheimer’s disease (AD) might be due to type-2 diabetes. One of the studies stated the following:

“We conclude that the term type 3 diabetes accurately reflects the fact that AD represents a form of diabetes that selectively involves the brain and has molecular and biochemical features that overlap with both type 1 DM and type 2 DM.“

Another publication said that type 3 DM is a neuroendocrine disorder that represents the progression of type 2 DM to Alzheimer’s disease.

Dr. Trindade presented several hormone studies in postmenopausal women who started to develop Alzheimer’s disease. Older women with existing Alzheimer’s did not respond to estrogen hormone replacement. They did not recover with regard to their memory loss. However, younger women who just entered menopause responded well to estrogen hormone replacement and many recovered from their memory loss.

Hormone changes in menopause

There are a number of hormones that experience changes with the onset of menopause. Estrogen production ceases in the ovaries. The production of progesterone in the ovaries also ends. In addition thyroid and adrenal gland hormone production decreases. Often insulin production is increased, but insulin resistance is present at the same time.

Stress can interfere with progesterone and aldosterone production as pregnenolone is the same precursor molecule for both hormones.

How stress interferes with Selye’s general adaptation syndrome

Stage 1 of Selye’s adaptation syndrome, called arousal, involves elevation of cortisol and DHEA. When stress is over, the patient recovers on his/her own.

Stage 2 is the adaptation stage, where cortisol is chronically elevated, but DHEA is declining. The patient feels stressed, has anxiety attacks and may experience mood swings and depressions.

Stage 3 is the exhaustion stage. The underlying cause of this stage is adrenal insufficiency. Both cortisol and DHEA blood levels are low. Patients often suffer from depression and chronic fatigue.

Other hormones and menopause

DHEA and cortisol (stress) have the same precursor (pregnenolone). This means that when a patient is stressed, DHEA production tends to suffer as most of the pregnenolone is used for the production of cortisol.

Dr. Trindade spent some time explaining the complicated details of thyroid hormones during menopause. In essence stress can interfere with the normal metabolism of thyroid hormones with respect to T3, T4 and reverse T3. The end result is that not enough functioning thyroid hormones are present and hypothyroidism may develop.

Both estrogen and progesterone are lower in menopause. In a longitudinal French study with over 80,000 postmenopausal patients the women that received replacement with bioidentical progesterone and estrogen did the best in terms of low Alzheimer’s rates and lower heart attack rates. You achieve optimal Alzheimer’s prevention best starting hormone replacement at the time when menopause starts. You need both estrogen to control hot flashes and to give you strong bones, and progesterone for preservation of your brain, your hair growth and a good complexion.

Hormones Helping In Menopause

Hormones Helping In Menopause

Conclusion

Hormones are missing in menopause and this becomes the starting point for many postmenopausal complaints of patients. The sooner the physician does blood tests to diagnose hormone deficiencies, the better. Various studies showed that the best result in terms of Alzheimer’s prevention is possible, when estrogen and bioidentical progesterone are replaced right at the beginning of menopause. This approach prevents neuroinflammation. There are no extracellular beta amyloid protein deposits and no intracellular tau protein deposits that typically are present with Alzheimer’s disease. In addition the cardiovascular system stays healthier for longer. It contributes to preventing heart attacks and strokes. A longitudinal French study with over 80,000 women who have received treatment with a combination of estrogen and bioidentical progesterone have excellent survival data. The women also enjoy excellent mental health, no cardiovascular complications and less cancer than controls without hormone treatment.

 

Jan
24
2019

Death By Fried Chicken

A new study has shown that when you eat one piece of fried chicken per day, you risk “death by fried chicken”.

Details of a postmenopausal women study

This was a study by the same group that published the Women’s Health Initiative. Participants were asked whether they would take part in a dietary prospective study published in the British Medical Journal January 2019.

93,676 women were part of the study, and researchers observed them for an average of 17.9 years. There were 9,320 deaths from cardiovascular disease, 8,358 deaths from cancer, and 13,880 deaths from other causes.

Here are the results for all cause mortality

Total fried food consumption: 1% risk for less than 1 serving per week

3% risk for 2 to 3 servings per week

3% risk for 3 to 6 servings per week

8% risk for eating at least 1 serving per day

Fried chicken consumption:     6% risk for less than 2 servings per month

12% risk for 2 to 3 servings per month

13% risk for at least 1 serving per week

Fried fish/shellfish consumption: 7% risk for at least 1 serving per week

Risk factors for cardiovascular mortality

The following are the risk factors for cardiovascular mortality of the consumer of fried chicken or fish.

8% risk for less than 2 servings per month

17% risk for 2 to 3 servings per month

12% risk for at least 1 serving per week

Fried fish/shell fish consumption.: 13% risk for at least 1 serving per week

Cancer mortality from fried foods was not that clear. Here are two interesting statistics.

Cancer mortality for fried fish consumption

-8% risk for less than 3 servings per month.

Other fried food consumption:

+9% risk for less than 2 servings per month.

Discussion of the results

This has been an extensive prospective study involving a large amount of postmenopausal women from the Women’s Health Initiative. In addition the observation time was very long, namely an average of 17.9 years. These properties give the study an unusually strong statistical significance. The following features are noteworthy.

Comparing fried chicken with fried fish/shell fish

Fried chicken, prepared in the US in 40 different states has a risk of 17% to cause a heart attack or a stroke for persons that consume two or three servings per month.

Fried fish/shell fish only has a risk of 13% when eaten once per week of causing a heart attack or stroke.

Comparison between this study and a Spanish study

The authors discussed that their findings are different from a Spanish study that found no increased cardiovascular risk of deep fried chicken. They pointed out that in Spain the oil used for deep-frying is usually olive oil while in the US it is mostly corn oil. Frying causes the process of oxidation and hydrogenation, which leads to a loss of unsaturated fatty acids. Linoleic acid experiences a reduction and a corresponding trans fatty acid formation. The end result is that the concentration of trans linoleic acid increases. This may be an important factor increasing the risk of heart attacks and strokes in the US where the use of corn oil is common for deep-frying, but not in Spain where chefs use olive oil instead. Olive oil is a monounsaturated fatty acid and stable with cooking.

Comparison between fried fish consumption and other fried food

There was a less than average cancer risk (-8%) when fried fish consumption was compared to other fried food consumption. With other fried food consumption a +9% risk for cancer mortality was found. This is a spread of 17%. Frying fish, which contains omega-3 fatty acids may neutralize the cancer causing effect from frying other foods. Omega-3 fatty acids are natural anti-oxidants. This may be the reason why fried fish/shell fish did not cause excessive cancer deaths.

Other considerations

The authors did not delve into the quality of the chicken meat in the US fast food industry. It is known that chicken farmers use an arsenic compound (“3-nitro”) for faster growth and prevention of infections among crowded living conditions of the birds.  3-nitro is a carcinogen, which contributes to cancer toxicity in humans as non-organic chicken meat contains it.

It likely would be wiser to buy organic chicken and pan-fry it in olive oil. Alternatively you may want to BBQ chicken at a low temperature.

Death By Fried Chicken

Death By Fried Chicken

Conclusion

Buying deep fried chicken from a fast food outlet is a favorite for many Americans. This study shows clearly that it is deep fried chicken that causes the highest heart attack and stroke mortalities in the US. But “death by fried chicken” does not have to be. The problem may be that the kitchen used the wrong fats to prepare deep fried chicken. In a similar study in Spain there was no increase in cardiovascular risk when cooks used olive oil for deep-frying chicken.

Alternative to buying fast food

The small extra step of buying organic chicken and preparing it at home in a frying pen with olive oil will pay big health dividends. Similarly, fish and shellfish prepared in olive oil at home will also not have any risks for you. A lot of people rave about the convenience of buying deep fried food and in this case deep fried chicken. This article, however, shows that it is time that we take at least some control back in our own hands to prepare healthy food for our families and ourselves. It is a poor trade to choose convenience over health!

Jan
05
2019

Health Benefits of Vitamin E Tocotrienols

Dr. Barrie Tan gave a talk about health benefits of vitamin E tocotrienols that I attended. This occurred at the 26th Anti-Aging Conference of the American Academy of Anti-Aging Medicine in Las Vegas (Dec. 13-15, 2018).

First of all, Dr. Tan stressed that there has been some confusion about vitamin E, as in the past the school of thought was that the main active ingredient of vitamin E would be alpha-tocopherol. Furthermore, many clinical trials with this ingredient go back to the 1960’s, which showed antioxidant activity. But further research revealed that there were many other tocopherols and isomers of tocotrienols. What is worse is that beneficial cardiovascular effects of the newer tocotrienols became null and void through traces of alpha-tocopherol in the mix.

Finally, this led to purer vitamin E production without alpha-tocopherol contamination. Recent clinical trials found that health benefits of vitamin E tocotrienols are linked to delta- and gamma-tocotrienols. They were many times more active in preventing heart attacks and strokes than former mixes of vitamin E.

Annatto derived tocotrienol

In 2002 scientists were able to extract pure tocotrienol without contamination of alpha-tocopherol from annatto. Prior to this vitamin E came from rice and the red palm fruit. But rice contained 50% of tocopherols, while the red palm fruit contained 25% of it.

Here are several sources of vitamin E. The components of tocopherols and tocotrienols vary depending on the source as follows.

Rice: 50% tocopherols (inactive or antagonistic), 15% alpha- and beta-tocotrienols (less active); 35% delta- and gamma-tocotrienols (most active).

Red palm fruit oil: 25% tocopherols, 25% alpha- and beta-tocotrienols, 50% delta- and gamma-tocotrienols.

Annatto: 90% delta tocotrienols and 10% gamma-tocotrienols.

Subsequent research was able to discern between the detrimental effect of alpha-tocopherol and the protecting effect of delta- and gamma-tocotrienols. Now the recommendation of Dr. Tan is to use only annatto-derived vitamin E to prevent heart attacks and strokes. He called annatto-derived vitamin E the vitamin E for the 21st century.

Tocopherol interfering with action of tocotrienols

Dr. Tan explained that alpha-tocopherol blocks absorption of tocotrienols from the gut. It also prevents storage of tocotrienols in liver and fatty tissue. By itself alpha-tocopherol leads to premature elimination of prescription drugs. It also increases blood pressure and cholesterol. What is worse is that alpha-tocopherol increases the risk of prostate cancer and glioblastoma in humans. It also decreases bone mass and increases LDL oxidation, which leads to accelerated hardening of the arteries.

Action of tocotrienols

In contrast to tocopherols, tocotrienols (particularly the delta and gamma isomers) have all the attributes that you want from vitamin E. It has the highest anti-oxidant properties among the tocotrienols. Delta- and gamma-tocotrienols accumulate in LDL cholesterol and in lipid-rich organs like the brain, heart, kidneys, lungs, spleen and skin. Abdominal adipose tissue from obesity also stores delta- and gamma-tocotrienols.

Tocotrienol’s antioxidant activity

When you use a vitamin E preparation consisting of only delta- and gamma-tocotrienols, the portion of vitamin E contained in cell membranes protects against oxidation. Vitamin E  also protects lipids from omega-3 supplements and lipids in foods and beverages from oxidation. Tocotrienols are about 50-fold more potent as antioxidants compared to tocopherols. Based on this information it is not by chance that the following statistics were the results of clinical trials.

Cholesterol lowering effect of vitamin E delta- and gamma-tocotrienols

Dr. Tan cited a 6-week placebo controlled clinical study where the anti-oxidant power was measured in terms of reduction of LDL and total cholesterol.

A group of elderly patients were divided into a subgroup that had normal levels of cholesterol and another subgroup with elevated lipid levels. After 6 weeks of taking a vitamin E preparation consisting of 90% delta tocotrienols and 10% gamma-tocotrienols the blood levels dropped as follows.

Hypercholesterolemic group:    LDL cholesterol    Triglycerides       CRP

                                                          20-28%                11-18%         31-48%

In healthy elderly patients the CRP still dropped 21-29%. Gamma-glutamyl transferase, a predictor for heart attacks dropped by 14-20%.

Another study on postmenopausal women for 12 weeks also showed beneficial effects of tocotrienols.

Hardening of arteries

Dr. Tan explained that hardening of arteries is due to a combination of factors. It is due to combined chronic inflammation and deposits of LDL cholesterol in the wall of the arteries. Studies have shown that monocyte adherence is the first step in fatty streak formation in arteries. Delta-tocotrienol is 60 times more powerful than alpha-tocopherol in inhibiting monocyte adherence. Gamma-tocotrienol is 30 times more powerful than alpha-tocopherol. This proves that taking a vitamin E preparation of 90% delta tocotrienols and 10% gamma-tocotrienols is the most advantageous vitamin E combination to take.

Health benefits of vitamin E tocotrienols include hardening of carotid artery

A 4-year study examined the effect of taking 240mg of tocotrienol-tocopherol supplementation. 88% of patients who took the vitamin E supplement showed improvement (regression of the carotid artery stenosis). Placebo patients deteriorated 60%, only 8% improved. In the 4th year of the study total cholesterol decreased by 14% and LDL cholesterol fell by 21%.

Health benefits of vitamin E tocotrienols include type 2 diabetes

Patients with type 2 diabetes received tocotrienols. Within 60 days of taking 250 mg of tocotrienols the serum total lipids were reduced by 23% and total cholesterol by 30%. The LDL cholesterol was reduced by 42%. Triglycerides were also lowered by 15-20%. C-reactive protein (CRP), a marker for inflammation was lowered between 35-60%.

Beneficial effects of tocotrienols on the eyes and skin

Tocotrienols have antioxidant effects on the eyes and skin. With regard to eye diseases glaucoma and cataracts are improving and macular degeneration in diabetics is responding as well.

The subcutaneous fatty tissue absorb tocotrienols well. Delta- and gamma-tocotrienol largely neutralize oxidative stress from UV light and ozone.

Non-alcoholic fatty liver disease (NAFLD)

This condition has a close association with obesity and the metabolic syndrome. The liver stores excessive fats. About 30-40% of US adults suffer from this disease. Researchers conducted a 12-week study with 71 NAFLD patients. It was randomized, double blind and placebo-controlled. After 12 weeks of supplementation with delta- and gamma-tocotrienol there was evidence of reduction of stress on the liver by improved liver enzymes. The ALT and AST enzymes were reduced by 15-16%. There was also an 11% reduction of triglycerides and 18% lowering of CRP, which indicates a reduction of inflammation. The fatty liver index score showed a decrease of 11%. This suggests that there was intrahepatic fat reduction. The group with delta- and gamma-tocotrienol supplements lost on average 9.7 pounds. Here is another study regarding non-alcoholic fatty liver disease and using tocotrienols.

Health Benefits of Vitamin E Tocotrienols

Health Benefits of Vitamin E Tocotrienols

Conclusion

Vitamin E supplementation is undergoing rejuvenation after research has established that it is delta- and gamma-tocotrienol that are the active antioxidants among the 10 or so tocopherol and tocotrienol isomers. The most active of them, delta- and gamma-tocotrienol, have excellent absorption in the gut and migrate through the blood stream to the lipid rich cells in the body. Key organs like the brain, heart, kidneys, lungs, spleen and skin accumulate vitamin E. Even the abdominal adipose tissue takes up vitamin E, which is beneficial when a person becomes obese or develops diabetes. Apart from lowering triglycerides, total and LDL cholesterol, vitamin E (delta- and gamma-tocotrienol) is also important for directly interfering with hardening of the arteries.

Vitamin E protecting skin, eyes and liver

Vitamin E also protects the skin and eyes against UV light. There can be a partial reversal of tissue damages. Finally, I pointed out that vitamin E can reverse non-alcoholic fatty liver disease (NAFLD). It is important to leave out alpha-tocopherol, which is an older form of vitamin E that is cheaper to produce, but will interfere with the function of delta- and gamma-tocotrienol as explained. As I mentioned earlier, various vitamin E supplements are on the market. It is obvious that they are not equally beneficial.

I recommend you take about 125 mg of vitamin E in the form of delta- and gamma-tocotrienol every day. I take Annatto tocotrienols (Cardiovascular Research Ltd.) 1 softgel daily.

Dec
22
2018

Biological Age Is Different From The Chronological Age

Biological age is different from the chronological age said professor Morgan Levine from Yale Medical School. She is working in the department of pathology. She has found in her research that people of the same chronological age have very different biological ages. From a biological standpoint they may be much younger or older than their chronological age. When people are younger than their chronological age, they have less disease and less mortality. This article has reviewed the facts.

Measuring biological age

Dr. Levine also has developed tools how to determine the biological age. And when the biological age is higher than the chronological age, she recommends lifestyle changes that will set back the biological clock. We age differently according to what we eat, how our genetic make-up is, which we cannot change, whether we are physically active and what environmental toxins we are exposed to. So, the biological age determines our health status and what our final life expectancy will be.

Biomarkers for biological age

A simple blood test that your family doctor can order consists of the following. A fasting blood sugar, kidney and liver tests, immune tests and inflammatory tests. In addition the doctor will want to know whether you are smoking or not, how much alcohol you consume and how much red meat and processed meat you eat. A computer program processes these results, which determines your biological age.

Lifestyle improvements can lower biological age

Biological age testing has a strength built in. By changing your lifestyle you can lower it. When you exercise more regularly and switch to eating a Mediterranean diet you can lower your biological age. Other studies have shown that the Mediterranean diet is anti-inflammatory. A telomere test, which also determines the biological age, is fixed. It is not easily changed by dietary measures and increasing your exercise.

Dr. Levine said: “I think the most exciting thing about this research is that these things aren’t set in stone.”

Putting the biological age to the test

Dr. Levine was curious what her own biological age was. She entered her blood test data and lifestyle facts into the computer. She was surprised that her biological age was not as good as her first assumption. Now she is trying to get more sleep, has increased her exercise level and improved her diet.

Her research team is working on getting the algorithm online so that everyone will be able to put one’s blood tests and other data into the computer program and calculate the biological age. The program will also recommend what steps are likely most helpful to increase one’s health and decrease the biological age.

Lower your biological age

No one wants to live a long life, if they are in pain and have various illnesses like arthritis or Alzheimer’s. But things are different, if they can change lifestyle factors and maintain a low biological age for a long time. Now they can stay active, have no pains and are able to contribute to society.

“By delaying the onset of diseases and cognitive and physical functioning problems people can still be engaged in society,” Dr. Levine said. “I think that is the ideal we should be striving for.”

Other literature about biological age

Inflammation increases the biological age

In this publication the authors stressed that inflammation is the common denominator for developing disease and premature aging. The authors stress further that it is mandatory to change one’s lifestyle to lower the biological age and live longer.

Diastolic blood pressure predicts mortality

In an older study the diastolic blood pressure was related to mortality. The higher the diastolic blood pressure was, the higher the mortality.  The authors also noted that it was the persons with the higher biological age who were at the highest risk of dying.

Scientific study about the predictors for the biological age

Here is a scientific study that examines predictors for the biological age.  This is not easy reading, but I placed it here for completeness sake.

Link to a site that can calculate your biological age

Here is a link to a site that calculates your biological age. It is probably not as good as Dr. Levine’s computer analysis will be when it is available. However, it is a good approximation to what it will be like.

Biological Age Is Different From The Chronological Age

Biological Age Is Different From The Chronological Age

Conclusion

The dream of staying younger for longer is not new. Research has shown that we actually can do something about it. If we look after our lifestyle, don’t smoke, don’t drink excessively, eat a sensible Mediterranean-type diet and exercise regularly, our biological age will be less than our chronological age. It is the biological age that determines how old we get and whether or not we will suffer from age-related illnesses. Researchers also found out that when your biological age is younger than your actual age mortality will occur later. The math is simple. Let’s assume that your biological age is 15 to 20 years younger than your chronological age. As the average life expectancy presently is 80 years, your life expectancy can increase to 95 or 100 years.

Dec
16
2018

Can Longevity Research Make Us Age Slower?

Longevity research has done a lot of experiments, but can longevity research make us age slower?

This year an 800-page summary was published of all the longevity research that has been going on. A review of this research is in this abbreviated article. In the following I like to address some of the problems of anti-aging or longevity research.

Telomere lengthening

We know that people with longer telomeres live longer than people with short telomeres. When telomeres are longer, the cells can continue to divide and function normally. When telomeres shorten there comes a point when no more cell division is possible.  At this point the cell will normally be dissolved. When it persists, there is the danger that it undergoes a malignant transformation. This can cause premature deaths. On the other hand, if enough shortened telomeres accumulate in various organs, organ failure ensues. This will also result in premature deaths.

Research in humans has shown that increased physical activity elongate telomeres. So do vitamin C, E, vitamin D3 supplementation and resveratrol. A Mediterranean diet and marine omega-3 fatty acid supplementation elongate telomeres as well. In addition higher fiber intake, bioidentical estrogen in women and testosterone replacement in men can be effective in elongating telomeres. Finally, relaxation techniques like yoga and meditation are also elongating telomeres.

Antioxidants

Many processes lead to free radicals. Free radicals are unstable atoms that may damage cells and can cause illness and premature aging. Inflammation, the metabolism of our mitochondria, radiation exposure, industrial solvents and ozone are just some examples of what can cause free radicals in our system. If we have enough antioxidants on board, there is a balance between free radicals and antioxidants. No damage would occur then. In humans the two major antioxidants present are vitamin C and glutathione. Vitamin C comes from our food. Glutathione is produced by the liver and circulates in the blood. These two antioxidants are keeping free radicals in balance.

 

Anti-inflammatories

This Harvard site explains that even food can cause inflammation in us. For instance sugar, French fries, red meat and margarine cause free radicals. Anti-inflammatory foods are tomatoes, green leafy vegetables, olive oil, nuts, fatty fish, berries and fruit. A Mediterranean diet has anti-inflammatory qualities. There are 6 anti-inflammatory supplements that are useful to know about: ginger, fish oil, alpha-lipoic acid, curcumin, resveratrol and spirulina. In addition to the above, vitamin D3 also has anti-inflammatory effects in higher doses.

Chronic inflammation can cause cancer down the road, so it is important to prevent this by eating sufficient amounts of anti-inflammatory foods and supplements.

Genetic repairs

Spontaneous mutations of DNA, mutations of suppressor genes, oncogene activation and insufficient DNA damage response can all lead to cancer. In the past there was the hope of using chemotherapy and radiation therapy as a means to influence the outcome of cancer treatment. A reinvestigation of this concept is ongoing.

More specific treatment modalities are under investigation. When more cancer can be prevented and when it is possible to cure more cancers longevity in the population will increase. Cancer has been one of the major killers over the years.

Metformin research

Metformin has been in use for decades to prevent and treat diabetes. But beyond this it also has anti-cancer activity, it prevents Alzheimer’s, prevents cardiovascular disease and may be the first anti-aging drug. A trial to this effect is ongoing.

It makes sense that a drug that treats and prevents diabetes would be a longevity drug at the same time. The fact that it also helps to prevent cardiovascular disease and Alzheimer’s disease also makes sense. Anytime you remove a chronic disease, life expectancy improves. As a result metformin will likely receive approval as a longevity drug soon.

Mitochondrial repair

The mitochondria are small organelles in each cell. The purpose of this structure is to provide energy. In normal cells there are hundred of these organelles in each cell. In heart muscle cells, brain cells and liver cells there are thousands of mitochondria in each cell to provide energy. Muscles, nerve cells and liver cells require more energy to function properly.

Two supplements have been in use for some time to support mitochondria function.

  1. Co-Q10. This supplement supports mitochondrial function. It prevents heart disease, together with vit. K2 and vitamin D3 and it keeps blood vessels open.
  2. Pyrroloquinoline Quinone (PQQ). This supplement can increase the number of mitochondria in a cell. It can also improve their functioning. With aging we know that we are slowly losing mitochondria. It is important to know that there is a supplement that can counter the aging effect and prevent further mitochondrial loss.
Can Longevity Research Make Us Age Slower?

Can Longevity Research Make Us Age Slower?

Conclusion

For centuries people were hoping to live longer. Nowadays this dream seems to become a reality. But it does not happen with one magic pill. The aging process involves multiple targets that need attention. The telomere length is one factor. I listed a number of items that will elongate telomeres, like regular exercise and a Mediterranean diet. Antioxidants and anti-inflammatories are prolonging life as well. You want to preserve the function of your genes. Research is concentrating on improving gene repair.

Metformin has been found to prolong life. This molecule might be the first longevity drug. It has been in use to prevent and treat diabetes, but it also helps to prevent cardiovascular disease and Alzheimer’s disease. Two supplements help with mitochondrial repair, namely Co-Q10 and PQQ. Because life is all about energy, it is important to have well functioning mitochondria in all of your cells. When mitochondria are functioning, your body functions at its best, and you feel well.

Dec
08
2018

Not Exercising Is More Risky For You Than Smoking

A new study showed that not exercising is more risky for you than smoking. We all know that smoking puts you at risk to get a heart attack or a stroke. It can also cause lung cancer and other cancers. So, hearing that not exercising is even more risky than smoking comes as a shocker.

The study

Dr. Wael Jaber, a cardiologist at the Cleveland Clinic was the senior cardiologist of this study. It was based on 122,007 patients who underwent tests using an exercise treadmill test at the Cleveland Clinic. This took place between the beginning of January 1991 and the end of December 2014. The end point in the study was all-cause mortality. The question in the study was whether exercise and fitness were lowering the risk of mortality. The result showed that 12% of the study group had the lowest exercise rate. This sedentary group had a mortality rate that was 500% higher than the top exercise performers. Compared to someone who exercises regularly the sedate group that hardly exercises still had a 390% higher death rate.

No ceiling of the benefit of exercise

What was astounding to the researchers was the fact that there was no ceiling of the benefit of exercise. The ultra fit group still had a super low mortality rate, lower than the next higher fitness group. Age did not matter either. Whether you were 40 or 80, the more you exercised, the lower your mortality rate was.

Comments about the study

Jaber said: “Being unfit on a treadmill or in an exercise stress test has a worse prognosis than being hypertensive, being diabetic or being a current smoker. We’ve never seen something as pronounced as this and as objective as this.” He went on to say: “If you compare the risk of sitting versus the highest performing on the exercise test, the risk is about three times higher than smoking.”

A sports medicine physician, Dr.Jordan Metzl who was not part of the study, said: “Cardiovascular disease and diabetes are the most expensive diseases in the United States. We spend more than $200 billion per year treating these diseases and their complications. Rather than pay huge sums for disease treatment, we should be encouraging our patients and communities to be active and exercise daily.”

Other studies showing that not exercising is associated with a high mortality rate

 

The STABILITY trial

This trial was based on 15,486 patients with heart disease and found that even 10 minutes of exercise per day reduced mortality. They compared the death rate of people engaging in 10 minutes of a brisk walk with a group who did not exercise at all. The brisk walkers had a 33% lower death rate than the group who was entirely sedentary.

A lack of exercise causes a lot of chronic diseases

This review article mentions that a number of chronic diseases were related to sedentary lifestyle. Major diseases like heart attacks, strokes, arthritis, depression and anxiety and others were clearly much more common in people who were more sedentary than those who were exercising regularly.

Poor lifestyle in general causes diseases

Lifestyle, in particular regular exercises, a healthy diet and NOT smoking has a profound positive effect on our health. In one study researchers showed that 79% of major diseases including heart attacks and strokes could be prevented with a healthy lifestyle. I reviewed this in this blog.

High blood pressure reduced by regular exercise

This 2017 study from Brazil has examined the effects of regular exercise on high blood pressure patients. They came to the conclusion that regular exercise can be as powerful as blood pressure lowering medication. Both bring down systolic and diastolic blood pressure. Even complications of previously untreated high blood pressure will be reversed with regular exercise while medication will not have this positive effect. Controlling high blood pressure with regular exercise will prevent diseases like heart attacks and strokes and the associated mortality.

Regular exercise and diet change to prevent type 2 diabetes

In this 2015 study the researchers noted that a combination of adopting a healthy diet and regular exercise could lead to weight loss. This was shown to prevent type 2 diabetes. The authors question why such a lifestyle change was not more widely taught to people to prevent cardiovascular diseases and diabetes.

Not Exercising Is More Risky For You Than Smoking

Not Exercising Is More Risky For You Than Smoking

Conclusion

The medical profession knows for a long time that regular exercise is good for your health. But there always was a concern that perhaps too much exercise may be hazardous. A 2018 study from the Cleveland Clinic followed 122,007 patients for 14 years. All patients underwent an exercise treadmill test as a baseline. The end point was mortality during the 14 years of follow-up. The results made clear that there was no upper limit of exercise. Patients who were exercising the most still had a lower mortality than those who exercised less.

Sessile patients

But perhaps the most impressive result was that sessile patients who did hardly any or no exercise had the highest mortality. Their mortality was higher than that of smokers who exercised a little bit. If you want to avoid getting a heart attack, a stroke, diabetes or many types of cancer, exercise regularly, don’t smoke and eat a Mediterranean type diet. Regular exercise can reduce cardiovascular disease by 79%. And since the Cleveland study we know that more exercise is even better as the top athletes had the lowest mortality.

Nov
24
2018

Intermittent Fasting May Benefit Health

There is a lot of discussion about the fact that intermittent fasting may benefit health. But there are a confusing variety of intermittent fasting schedules. This makes it difficult to compare notes regarding the specific effect of an intermittent fasting diet. Generally speaking when there is some form of calorie restriction, our body goes into a survival mode of operating. These types of diets provide enough nutrients to not get into malnutrition, but at the same time they may stimulate sirtuins, particularly SIR2. This is thought to be associated with longevity.

Various forms of fasting

Eating after 5 PM

The Taylors in the CNN article eat the same amount of calories, but they only eat after 5PM. They claim to have more energy and be less vulnerable to infections. They also think that they feel younger than in the past.

Fasting every other day

This was an observation in the 1980’s to help rats live longer compared to rats that have food available every day. Recent experiments on mice showed similar results: calorie restriction in whatever form leads to prolonged life and health.

Human fasting mimicking diet

A 2017 study on 100 humans divided this group into half. One half ate any food as they wished. The other half consumed only 800 to 1100 calories for 5 days of each month as a fasting mimicking diet. The experimental group had lower fasting blood sugars; cholesterol, triglycerides and other heart disease markers went down. The IGF-1 markers for various cancers also went down. The experimental group lost abdominal fat, but preserved lean body mass. Valter Longo, who co-authored the clinical study said that a human trial on longevity would almost be impossible to design, and would cost “a hundred million dollars or more. But if you look at the data from our trial … it would be hard to see how they would not live longer.”

5:2 diet

Patients are allowed to eat what they want for 5 days of the week, but then they restrict their diet for 2 consecutive days. The control group had no restriction of calories. The 5:2 experimental group had better glucose control and loss of abdominal fat than the control group.

Fasting can help you live-longer

Experts on calorie-restricted diets tell us that there is a switch in metabolism from burning glucose as fuel to using ketones as fuel. Extended periods of exercise will also cause a switch to using ketones as fuel. Repeated cycling from fasting to eating may also benefit our brain function. Intermittent fasting will help us cope better with stress and disease. But Dr. Longo says that this is only one aspect. He found in his research that with intermittent calorie restriction there is a multi-system regeneration going on. For instance, damaged white blood cells are depleted, stem cells are activated, blood sugar control is improved and heart risk factors are being controlled. Dr. Longo mentioned that when tissues are healthy and functional, risk factors for disease decrease.

Mechanisms behind longevity

Dr. Longo explained in detail the complex aging pathways that involve three components, IGF-1, mTOR and PKA. When lifestyle choices stimulate these genetic markers, accelerated aging is the consequence. But with the inhibition of those markers longevity will happen. Here are some of the effects on the body of a fasting mimicking diet.

  • Obesity diminishes, because of the weight loss effect due to missing calories.
  • Diabetes: insulin resistance becomes lower and blood sugar levels drop.
  • High blood pressure reduced: many patients were able to reduce their medications or discontinue them
  • Pain conditions improve as all kinds of pain disappears, an effect for which there is no explanation at this point
  • Autoimmune diseases like MS and rheumatoid arthritis improve, likely because of the effect of increased stem cell circulation
  • Prevention of heart attacks and strokes because of reduction of LDL, triglycerides and CRP
  • Cancer cure rates improve by protecting normal cells and the bone marrow
  • Longevity improved in mice with a 3-fold increase of their life span. Telomere length in humans was increased. Increased stem cells will find defective areas that need repair. This effect will open up a new chapter in medicine.
Intermittent Fasting May Benefit Health

Intermittent Fasting May Benefit Health

Conclusion

Calorie restriction is a powerful method to rejuvenate the body. Surprisingly 5 days out of one month of a calorie restricted fasting mimicking diet is all that is necessary to improve the body’s metabolism. Telomeres get increased, damaged white blood cells are removed and stem cells get stimulated. But weight loss, improvement of pain perception and cardiovascular risk reduction take place as well. In mice longevity was significantly prolonged, but this needs to still be shown in humans.

One can think of an intermittent fasting mimicking diet as a kind of internal cleansing. Following this it is easier to restart the metabolism with clean ingredients.

So far I have followed 11 courses of the fasting mimicking diet. But I don’t buy boxes of 300.00 USD every month. Instead I count calories myself, keep the diet balanced and buy the ingredients in the health food store. I agree that the fasting mimicking diet seems to be effective and it helps to keep my body mass index under control.