Category Archives: Longevity

QOTD: John Wilder on Medical Care

“Stay away from doctors as much as you can.”

You’re not familiar with John Wilder but you should be. Take the following with a grain of salt; Wilder is a jokester:

Medical care.  In general, the very best medical advice I’ve seen says to stay away from doctors as much as you can.  Eat healthy food.  Get exercise.  Stay hydrated.  Wash your hands.  Try not to get crushed under heavy things.  Avoid Chicago.

The problem is that none of this is very profitable for the medical industry.  Healthy people are lousy customers.  Goldman Sachs® asked it themselves, “Is curing patients a sustainable business model?”  Yes, this is a real quote.

Well, no, curing patients doesn’t work for big financial companies – they hate that idea.  No one makes money off of diet foods if you maintain a healthy weight.  No one makes money off of insulin if you can avoid diabetes.  And they actually want you to get cancer.  This is again a comment from the same Goldman Sachs® report:  “Where an incident pool remains stable (e.g., in cancer) the potential for a cure poses less risk to the sustainability of a franchise.”

Hmmm.  Does the Pfizer™ vaccine make more sense now?  If they have their way, boosting will be an annual event.  Does that sound sustainable?  I’m sure Goldman Sachs© is thrilled.

https://wilderwealthywise.com/the-modern-world-part-iii-you-exist-to-be-farmed/

Let me help you stay away from doctors.

Steve Parker, M.D.

Yet Another Study Supports the Life-Preserving Effect of the Mediterranean Diet

Cardiovascular diseases include heart attacks and strokes. Those are major killers. So it’s good to know about dietary habits that counteract the threat.

Mozzarella cheese, roasted garlic cloves, olives, salami, spinach, tomato, and roasted peppers

Article

ABSTRACT

Background

Examining a variety of diet quality methodologies will inform best practice use of diet quality indices for assessing all-cause and CVD [cardiovascular disease] mortality.

Objective

To examine the association between three diet quality indices (Australian Dietary Guideline Index, DGI; Dietary Inflammatory Index, DII; Mediterranean-DASH Intervention for Neurodegenerative Delay, MIND) and risk of all-cause mortality, CVD mortality and non-fatal CVD events up to 19 years later.Design

Data on 10,009 adults (51.8 years; 52% female) from the Australian Diabetes, Obesity and Lifestyle study were used. A food frequency questionnaire was used to calculate DGI, DII and MIND at baseline. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% CI of all-cause mortality, CVD mortality and non-fatal CVD events (stroke; myocardial infarction) according to 1 SD increase in diet quality, adjusted for age, sex, education, smoking, physical activity, energy intake, history of stroke or heart attack, and diabetes and hypertension status.Results

Deaths due to all-cause (n = 1,955) and CVD (n = 520), and non-fatal CVD events (n = 264) were identified during mean follow-ups of 17.7, 17.4 and 9.6 years, respectively. For all-cause mortality, HRs associated with higher DGI, DII and MIND were 0.94 (95% CI: 0.89, 0.99), 1.08 (95% CI: 1.02, 1.15) and 0.93 (95% CI: 0.89, 0.98), respectively. For CVD mortality, HRs associated with higher DGI, DII and MIND were 0.93 (95% CI: 0.85, 0.99), 1.10 (95% CI: 1.00, 1.24) and 0.90 (95% CI: 0.82, 0.98), respectively. There was limited evidence of associations between diet quality and non-fatal CVD events.Conclusions

Better quality diet predicted lower risk of all-cause and CVD mortality in Australian adults, while a more inflammatory diet predicted higher mortality risk. These findings highlight the applicability of following Australian dietary guidelines, a Mediterranean style diet and a low-inflammatory diet for the reduction of all-cause and CVD mortality risk.


Steve Parker, M.D.

Anti-Aging: Glycine and N-acetylcysteine

young woman, exercise, weight training, gym

The following article tempts me to take supplemental glycine and N-acetylcysteine. I also wonder if they would help counteract the cyktokine storm of serious COVID-19.

From The Journal of Nutrition:

ABSTRACT

Cellular increases in oxidative stress (OxS) and decline in mitochondrial function are identified as key defects in aging, but underlying mechanisms are poorly understood and interventions are lacking. Defects linked to OxS and impaired mitochondrial fuel oxidation, such as inflammation, insulin resistance, endothelial dysfunction, and aging hallmarks, are present in older humans and are associated with declining strength and cognition, as well as the development of sarcopenic obesity. Investigations on the origins of elevated OxS and mitochondrial dysfunction in older humans led to the discovery that deficiencies of the antioxidant tripeptide glutathione (GSH) and its precursor amino acids glycine and cysteine may be contributory. Supplementation with GlyNAC (combination of glycine and N-acetylcysteine as a cysteine precursor) was found to improve/correct cellular glycine, cysteine, and GSH deficiencies; lower OxS; and improve mitochondrial function, inflammation, insulin resistance, endothelial dysfunction, genotoxicity, and multiple aging hallmarks; and improve muscle strength, exercise capacity, cognition, and body composition. This review discusses evidence from published rodent studies and human clinical trials to provide a detailed summary of available knowledge regarding the effects of GlyNAC supplementation on age-associated defects and aging hallmarks, as well as discussing why GlyNAC supplementation could be effective in promoting healthy aging. It is particularly exciting that GlyNAC supplementation appears to reverse multiple aging hallmarks, and if confirmed in a randomized clinical trial, it could introduce a transformative paradigm shift in aging and geriatrics. GlyNAC supplementation could be a novel nutritional approach to improve age-associated defects and promote healthy aging, and existing data strongly support the need for additional studies to explore the role and impact of GlyNAC supplementation in aging.

Steve Parker, M.D.

What If You Had Only a Few Months to Live?

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Jack Thomas is an 82-year-old newspaperman who unexpectedly learned he would die soon. He wrote about it at The Boston Globe. RTWT. If you’re old, you may need a tissue handy, in case you get something in your eye. He’s a talented writer. A few out-of-order excerpts:

“After a week of injections, blood tests, X-rays, and a CAT scan, I have been diagnosed with cancer. It’s inoperable. Doctors say it will kill me within a time they measure not in years, but months.

“As the saying goes, fate has dealt me one from the bottom of the deck, and I am now condemned to confront the question that has plagued me for years: How does a person spend what he knows are his final months of life?

“Atop the list of things I’ll miss are the smiles and hugs every morning from my beautiful wife, Geraldine, the greatest blessing of my life. I hate the notion of an eternity without hearing laughter from my three children. And what about my 40 rose bushes? Who will nurture them? I cannot imagine an afterlife without the red of my America roses or the aroma of my yellow Julia Childs.

“We told each of the three children individually. John Patrick put his face in his hands, racked with sobs. After hanging up the telephone, Jennifer doubled over and wept until her dog, Rosie, approached to lick away the tears but not the melancholy. Faith explained over the telephone that, if I could see her, she was weeping and wondering how she could get along without her dad. Now, she is on the Internet every day, snorkeling for new research, new strategies, new medications. My wife cries every morning, then rolls up her sleeves and handles all doctor appointments and medication. Without her . . . I cannot imagine.

“Editing the final details of one’s life is like editing a story for the final time. It’s the last shot an editor has at making corrections, the last rewrite before the roll of the presses. It’s more painful than I anticipated to throw away files and paperwork that seemed critical to my survival just two weeks ago, and today, are all trash. Like the manual for the TV that broke down four years ago, and notebooks for stories that will never be written, and from former girlfriends, letters whose value will plummet the day I die. Filling wastebasket after wastebasket is a regrettable reminder that I have squandered much of my life on trivia.

“Unlike Roman Catholics, Jews, and atheists, we Episcopalians are very good at fence-sitting. We embrace all viewpoints, and as a result, we are as confused as the Unitarians.

Photo by Pixabay on Pexels.com

“Does the intensity of a fatal illness clarify anything? Every day, I look at my wife’s beautiful face more admiringly, and in the garden, I do stare at the long row of blue hydrangeas with more appreciation than before. And the hundreds and hundreds of roses that bloomed this year were a greater joy than usual, not merely in their massive sprays of color, but also in their deep green foliage, the soft petals, the deep colors and the aromas that remind me of boyhood. As for the crises in Cuba and Haiti, however, and voting rights and the inexplicable stubbornness of Republicans who refuse to submit to an inoculation that might save their lives — on all those matters, no insights, no thunderbolts of discovery. I remai­­n as ignorant as ever.

“I’ll miss my homes in Cambridge and Falmouth. I’ll never again see the sun rise over the marsh off Vineyard Sound, never again see that little, yellow goldfinch that perched atop a hemlock outside my window from time to time so that both of us could watch the tide rise to cover the wetland.

“As death draws near, I feel the same uncomfortable transition I experienced when I was a teenager at Brantwood Camp in Peterborough, New Hampshire, packing up to go home after a grand summer. I’m not sure what awaits me when I get home, but this has certainly been an exciting experience. I had a loving family. I had a great job at the newspaper. I met fascinating people, and I saw myriad worldwide wonders. It’s been full of fun and laughter, too, a really good time.

“I just wish I could stay a little longer.”

Photo by Min An on Pexels.com

Parker here. Are you good with God? Have you examined the life of Jesus and accepted him as your Lord and Savior? Consider and decide before it’s too late.

Steve Parker, M.D.

Aspirin 325 vs 81 mg/day: Which is Better?

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For patients with established cardiovascular disease, a recent study found that aspirin 81 mg/day was just as effective as 325 mg/day in preventing combined risk of death and hospitalization for heart attack or stroke. Rates of major bleeding were the same regardless of dose.

Click for details at NEJM.

Steve Parker, M.D.

PS: What else prevents heart attacks and strokes? The Mediterranean diet!

High Glycemic Index Eating Associated With Premature Death and Cardiovascular Disease

Naan, a type of flat bread with a high glycemic index

Haven’t we know this for years? From New England Journal of Medicine:

Most data regarding the association between the glycemic index and cardiovascular disease come from high-income Western populations, with little information from non-Western countries with low or middle incomes. To fill this gap, data are needed from a large, geographically diverse population.

METHODS

This analysis includes 137,851 participants between the ages of 35 and 70 years living on five continents, with a median follow-up of 9.5 years. We used country-specific food-frequency questionnaires to determine dietary intake and estimated the glycemic index and glycemic load on the basis of the consumption of seven categories of carbohydrate foods. We calculated hazard ratios using multivariable Cox frailty models. The primary outcome was a composite of a major cardiovascular event (cardiovascular death, nonfatal myocardial infarction, stroke, and heart failure) or death from any cause.

RESULTS

In the study population, 8780 deaths and 8252 major cardiovascular events occurred during the follow-up period. After performing extensive adjustments comparing the lowest and highest glycemic-index quintiles, we found that a diet with a high glycemic index was associated with an increased risk of a major cardiovascular event or death, both among participants with preexisting cardiovascular disease (hazard ratio, 1.51; 95% confidence interval [CI], 1.25 to 1.82) and among those without such disease (hazard ratio, 1.21; 95% CI, 1.11 to 1.34). Among the components of the primary outcome, a high glycemic index was also associated with an increased risk of death from cardiovascular causes. The results with respect to glycemic load were similar to the findings regarding the glycemic index among the participants with cardiovascular disease at baseline, but the association was not significant among those without preexisting cardiovascular disease.

CONCLUSIONS

In this study, a diet with a high glycemic index was associated with an increased risk of cardiovascular disease and death.

Source: Glycemic Index, Glycemic Load, and Cardiovascular Disease and Mortality | NEJM

The Advanced Mediterranean Diet (2nd edition) is low glycemic index.

Steve Parker, M.D.

Maintain Vigor as You Age With the Mediterranean Diet

Winning against gravity, for now…

The opposite of vigor is frailty. Aging is a life-long fight with gravity. If you’re frail, you’ll lose the battle sooner. In the study at hand, frailty was measured by exhaustion, weakness, physical activity, walking speed, and weight loss. The Mediterranean diet was linked to decreased frailty. From the Journal of the American Medical Medical Directors Association way back in 2014:

Abstract

Background and objective: Low intake of certain micronutrients and protein has been associated with higher risk of frailty. However, very few studies have assessed the effect of global dietary patterns on frailty. This study examined the association between adherence to the Mediterranean diet (MD) and the risk of frailty in older adults.

Design, setting, and participants: Prospective cohort study with 1815 community-dwelling individuals aged ≥60 years recruited in 2008-2010 in Spain.

Measurements: At baseline, the degree of MD [Mediterranean Diet] adherence was measured with the Mediterranean Diet Adherence Screener (MEDAS) score and the Mediterranean Diet Score, also known as the Trichopoulou index. In 2012, individuals were reassessed to detect incident frailty, defined as having at least 3 of the following criteria: exhaustion, muscle weakness, low physical activity, slow walking speed, and weight loss. The study associations were summarized with odds ratios (OR) and their 95% confidence interval (CI) obtained from logistic regression, with adjustment for the main confounders.

Results: Over a mean follow-up of 3.5 years, 137 persons with incident frailty were identified. Compared with individuals in the lowest tertile of the MEDAS score (lowest MD adherence), the OR (95% CI) of frailty was 0.85 (0.54-1.36) in those in the second tertile, and 0.65 (0.40-1.04; P for trend = .07) in the third tertile. Corresponding figures for the Mediterranean Diet Score were 0.59 (0.37-0.95) and 0.48 (0.30-0.77; P for trend = .002). Being in the highest tertile of MEDAS was associated with reduced risk of slow walking (OR 0.53; 95% CI 0.35-0.79) and of weight loss (OR 0.53; 95% CI 0.36-0.80). Lastly, the risk of frailty was inversely associated with consumption of fish (OR 0.66; 95% CI 0.45-0.97) and fruit (OR 0.59; 95% CI 0.39-0.91).

Conclusions: Among community-dwelling older adults, an increasing adherence to the MD was associated with decreasing risk of frailty.

Did you notice another good reason to eat fish?

I wonder why the research was published in the Journal of the American Medical Medical Directors Association?

Steve Parker, M.D.

You Don’t Have to Lose Muscle as You Age

young woman, exercise, weight training, gym
Not enough weight!

Axel Sigurdsson, MD, PhD, published a great article on prevention of age-related sarcopenia (loss of muscle mass). Click through for details. To stay vigorous as you age, you want to preserve muscle mass and the strength it provides. If you’ve lost muscle mass, you can re-build it. Summary from the good doctor:

Age-related loss of muscle mass (sarcopenia) may start as early as in our thirties and appears to continue for the rest of our lives.

There is also a loss of muscle strength and muscle function. The consequences may often be severe, particularly in the elderly.

Increased physical activity and adequate nutrition are the most powerful tools at our disposal to delay age-related loss of muscle mass.

Well-rounded exercise programs consisting of aerobic and resistance exercises are believed to be most effective.

Modification of dietary habits may be an important tool to prevent the decline in muscle mass and function that occurs with aging.

Adequate protein intake is of key importance. Animal-derived protein may provide a higher and broader biological value than vegetable protein.

Fish consumption is recommended and fruits and vegetables should be consumed regularly.

Nutritional supplements containing essential amino acids may be helpful. This is particularly true for whey protein.

Fish-derived protein hydrolysates also appear promising.

Pro Tip: Hold your fish in front of your body with outstretched arms to make it look bigger!

Adequate intake of vitamin D is essential.

“Fish-derived protein hydrolysates” doesn’t sound very appetizing. I’ll stick with real fish for now, especially cold-water fatty fish.

Steve Parker, M.D.

Eat Chicken Brains for Longer life

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Dexter Kruger, a retired cattle rancher, is Australia’s oldest-ever living man. He’s 111 now. He attributes his longevity (only in part?) to eating chicken brains. The article doesn’t say whether the brains are cooked or raw. I’m heading over to Allrecipes lickety split.

Steve Parker, M.D.

PS: The Mediterranean dIet is famous for prolonging life. No chicken brains involved.

Mediterranean Diet Decreased Hospital Length of Stay, Reduced Mortality, and Cut Medical Costs of Elderly Patients

Somewhere on on the Mediterranean Sea

The study at hand involved 183 patients in Greece.

In multivariate analyses, hospital LOS [length of stay] decreased by 0.3 d for each unit increase of MedDiet score (P < 0.0001), 2.1 d for each 1 g/dL increase of albumin (P = 0.001) and increased 0.1 d for each day of previous admissions (P < 0.0001). Extended hospitalization (P < 0.0001) and its interaction with MedDiet score (P = 0.01) remained the significantly associated variables for financial cost. Mortality risk increased 3% per each year increase of age (hazard ratio [HR], 1.03; P = 0.02) and 6% for each previous admission (HR, 1.06; P = 0.04); whereas it decreased 13% per each unit increase of MedDiet score (HR, 0.87; P < 0.0001).

Conclusion

Adoption of the MedDiet decreases duration of admission and long-term mortality in hospitalized patients >65 y of age, with parallel reduction of relevant financial costs.

Steve Parker, M.D.

Source: Effects of Mediterranean diet on hospital length of stay, medical expenses, and mortality in elderly, hospitalized patients: A 2-year observational study – ScienceDirect