Science of Aging
Marin County’s top minds weigh in on healthy living and longevity. Part 1 of 2
Kale. Coconut oil. Matcha. Probiotics. Vitamin D. Strength training. Sleep.
Each day, we are bombarded with information on ways to stay healthy — lists of new superfoods, elixirs for longevity, the latest vitamins or supplements, miracle antidotes — but sorting through the research and information on aging and health can be daunting. How do we know what’s snake oil or what might be truly good for us? Thankfully, Marin County is home to a wealth of experts on nutrition, exercise, brain health, food as medicine and more. In particular, the savvy scientists at the renowned Buck Institute for Research on Aging are devoted to geroscience, studying the mechanisms of aging and the connection between normal aging and chronic disease, in the institute’s Novato labs.
Considering that the mission statement of the Buck Institute is to “increase the healthy years of life,” we checked in with scientists there to see what knowledge we might be able to glean from all their hard work. “This is a really exciting time. The science of aging research is supporting commonsense lifestyle and nutritional changes that can give people a good shot at extending their feel-good years,” says Brian Kennedy, the institute’s president and CEO. “I think that those lifestyle changes, coupled with treatments that are being developed in the lab, will enable us to forestall or even prevent a whole host of conditions that all of us now dread — including Alzheimer’s, cancer, Parkinson’s and Type 2 diabetes.”
While we may be preaching to the choir here in Marin — known for having one of the most health minded populations in the country — we’ve broken down the latest research on healthy aging and asked local practitioners for everyday health care advice.
The Power of Food and Spice
“The relationship between food and longevity and brain health does not rely on speculation, but rather on thousands of published scientific studies,” says Rebecca Katz, a Marin-based author, cook and Buck Institute lecturer, who has a master’s in nutrition. Katz, who calls herself a culinary translator, delivering “nutritional science to the plate, seasoned by wisdom and the alchemy of flavor,” explores the benefits of good food in two cookbooks, The Longevity Kitchen and The Healthy Mind Cookbook. She encourages people to look to their pantries, spice racks and farmers’ markets as sources for their own personal culinary Rx: “Eating the right foods will keep your cellular energy high and immune system strong, helping stave off the inevitable decline of these systems due to the aging process.” Basically, she adds, “food can alter your genetic expression.”
For longevity, Katz spotlights the Super 16, foods rich in antioxidants and sources of omega-3 fats, probiotics, phytochemicals, vitamins and minerals, including asparagus, avocado, basil, blueberries, coffee, dark chocolate, garlic, green tea, kale, olive oil, pomegranate, sweet potato, thyme, walnuts, wild salmon and yogurt. While both chia and matcha were not on most people’s minds while she was writing her books, she says she would alter her list to add them. Matcha is a finely powdered green tea that’s chock-full of powerful antioxidants, boosts metabolism, enhances mood and aids concentration, she says. Matcha is to green teas as Dom Pérignon is to champagne; Marin-based matcha master Eric Gower’s company Breakaway Matcha offers “some of the best matcha I’ve ever tasted,” Katz adds. Chia seeds are another wonderful food that’s high in omega-3 fatty acids and a great source of fiber.
Katz also calls for ditching unhealthy damaging fats (trans fats, corn oil, cottonseed oil, etc.) and replacing them with foods that contain good ones like avocado, olive oil, coconut oil, nuts, seeds and whole eggs. And yes, she says it’s fine to cook with olive oil, despite the ongoing debates, as most home stoves won’t heat the oil to a smoking point where it breaks down and forms toxins. (Restaurant kitchens are another story, she concedes.)
Another superstar ingredient that has people talking these days is turmeric, India’s golden spice. Think yellow curries popular in Indian, Thai or Vietnamese dishes. Buck Institute researcher Ram Rao, Ph.D., champions turmeric as being able to help with “degeneration, immunity, inflammation and infection.” Rao, who advised Marin’s Whole Foods to carry fresh turmeric root, contends that it’s best in that form and can be added to soups, curries and vegetable dishes. The curcumin in turmeric acts as a multifaceted anti-inflammatory agent, Rao says, and myriad studies have shown its potential to stave off arthritis, cancer and even Alzheimer’s. Turmeric boasts an astonishing array of antioxidant, anticancer, antiviral and antibiotic properties, and as an immune system booster, it’s stronger than vitamins C and E. Curcumin is better absorbed with piperine, an active component in black pepper. So if you’re taking turmeric or curcumin supplements, be sure they contain piperine or black pepper extract.
TIP: Educated shopping. Nearly two-thirds of produce samples tested by the U.S. Department of Agriculture and analyzed by the Washington, D.C–based EWG for the 2015 “Shopper’s Guide to Pesticides in Produce” contained pesticide residues. “The bottom line is people do not want to eat agricultural chemicals with their fruits and vegetables,” says Ken Cook, EWG’s president and cofounder and a San Anselmo resident. “That is why we will continue publishing our Shopper’s Guide to help consumers figure out which produce items carry the most and least pesticide residues.” Shoppers can opt for items on EWG’s Clean 15 list, like avocados, cabbage and asparagus, and buy the organic versions of the produce on EWG’s Dirty Dozen list to reduce their exposure to pesticides in their diet. “The information we provide is incredibly valuable because pesticides have been linked to a number of health problems, including cancer and lower IQ in children,” Cook says.
“There’s a lot of research around intermittent fasting right now,” says the Buck’s Brian Kennedy, who is also a Ph.D., “and I think most of it is suggesting it’s very good for you.” Scientists have known for a long time that caloric restriction extends life span for yeast, worms, mice and probably primates. But while this concept also has positive implications for humans, most people do not want to sustain themselves on minimal calories. To study the effects of intermittent fasting, scientists gave mice as much food as they wanted one day, then starved them the next day, in a continuous cycle, and compared them to mice on restricted-calorie diets. The “fasting” mice lived almost as long as the mice on restricted diets, yet they ate plenty of food. So the good news is that you may not have to endure intense caloric restriction to reap similar benefits from short-term fasting. Some diets, like the 5/2, call for five days of eating and two of fasting each week, but an easier method may be to wait 12 to 14 hours after your evening meal before eating again the next day. More research is needed, but the current data looks promising. Kennedy also believes that our bodies are already adapted to deal with fasting, as our ancestors who were hunters and gatherers ate when food was at hand and fasted when hunting for new sources.
TIP: Eat well. To optimize your period of fasting, Caitlin Beale, a clinical dietitian at Marin General Hospital, recommends focusing on nutrient-dense foods prior to fasting to ensure your body has what it needs. “Studies of intermittent fasting that do exist in both mice and human subjects are promising and exciting with regards to beneficial changes in insulin resistance, blood lipids, gene expression, mental clarity and even reproductivity,” she says. However, she notes, “as we are still in early stages, more research is needed, especially in human subjects with regards to gender, age and body composition. For instance, right now the benefit appears to be seen more in men than women.” A juice fast would not qualify as intermittent fasting, she adds, because juice contains calories; for it to be a true fast, no calories can be consumed.
Controversies continue to swirl around supplements, yet the promise of health via a pill is a lure few can resist. Basically, supplements are not meant to replace healthy whole foods, but they can complement a basically good diet that has a deficiency. Dosage and efficacy are key. “Unfortunately it’s an unregulated market, and some companies are getting away with selling nonsense,” says Buck Institute researcher Dr. Gordon Lithgow. “Some supplements for sale at health food stores don’t even contain any of the items said to be in the bottle. And that’s a problem.”
Ingesting certain supplements may also contribute to the aging process and chronic disease. For example, researchers have known for decades that some metals, including high levels of iron, have been linked to neurologic diseases such as Parkinson’s and possibly to Alzheimer’s. Lithgow’s recent work at the Buck Institute with the nematode C. elegans (a type of worm) has shown how iron accumulation can accelerate the aging process. He urges people considering iron supplementation, especially postmenopausal women, to talk to their physicians first.
Dr. Dale Bredesen, a Buck faculty member who has developed a comprehensive program to reverse memory loss, agrees. Consumers should make sure to get supplements from a trusted source, he adds, since there is “a lot of garbage out there. For herbs, good examples [for brands] include Metagenics, Banyan or Gaia.”
The typical modern processed-food diet leaves many of us low in omega-3s, Bredesen says, so fish or krill oil from a trusted source is a good idea. And then there’s buzz-worthy vitamin D, which is vital in regulating the absorption of calcium for healthy bones and facilitating function of the immune system. Mounting evidence suggests low D levels may be linked to an increased risk of Type 2 diabetes, Alzheimer’s and cancers, while raising D levels may reduce heart disease and more. Most of us are not getting enough Vitamin D from the sun or food sources like salmon, sardines, egg yolks or fortified milks and cereals.
TIP: Food first, then supplements. Dr. Elson Haas of San Rafael has recently published his 10th book on health and nutrition, Ultimate Immunity, which includes a breakdown of the hot topic of cooling down inflammation through diet, mind and body exercises and supplements. He has been guiding his patients on supplement intake for more than three decades from his Preventive Medical Center of Marin in San Rafael. “I look at deficiencies to our cells and tissues as a primary underlying issue for many health problems,” he says. “I counsel my patients to get as much of their nutrients from quality foods as possible, and supplements can then add to [promote] optimal function.” Patients commonly test low for vitamin D, he confirms: “I usually suggest 2,000–5,000 IUs daily.” Other nutrients insufficient in most diets include magnesium and potassium, B12, other Bs and good oils. At the top of his list of sources for anti-inflammatory nutrients are turmeric, boswellia herb and MSM (methylsulfonylmethane), as well as fish oils and probiotics. To test the ease of absorption (bioavailability) of your tableted vitamins, especially calcium-containing supplements, he suggests placing a couple pills into warm water; if they do not dissolve within 20 to 30 minutes, chances are they are not being absorbed into your body.
Moving the body is crucial to good health and aging well, but in the United States it seems we have “engineered exercise out of our lives, as we hardly walk anywhere,” Kennedy says. “Exercise has turned into something we have to find time for rather than incorporating daily. This may be one reason why the Japanese tend to live longer than us — they walk regularly.”
Buck Institute’s Simon Melov, a Ph.D. and professor, agrees: “People who are more active are healthier for longer. There’s an overwhelming body of data that directly relates exercise to overall health.” That includes Melov’s own study of seniors that revealed strength training exercise reverses aging in human skeletal tissue.
“About six or seven years ago we recruited a group of elderly folk who had done no resistance training,” he recalls. “In collaboration with our Canadian colleagues at McMaster University Medical Center, we did muscle biopsies on those individuals, and then put them on a six-month strength-training program. We took a second muscle biopsy to see what happened to their individual gene expression profile, which is a genetic portrait of gene activity. When compared to young people, it showed that the gene expression profile, after resistance training for six months, was reversed back to that of a more youthful state. In a very real sense, the resistance training had reversed certain aspects of the aging process at a genetic level. And that was a pretty impressive result.” Many studies have since backed up those results. Bottom line: age-related disease is reduced if you are a regular exerciser. “It’s a really powerful anti-disease mechanism,” Melov says.
TIP: Stay light. Given the high activity level here in Marin, the word athlete no longer has an age association, says Dave Goltz, an orthopedic surgeon and sports medicine specialist who works in Larkspur at Mt. Tam Orthopedics as well as in Park City, Utah, as the head team physician for the U.S. freestyle Olympic ski team. “Patients ask me all the time how they can keep their bodies in the best shape possible,” he says. “The key is moderating exercise, choosing low-impact activities and keeping the routine varied. One of the top concerns for older athletes seems to be knee arthritis, and for this I tell my clients to not gain weight. Losing weight saves your knees.” His tips for staying on the trails for as long as possible? Low-impact activities like hiking, biking and swimming, when combined with body-weight core strengthening, such as Pilates or in some types of yoga, can be a lifelong strategy for fitness. Bone mass is especially helped by low-impact choices like hiking.
Sleep and Restoration
We all know about the importance of REM, but don’t discount slow-wave sleep. Slow-wave sleep is when the heart rate lowers, bones and tissues have a chance to regenerate, energy stores recharge and the immune system strengthens. According to Dr. Mehrdad Razavi, medical director of the Marin Memory and Sleep Center, the three cornerstones of optimal health are nutrition, exercise and sleep. “While most folks know the importance of exercise and nutrition, sleep has been somewhat neglected by both the public and medical community,” he says.
“Slow wave (deep) sleep seems to be more important for physical regeneration, while REM sleep is more critical for emotional regeneration. Therefore, sleep disturbance could result in impairment in any or all of those systems, i.e., increased cardiovascular risk, hormonal imbalance, weight gain, pain, increased infection and premature death.” On the other hand, improving the quality of sleep has been shown to have positive effects on all of the above. “It is critical that the public and medical community look at sleep health the way we look at exercise and nutrition, as the impact and reward could be great,” Razavi says.
Ideally, restorative sleep is made up of five stages that take place during 90- to 120-minute cycles throughout the night. During these stages, growth hormones and melatonin levels (which are important for muscle maintenance and repair) increase, while the stress hormone cortisol decreases. It’s no surprise that daytime sleepiness makes people more accident prone and impatient, but recent research suggests far more alarming consequences: one recent study found non-restorative sleep can take a toll on the nervous and endocrine system and raise risk for stroke, diabetes, obesity and heart disease. Continual lack of sleep also affects the outside of your body, exacerbating fine lines and leading to under-eye circles and drab skin.
Sleep trackers now on the market can help us track our z’s, but do these devices work? Kind of, but not in the way you may expect, Razavi says: “While none of these sleep trackers (such as Fitbit) have been scientifically validated or endorsed by AASM (American Academy of Sleep Medicine) or can tell about the underlying cause and diagnoses of a lack of sleep, they are still useful as far as increasing the sleep awareness and engagement of the public.”
TIP: Can’t sleep? Rest. Michael Feldman of Mike’s Body Shop in Mill Valley has been working with clients for 28 years on optimizing and balancing/aligning the body through strength training and the movement/manipulation technique called structural integration. When it comes to healthy aging, he says, “five to 10 minutes of a restorative pose is the new apple a day.” Why? According to Feldman, the intent is to quiet the mind and support the diaphragm, which will in turn oxygenate the blood and connective tissue where stress accumulates and is stored, as well as activate the parasympathetic nervous system that governs bodily functions. One helpful pose is savasana, propping the legs up against a wall as you lie on your back with support from pillows or yoga blocks. “Support is critical,” Feldman says. “We live in a ‘go and do’ culture, which heightens the sympathetic nervous system. But when the body is supported the parasympathetic [system] can heal all of [the body’s] systems, including metabolism, nervous and digestion.” What does this have to do with aging gracefully? A lot, says Feldman. When the body’s internal connective tissue fails, the aging process accelerates and you start to see wrinkly skin, poor vision, bad muscle coordination and other problems.