These are the unedited lecture notes for a presentation I gave at the Nov. 1, 2015 meeting of the Fort Lauderdale Prime Timers, and a Nov. 7 Lunch and Learn session of SAGE South Florida.
Can we really change our aging?
Two years ago I gave a talk called “Making our Brains Younger”. It had a optimistic tone, there was excitement about brain exercises that you can do on your computer having good effects. Since then a lot of research has been going on, about effects of body exercise, brain exercise, diet, anti-aging chemistry.
..and skepticism is growing about claims of the wonders of special diets, anti-aging dietary supplements and brain exercise. When you look closely the scientific evidence is not there.
So, my title today is “Can we really change our aging?” I have reviewed the contents of about 250 brief articles I’ve written describing research on aging that I’ve put my blog on the internet. I want to pass on some of the facts I think are most striking.
I’m actually not all that happy with some of the facts that emerge. You probably won’t be either, may disagree with some of what I say, but there you are….
Let me start off by asking you a question. How much influence do you think you have over whether you will still be around 10 years from now? Now, you don’t get to abstain, you have to hold up your hand one way or the other. How many of you think you have a lot of influence, how many not so much? How many maybe a little? How many optimists versus pessimists?
Well, here are some facts, from many studies.
-50% of the odds of your dying in a given year is determined by your genetics, how long people in your family lineage have lived.
-50% of the chance that you will get a debilitating or terminal disease, especially cancer, is a throw of the dice, good or bad luck on whether particular genes randomly mutate to a bad place when cells divide,
we get to influence only 30% of the risk of our getting cancer by changing lifestyle, diet, supplements, whatever.
-50% of what determines your cognitive vitality and intelligence in later life depends on how you started out - your intelligence when you were 11 years old.
The bottom line is that 2/3 of the odds of whether we are going go bonkers or croak at a given age is random chance or genetics.
I, and I think most of us, don’t like this kind of information. We don’t like randomness, we want there to be connections and patterns to things. Because of this we frequently assume connections and causes that are not there.
Well, I guess I’m giving a new talk, or changing my title to:
“Can we really change a third of our aging.” or play with a third of the probability that we are still going to be around in ten years.
OK, we’ll take what we get, let’s run with that, talk about what we eat and drink, how we move, how we think.
In fact, I’ll start with booze. I am very attached to my daily happy hour, so I’m always glad to an article that describes an experiment showing that little bit of alcohol doesn’t hurt, even helps a bit.
A single study doesn’t tell you a damn thing, though, you have to combine the results of lots of studies, and this kind of analysis shows that compared with abstainers, male drinkers reduced their risk for dementia by 45 percent, and women by 27 percent. The death rate among non-drinkers is twice that of moderate drinkers.
Other studies show that moderate alcohol consumption can increase HDL, or “good cholesterol,” improve blood flow to the brain and decrease blood coagulation, increase the size of the hippocampus in our brain that is important for memory.
What about how much we eat, health risks go up with obesity, so you would think that the death rate should go up with obesity. Well, a study has been done on that, that most researchers wish would just go away, looking at 97 other studies including 2.88 million people … those deemed 'overweight' by international standards are 6% less likely to die than were those of 'normal' weight over the same time period. Go figure…maybe a bit of extra weight is not particularly harmful, and may even be helpful.
What about eating way less, rather than more? In animals, from worms, through to mice to monkeys, restricting calories slows down aging. A west coast group started up on a calorie restricted diet a few years ago…so what happened?
They got very cranky and grumpy!
What about what we eat in our ordinary diet?
What’s the proper balance of fat, carbohydrate, protein, salt in a normal diet? People can feel very passionate about this. It turns out the science behind USDA dietary guidelines is contradictory and in disarray. looking at lots of studies suggests that evidence against sodium, salt, and saturated fats is not strong.
Replacing fats with carbohydrates doesn’t reduce the risk of cardiovascular events and mortality. Vegetables, grains, unsaturated fats, complex rather than simple carbohydrates, fine, but butter, meat and cheese belong in a healthy diet too.
A recent book on flip-flops in medical advice and practice, estimates that about 40 percent of what we consider state of the art health care is likely to turn out to unhelpful or actually harmful. Extremely stringent diets prescribed for diabetes turn out to be unnecessary. Surgical repair of the meniscus in the knee turns out to be no more effective than physical therapy alone. The book lists almost 150 disproved common treatments.
What about going beyond our normal diet with supplements? A lot of us do this, I take pills of five of the more common supplements, based by articles I’ve read here and there saying they are good for brain health.
What I probably didn’t see, however, were articles describing experiments that failed to show an effect of the supplements. Studies with negative results seem kind of boring and are less likely to get published that ones with positive results. It is clearly documented that journals show this bias.
One of the supplements I take is a fish oil pill with lots of omega-3 fatty acids…I’m curious, how many of you take this supplement? Almost nobody argue against the idea that omega 3 fatty and other antioxidants are good for your brain. People who eat lots of fish have better brain health.
So, there is a correlation: eating more fish (left hand) - better brain health (right hand). But remember, just because two things happen together doesn’t mean one causes the other. A correlation is not a cause. We have to remain aware of our tendency to alway want to assign reasons and causes to things, even when they are not there.
So, I was not happy to see a recent massive NIH study of ~3,500 subjects, recruited from 82 academic and community medical centers that finds no cognitive effects of dietary supplementation with omega-3, other long-chain polyunsaturated fatty acids, and many other compounds for which effects are claimed in smaller individual studies, things like, lutein, zeaxanthin, vitamins D, C, E, beta carotene, and zinc.
Here in Southern Florida we are at an epicenter of the national life extension and life enhancing supplement industry. Several magazines report recent studies and sell pills. The usual article starts with “A new study has shown that…just fill in the blank with names of like theanine, piracetam, galantamine, metformin, dopamine, riluzole, resveratrol, ginko-biloba, DHEA, testosterone …”. Just remember, one, or a few studies don’t get you there, we need a lot of studies involving lots of subjects that reach a conclusion.
If you want to get into this you should tread very cautiously. Dietary supplements are responsible for more than 20,000 emergency room visits each year. Until the FDA issued a warning letter to 14 companies, at least a dozen supplements sold in the United States for weight loss, enhanced brain function, and improved athletic performance contained a synthetic stimulant similar to dimethylamylamine or DMAA. It had never been tested in people, only in two animal studies from the 1940s. Other supplements with proprietary unnamed ingredients have been found to have prozac, viagra, the corticosteroid dexamethasone, and so on. A recent investigation found that 30-50 percent of the herbal supplements, like ginko-baloba, being sold by CVS and Walgreens contained filler starch, sawdust, and little or none of the advertised herbal ingredient.
I’m curious, how many of you have tried some company’s mix of vitality or brain enhancing supplements? Don’t be timid, admit it if you did. I’ve tried some. What did you think?
I’ve actually tried, after researching their components, the magic elixirs that three different companies have sent me, hoping I would promote their product on my blog.
I’ve sometimes felt a mental lift, increase in clarity, attentional focus. But I have to ask “was this real, or was it a placebo effect, my believing they might work leading me to decide they had. My experience was that over time, the clarity of the effects I initially experienced went away, I felt less and less effect of taking them, and I began to notice unpleasant side effects.
Something very basic happens when you give your system a jolt, maybe you rev it up for awhile, feel great. Your brain and your body kinda know where they want to be, and when they get goosed, they start adapting, habituating, playing with the chemistry until they get back to where they want to be. Highs don’t last.
The body kind of knowing where it wants to be also applies to efforts to loose weight or to exercise. Your body reacts to your eating less by lowering its metabolic rate to try to maintain a weight set point it has decided on.
Sitting is bad for us, there is universal scientific agreement on this.
If you are an office worker who uses one of the new popular standing desks to get a bit of exercise, rather than sitting down, it turns out you sit down more at home when you are not working, so overall time spend sitting doesn’t change that much.
Anyway, my bottom line on supplements is that if you tell me you’ve found a product that is not dangerous and you think it makes you think better or feel more vital, it doesn’t matter whether the components are having a real biological effect or if it is a placebo effect, your belief in the product is causing the changes you feel. If it works for you, it works.
Well, moving on from the effects of what we ingest,
The “Can we really change our aging?” question gets one resounding positive yes answer from massive scientific evidence that just moving, exercise, improves our general health and brain fitness. Just Move! Anything to get just a little bit out of breath, whether your running, walking, using a walker, or in a wheelchair.
Regular aerobic exercise increases blood flow to the brain, and helps to support formation of new neural and vascular connections. Exercise improves attention, reasoning, and components of memory. It increases the number of stem cells that regenerate muscle, causes release of molecules that stimulate brain cell growth and connections. It is an antidote to depression, and generally makes people more relaxed and confident.
The exercise we are talking about here doesn’t have to be some big deal. Walking, housecleaning. People in their 60’s who walk three times a week, building up to 40 minutes at a stretch, after a year have a 2% increase in the size of the memory part of the brain, the hippocampus, while in a control non-walking group the volume has gone down by 1.5% Increasing amounts of aerobic exercise, from one up to 4 hours a week, go with corresponding increases cardiorespiratory fitness, but the maximum improvement in thinking skills, compared with people who don’t exercise, happens after only a hour of walking per week, isn’t increased by more walking.
Another clear point is that brain health is enhanced by novelty and new experiences, even things as trivial as shaving or brushing your teeth with the hand you don’t usually use. If you learn a new set of movements the part of brain managing that grows new connections and gets bigger. Habit - doing the same things on autopilot - causes areas of the brain to shrink.
Finally, our brains evolved to be engaged with other humans. Hundreds of studies have by now shown that social isolation correlates with diminished immune system function, increased susceptibility to illness, inflammation, feelings of helplessness and depression.
I really don’t have a conclusion for this talk, maybe just the suggestion to keep the body moving a little bit and chill. Eat what you feel like, not too much. Do new things. Be social. And, be skeptical about anti-aging products that are claimed to be science based.