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Healthy Aging Melissa C. Young, M.D. Tanya I. Edwards Center for Integrative Medicine, Wellness Institute, Cleveland Clinic Definition of Integrative Medicine Integrative Medicine is a healingoriented medicine that takes into account the whole person, mind, body, and spirit, including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative Integrative Medicine Principles ¾ Utilizes the best of all healing modalities ¾ Focus on health and healing ¾ Relationship centered care ¾ Supports the body’s innate ability to heal Integrative Medicine Principles ¾ Natural Interventions ¾ Promotes health and prevention of disease ¾ Emphasis on the whole person: mind, body, spirit, and emotions It is much more important to know what sort of patient has a disease than what sort of disease a patient has. Sir William Osler Each person’s signature of aging is a result of interactions among genetic make-up, lifestyle, and environmental factors/challenges Common Reversible Functional Causes of Premature Aging ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ Oxidative stress Dysglycemia and insulin resistance Chronic inflammation Altered methylation reactions Lipid atherogenesis Compromised detoxification capacity Chronic stress response Physical and mental inactivity • Integrative Medicine Textbook First ed. Chapter 80 Free Radical Theory of Aging and Oxidative Stress Oxidative stress is the burden placed on organisms by the constant production of free radicals from normal metabolism and from the environment Free Radical Theory of Aging “There is increasing evidence to suggest that many degenerative diseases or pathological processes, such as aging, cancer, and coronary heart disease, are related to reactive oxygen species and free radical-mediated reactions.” Plant Foods and Nutrition March 2011 Causes and Mediators of Oxidative Stress ¾ Natural metabolism ¾ Being overweight ¾ Chronic stress ¾ Food additives ¾ Environmental pollutants ¾ Lack of sleep ¾ Poor Dietary intake of antioxidants Can We Reverse the Aging Process and Where Can We Intervene? Age-Related Diseases ¾ Heart Disease ¾ Cancer ¾ Arthritis ¾ Alzheimer’s disease ¾ Osteoporosis What is our Focus? ¾ Prevention ¾ Disease modification ¾ Reversal of age related disease We Are NOT Our Genetic Destiny We have control over the decisions we make everyday related to our lifestyle choices Pillars of Lifestyle Modification ¾Nutrition ¾Physical activity ¾Stress management Where Do We Start? Inflammation ¾ Common underlying pathway for many, if not all, chronic disease and aging ¾ Researchers believe that chronic, low grade inflammation in the brain plays a part in memory decline as we age as well as in neurodegenerative diseases such as Alzheimer’s and Parkinson’s Inflammation: Prevention and Treatment ¾ Exercise ¾ Reduce Toxic Load ¾ Anti-inflammatory Diet ¾ Anti-inflammatory Supplements ¾ Adequate Sleep ¾ Manage Stress Prevent Inflammation ¾Exercise Prevent Inflammation ¾ Exercise 30-45 minutes daily z Decreases CRP levels z Promotes production of BDNF z Regular exercise can decrease risk of Alzheimer’s disease by up to 50% z Supports healthy body weight z Improves insulin sensitivity BDNF Brain-Derived Neurotrophic Factor BDNF-Growth Hormone for the Brain Acts on particular neurons in the brain to help support existing neurons and encourage the growth of new neurons ¾ Active in the hippocampus, cortex, and basal forebrain, areas important to memory and learning ¾ Low in people with Alzheimer’s disease ¾ What Influences BDNF? ¾Diets high in saturated fat and refined sugar decrease production ¾Exercise, curcumin, DHA, intellectual stimulation, calorie restriction increase production Prevent Inflammation ¾Exercise ¾Reduce toxic load Prevent Inflammation Reduce toxic load ¾Avoid pesticides Filter your water (especially well water) z Buy organic produce and meats/dairy z Decrease indoor air pollution z Prevent Inflammation Reduce toxic load ¾Avoid heavy z Fish z Amalgams ¾ Avoid metals common dietary excitotoxins Aspartame z MSG z Prevent Inflammation Reduce toxic load ¾ Choose natural beauty products and household cleaners ¾ Avoid unnecessary medications ¾ Avoid tobacco and alcohol Prevent Inflammation ¾Exercise ¾Reduce toxic load ¾Anti-inflammatory diet Food as Medicine Food is Information Prevent Inflammation Mediterranean Diet vs. SAD ¾ What foods to avoid? ¾ Focus on an Anti-inflammatory diet ¾ Low Glycemic Foods Anti-inflammatory Diet ¾ Fruits and Vegetables- THINK RAINBOW! ¾ Whole grains-don’t forget quinoa, millet, amaranth, buckwheat, black/red/brown rice ¾ Legumes-Beans and Lentils ¾ Healthy fats/Omega-3 fatty acids-extra virgin olive oil, nuts/seeds, fish, avocado, flax seed Anti-inflammatory Diet ¾ Quality protein-organic poultry, grassfed beef, wild fish, legumes, whole soy foods ¾ Herbs and spices-tumeric, ginger, garlic ¾ Green tea, purple grape juice, red wine, dark chocolate Anti-inflammatory Diet ¾ Avoid food additives like artificial colors and flavorings. ¾ Avoid natural flavors ¾ If you do not recognize an ingredient on a food label-Don’t buy it! ¾ Avoid factory raised meats ¾ Buy organic to avoid pesticides, antibiotics, hormones Food as Medicine Prevent Inflammation ¾ Exercise ¾ Reduce toxic load ¾ Anti-inflammatory diet ¾ Anti-inflammatory supplements Anti-inflammatory Nutrients ¾ Antioxidants z Curcumin 500mg twice daily z Green tea extract 200mg twice daily (or even better drink 2-4 cups of organic green tea daily) z Resveratrol 250mg daily (transresveratrol) z Vitamins B, C, D, E z N-acetyl-cysteine (NAC) 400-600 mg BID Anti-inflammatory Nutrients ¾Omega-3 Fatty Acids Fish Oil-EPA/DHA 2-6 grams daily Additional Nutrients ¾ Medicinal Mushrooms z Lion’s mane z Cordyceps Inflammation: Prevention and Treatment ¾ Exercise ¾ Reduce Toxic Load ¾ Anti-inflammatory Diet ¾ Anti-inflammatory Supplements ¾ Manage Stress ¾ Adequate Sleep Manage Stress ¾ Relaxation Techniques ¾ Sleep ¾ Supplements ¾ Build Relationships ¾ Learn something new! Manage Stress ¾ Stress management z Yoga z Tai chi z Meditation z Hypnotherapy z Breathwork z Music z Biofeedback techniques Manage Stress-Quantity and Quality of Sleep ¾ Aim for 7-8 hours nightly ¾ Sleep Hygiene Sleep in a cool, dark room z Dim the lights z No electronics z Establish routine z Get out into natural light to help reset a normal circadian rhythm z Manage Stress: Supplements ¾ Supplements z Adaptogens Rhodiola 100-500mg Ashwagandha 500-1,000mg z Energy Boosters CoQ-10 30-200mg Alpha-Lipoic acid 100-200mg Acetyl-L-Carnitine 500-1,500mg Manage Stress: Supplements ¾ Supplements z z Phosphatidylserine 100 mg three times daily for Alzheimer's disease, and other age-related thinking or memory impairment 150-300 mg at bedtime for insomnia related to stress Manage Stress ¾Build Relationships ¾Maintain a positive attitude Manage Stress ¾Mental Activity Learn Something new! Healthy Aging ¾ Exercise ¾ Reduce toxic load ¾ Anti-inflammatory diet ¾ Anti-inflammatory supplements ¾ Manage stress Healthy Aging ¾ Exercise ¾ Reduce Toxic Load ¾ Anti-inflammatory Diet ¾ Anti-inflammatory Supplements ¾ Manage Stress ¾ Keep learning new things ¾ Seek out social interactions Tanya I. Edwards Center for Integrative Medicine Services ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ Integrative Medicine consultations Adult health & wellness consultations Trim Life Program-Integrative Weight Management Chinese Medicine Consultations ~Chinese Herbal Consults ~Acupuncture Chiropractic Services Holistic Psychotherapy Mind-Body Consultations Massage Therapy Individualized Testing ¾ Advanced Metabolic Assessment Methylation-MTHFR and Homocysteine Fasting insulin, HBA1C C-reactive protein ¾ Serum and Functional Nutrient testing Individualized Testingcontinued ¾ Heavy metals and toxins ¾ Fatty acids ¾ Testing for Neurotransmitter and Stress Markers