Must We Grow Old? - Redux

Part 2

July 19, 2004


Preamble
    I've been shocked to learn just how much we don't know about personal health that we need to know. 
    What Iím going to tell you about in the following pages are ways that  will cut your chances of getting some of the major types of cancer, such as cancers of the breast, bowel, ovaries, colon, prostate, and esophagus by, I hope, a factor of several, with little or no cost or risk to you. Iím saying, ďI hopeĒ, because what Iíll be describing is ďunprovenĒ, and because thereís no guarantee that it will do all Iím claiming. But since it costs essentially nothing and involves essentially no risk, itís still worthwhile even if it only reduces your risk of getting these cancers by 30%.
    Beyond this, these simple steps should also help protect you against a host of other degenerative diseases such as heart disease, hypertension, rheumatoid arthritis, and both Type I and Type II diabetes which I'll cover in future installments, with specific information regarding each degenerative disease.
   There are reams of research papers supporting the suggestions Iíll be making, but these therapies remain "unproven". In the medical world, proving the effectiveness and safety of a therapy generally takes 10 to 30 years and tens of millions of dollars, culminating in large-scale, randomized, prospective intervention trials.  What Iím suggesting here hasn't gotten that far, but there is strong epidemiological, laboratory, and animal-model evidence that they work as described, and even if they don't, these measures shouldn't harm you.
    So why are you hearing this from me instead of reading about it in magzines or learning about it on the six o'clock news? To some extent, we probably are hearing about it on the six o'clock news, only, with all the other news bites that assail us, it probably goes in one ear and out the other. But the principal reason may be that these therapies are unproven, and until the requisite long-term, expensive intervention trials have been carried out and the results anointed with oil, these preventive measures can't be endorsed ex cathedra by the medical community. 
    It probably doesn't help that Big Pharma can't patent cinnamon fish oils, and make lots of money selling them.
    Most of our drugs are synthetic analogs of natural agents found in foodstuffs... synthetic not necessarily because they work better but because natural agents aren't patentable.

What a Healthy Lifestyle Can Do for You
    To give you an idea about just how much protection a healthy lifestyle can give you, the following study suggests what can be done with only modest preventive measures: 

"We followed 84,129 women participating in the Nurses' Health Study who were free of diagnosed cardiovascular disease, cancer, and diabetes at base line in 1980.... We defined subjects at low risk as those who were not currently smoking, had a body-mass index under 25, consumed an average of at least half a drink of an alcoholic beverage per day, engaged in moderate-to-vigorous physical activity (which could include brisk walking) for at least half an hour per day, on average, and scored in the highest 40 percent of the cohort for consumption of a diet high in cereal fiber, marine n-3 fatty acids, and folate, with a high ratio of polyunsaturated to saturated fat, and low in trans fat and glycemic load, which reflects the extent to which diet raises blood glucose levels.Women in the low-risk category (who made up 3 percent of the population) had a relative risk of coronary events of 0.17* (95 percent confidence interval, 0.07 to 0.41) as compared with all the other women.
CONCLUSION: Among women, adherence to lifestyle guidelines involving diet, exercise, and abstinence from smoking is associated with a very low risk of coronary heart disease."
* - About 1/6th of the risk among the other 97%.
--- "Primary prevention of coronary heart disease in women through diet and lifestyle.", www.pubmed.gov, 10882764 [pmid]


1.  Calorie Restriction
    As mentioned in last month's episode, the most effective cancer avoidance ploy is probably calorie restriction, reducing most cancer risks by half or better. The diabetes drug Glucophage (generic name: metformin) might confer most of these benefits without necessarily losing weight, although losing weight is, for many of us, a consummation most devoutly to be wished. (I'll talk about tricks for losing weight and keeping it off in a future section.) 
    In last month's article, I quoted a statement that the Life Exztension Foundation and the research team at the University of California - Riverside that they've supported: that calorie restriction in mice, begun later in life, partially reverses aging. An incandescently brilliant longevity researcher by the name of Michael Rae has challenged this assertion, stating that caloric-restiction does not partially reverse aging. However, two statements upon which we can all agree are 
(1) calorie restriction begun later in life reduces cardiovascular and diabetic risk factors (and presumably many others) to levels comparable to those of individuals 15 or 20 years younger; and
(2) although it will be decades before lifespan studies can be completed in humans, the best guess is that calorie restriction will add 10 to 20 years of "youthspan" to its practitioners' lives..

2.  Good Fats and Bad Fats
Avoid (Like the Plague) Trans (Hydrogenated) Fats (aka "Frankenfats")
    Like you, I've known for a long time that partially hydrogenated (trans) fats weren't good for us. What I didn't know was just how lethal they are, and just how ubiquitous they are. (They are said to be in 42,000 food products.)
    Trans fats (1) lower HDL and triglycerides; (2) raise LDL; (3) combat blood thinners such as aspirin by acting as blood-clotting agents; and (4) raise levels of apolipoprotein-a, which has been implicated in heart attacks. 
    How lethal are they?
    This lethal. 
     In the above-cited, NIH-funded, Harvard-managed Nurses Health Study of more than 80.000 nurses from 1980 to 1994, the nurses who derived 3% of their caloric intake from partially hydrogenated fats had 50% more heart attacks than those who got only 1% of their calories from partially hydrogenated fats ("Eat, Drink, and Be Merry", Walter C. Willettt, M. D., Harvard Department of Public Health,.Free Press (subsidiary of Simon and Schuster), New York, NY, 2003, pg. 69.)   It has been estimated that by replacing their additional 2% of calories in trans fats with polyunsaturated oil, these nurses consuming 3% of their daily calories in the form of partially hydrogenated fats could have approximately halved their heart attack rate. So how much fat is 1% of one's daily calorie intake?
    For normal adult women who are remaining slim, the daily calorie intake might be 2,200 calories. One percent of that is 22 calories. At 9 calories per gram, that amounts to about 2Ĺ grams, or about half a level teaspoon full of fat. Three percent of calories as partially hydrogenated fat represents about 7Ĺ grams of trans fats or about 5  grams (1 level teaspoon) of additional trans fats. Replacing 1 teaspoon full of polyunsaturated oil (e. g., corn oil, canola oil,  peanut butter oil, or fish oil) by one teaspoon full of partially hydrogenated fat increased the nurses' heart attack rate by 93%--i. e., approximately doubled it!!  The Harvard Department of Public Health has estimated that more than 30,000, and probably more than 100,000 heart attack deaths per year may be attributed to trans (hydrogenated) fats.
    That's what I call lethal.
    How ubiquitous are they? 
    They are in all the peanut butter brands on our local supermarket's shelves except for Smucker's Natural Peanut Butter containing only peanuts and salt.
    Every cake, cookie and brownie mix, including Betty Crocker, Pillsbury, and Duncan Hines, contain generous amounts of "Frankenfats". It's in all cakes, cookies, chips, crackers (including soda ceackers and Wheat Thins), and on and on and on. It's not in everything. We buy a powdered dry skim-milk coffee creamer. Some high-quality chocolate uses cocoa butter instead of partially hydrogenated soybean, cottonseed and/or palm kernal oil.
    One major source of trans (poisoned) fats was created when restaurants switched from frying in beef fat to frying in heavily hydrogenated vegetable oils rich in trans fats. French fries are now fried in trans fats. (Someone has just sued McDonalds for advertising that they have discontinued frying their french fries in trans fats when they haven't.) One KFC chicken pot pie contains 9 grams of trans fats (about 3% of daily calories.) A king-sized order of Burger King's french fries contains about 7 gms. (2% to 3% of daily calories) of trans fats. If it's this much for adults, think what it does to children! One Dunkin' Donuts cake doughnut contains 6 gms of trans fats (about 2% of daily calorie intake). One KFC biscuit harbors 4 grams of poisoned fats. One order of McDonalds chicken McNuggets slips 3 grams of poisoned fats into your system. One Burger King big fish sandwich will also assault you with 3 grams of trans fats. Three Nabisco Oreos contain 2 grams of trans fats (a bit less than 1% of daily calories). 16 Nabisco wheat thins also contain 2 gms. of trans fats. 
    To illustrate how tricky this is, I have here a bottle of "Fat Free" Coffee-mate. The second item in the list of ingredients is "vegetable oil  (partially hydrogenated cocoanut or palm kernel, and canola, hydrogenated palm, soybean, cottonseed, and/or safflower)". So how can they get away with listing the fat content as "0"? The answer is that if there is less than 0.5 grams of fat in a serving of a product, it may be labeled "Fat Free". Then when you look at the serving size, you see that it's one level teaspoonful or 2 grams. This means that the fat content of a serving of "Fat Free" Coffee-mate is 25%. Most people will want a rounded teaspoon of Coffee-mate or about 4 grams  in their cup of coffee, meaning that they will get 1 gram or about 0.3% to 0.4% of daily calorie intake in the form of the partially and/or fully hydrogenated fat in every cup of coffee they drink.
    It becomes really difficult when we eat out. There's no way of telling whether that fried catfish at Ruby Tuesday's or that pizza at the Olive Garden was cooked in polyunsatured oil or in partially hydrogenated oil.
   Trans fats are produced in small amounts as fermentation products in some ruminants (e. g., cows). However, they are synthesized in large amounts by industry because they allow manufacturers to slightly cut costs, and to improve shelf life. They do you absolutely no good. The FDA has ruled that there is no minimum safe intake of trans fats. They should be avoided--period. The FDA has been able to force explicit labelling of trans fats by 2006. They should obviously be banned, but reminiscent of the tobacco industry, corporate resistance is slowing the process. Eventually, this will probably happen, but in the meantime, we all need to protect ourselves.
    No one knows at this time whether the naturally occurring traces of trans fats in dairy and beef fat are as bad for you as synthetic trans fats.
    Considering how hard we try to avoid cardiovascular disease by minimizing animal fats, jogging, and taking statins, I find it pretty upsetting that it can all be undone by undetectable (by us) toxins that are added to our foods by food manufacturers. I realize that food manufacturers are in competition with each other and can't afford to protect us because their competitors will undercut their prices, but in the meantime, trans fats are presumably  killing people by the hundreds of thousands each year around the world..
    Dr. Willett has called trans fats the greatest public health disaster in history

Minimize Saturated Fats
    Saturated fats are found in animal products, and, while they pale by comparison with trans fats, they also raise  the risks of cardiovascular disease,. It has been estimated that increasing your saturated fat intake by 5% of daily calories (12.5 grams, or 2Ĺ level teaspoons full), you will increase your risk of heart disease by 17%. Replacing the same amount of polyunsaturated fats with saturated fats increases the risk of heart disease by 40%! 
    Many of us are minimizing our intake of saturated fat already. However, fast food hamburgers are a major source of saturated fat, and cheeseburgers, of course, are worse.
    We don't want to totally eliminate saturated fats. Living organisms have saturated fats because they need them.

Seek Out Polyunsaturated Oils (in Corn Oil, Safflower Oil, Fish Oil, and Canola Oil)
    See this web page for an overview of the essential polyunsaturated fatty acids.    
    Our bodies can't synthesize polyunsaturated oils, so we have to get them from food. In general, animal products are rich in saturated fats, while vegetable sources are rich in polyunsaturated oils. Polyunsaturated oils are very easily oxidized, so they don't work well for cooking (which is one reason why partially hydrogenated oils are used for cooking in restaurants.)
    Polyunsaturated fats tend to reduce levels of the "bad" LDL cholesterol without lowering levels of the "good" HDL cholesterol. The polyunsaturated omega-3 and omega-6 essential fatty acids are employed to, among other purposes, synthesize the archetypical hormones called the "eicosanoids" that are produced by every cell in your body, and that are used for intracellular signalling. 
    There are three basic classes of polyunsaturated fats: the Omega-3's, the Omega-6's, and the Omega-9's. 
Omega-3 Fats
    The omega-3 oils are the major constituents of the cell walls in the brain and the cardiovascular intimae, while the omega-6 oils are found in organ- and muscle-cell walls. Over the past 100 years, the omega-3 oils have largely disappeared from our diets as we switched from foods raised on our own farms, where our animals ate grasses (rich in omega-3's), to today's grain-produced foods. Omega-3 deficiencies typically show up in heart disease, cancer, all inflammatory diseases, including Alzheimer's diseases, and in mood disorders, including bipolar disorder and clinical depression. The American Heart Association's "New guidelines focus on fish, fish oil, omega-3 fatty acids" says this about it:.
    "Since 2000, the American Heart Associationís dietary guidelines have recommended that healthy adults eat at least two servings of fish per week, particularly fish such as mackerel, lake trout, herring, sardines, albacore tuna and salmon. These fish contain two omega-3 fatty acids Ė   eicosapentaenoic and docosahexaenoic acids (EPA and DHA).  A third kind, alpha-linolenic acid, is less potent. It comes from soybeans, canola, walnut and flaxseed and oils made from those beans, nuts and seeds. People who have elevated triglycerides may need 2 to 4 grams of EPA and DHA per day provided as a supplement. Even the 1 gram/day dose recommended for patients with existing cardiovascular disease may be more than can readily be achieved through diet alone. These people should consult their physician to discuss taking supplements to reduce heart disease risk. Patients taking more than 3 grams of omega-3 fatty acids from supplements should do so only under a physicianís care.  The FDA has noted that high intakes could cause excessive bleeding in some people. For middle aged and older men, and postmenopausal women, the benefits of eating fish far outweigh the risks within the established guidelines.
    "We also recommend eating tofu and other forms of soybeans, canola, walnut and flaxseed, and their oils. These contain alpha-linolenic acid (LNA),  which can become omega-3 fatty acid in the body. The extent of this modification is modest and controversial, however. More studies are needed to show a cause-and-effect relationship between alpha-linolenic acid and heart disease."
    Current guidelines call for U. S. citizens to get about 1 gram a day of omega-3 oils, which they can get from two 3-ounce servings of, e. g., salmon a week. ( For some reason, salmon has low levels of mercury, so I stick with salmon.)
    There has been concern lately about such environmental toxins as dioxin and the polychlorinated biphenyls (PCB's) that can be found in fatty fish, particularly in farm-raised salmon. The reason is that farm-raised salmon are often fed fish scraps that are high in pollutants. A safe alternative is wild Alaska canned salmon. These salmon are smaller, and eat krill and plankton that's lower on the food chain. The least contaminated kind of salmon are the wild Alaska red sockeye salmon. A few servings a week should be quite safe.
    The other way to get the omega-3 oils is through fish oil capsules. Barry Sears, in his book "The Omega Rx Zone", warns against contaminants. However, Consumer Reports, which recently tested vitamin supplements of various stripes, concluded that all the over-the-counter fish oil supplements they tested were safe, and contained roughly the doses they claimed, and they recommended going for the cheapest price. I would recommend salmon oil because salmon is low in mercury. (Tommie Jean and I actually use omega-3 capsules from the Life Extension Foundation that have been molecularly distilled under nitrogen to eliminate contaminants and to prevent oxidation.)
    It's very important that pregnant women get plenty of the omega-3 oil, docosahexaenoic acid (DHA), particularly during the third trimester, when the baby's brain is developing. The developing foetus drains the mother's body of omega-3 fats. 
    Supplementing a mother with omega-3 oils during pregnancy and during breast-feeding can raise a baby's IQ by several points. I'm unaware of studies that show that continued supplementation of fish oil for growing children will further raise IQ, but it would be reasonable to suppose that it would. Also, giving pregnant rats extra  choline, found in egg yolks and available at health food stores, has been found to enhance the nervous systems of their offspring, although to my knowledge, this hasn't yet been shown in humans. Still, choline is harmless, and is found in many foods. Here, too, continuing such supplementation during breast-feeding and beyond might benefit the nervous systems of infants and growing children, although this is strictly speculative on my part.
    The omega-3 fatty acids are used to produce anti-inflammatory eicosanoids, while the omega-6 fatty acids generate pro-inflammatory eicosanoids. The pro-inflammatory omega-6 eicosanoids mobilize the body's defenses for wound healing and against infectious agents. The anti-inflammatory omega-3 eicosanoids balance the pro-inflammatory eicosanoids, and come into play in the prevention of autoimmune diseases, such as arthritis, asthma, and the inflammatory diseases associated with C-reactive protein, such as atherosclerosis and cancer.
    Potential dangers of the omega-3 oils include blood thinning (stroke) and demands upon antioxidants. A multivitamin tablet is probably a good idea for everyone, and is probably good insurance for anyone taking fish oil supplements. However, someone eating 3-4 ounces of salmon twice a week (one gram of omega-3 oils a day) doesn't really have to worry about side effects.
    Three good books dealing with the omega-3 oils are 
(1)  Omega Rx Zone, Dr. Barry Sears, $3.95, .
(2) The Omega-3 Connection, Andrew L. Stoles, M. D., $4.99 
(3) The Omega Plan, Artemis P. Simopoulos, M. D., and Jo Robinson, $5.00 
Omega-6 Fats
    As mentioned above, the omega-6 fats are found in nearly everything we eat. We need a certain amount of them, but they need to be balanced by the omega-3 oils. We tend to get far too much of the omega-6 fats.
Omega-9 Fat
    Omega-9 fat is oleic acid, and it seems to be prevalent in everyone's diet. Apparently, we hear little about it because it poses no problems.
Seek Out Monounsaturated Fats (in Nuts, Olive Oil, and Peanut Butter)
    Monounsaturated oils offer the best of both worlds. Like saturated fats, they are resistant to oxidation and can be used for cooking. At the same time, they're healthy for us.
    One common and versatile monounsaturated fat is that found in olive oil (preferably cold-pressed, virgin olive oil). Like polyunsaturated fats, monounsaturated fats lower LDL without lowering HDL.

Avoid Olestra
    Dr. Walter Willett warns against using the synthetic fat, Olestra. Olestra blocks the absorption of fat-soluble substances such as vitamins A, D, E, and K, and the caretenoids. Olestra has been officially banned in Canada.Fast food companies have petitioned the FDA to use it in restaurants. If this ever happens, it will trigger another trans fat debacle.
Bottom line:  Don't use it!
Simplesse and Oatrim Are All Right
    Simplesse is made from whipped milk whey, and should be alright. However, it can't be heated, so it's limited to cold or frozen dishes. Oatrim is made from oats, and could be healthful.