COLUMN:

The Keys to Longevity

"Aging is inevitable, but there are ways you can slow down the process and enjoy optimum vitality."

As we age, our lungs and kidneys shrink and have reduced function. We also have less capacity in other organ systems. Peak heart rate and function gradually decreases. Blood pressure and blood sugars increase — more so if we are overweight. This is not good, as increases in blood pressure, cholesterol and sugar cause fat and calcium to be deposited in blood vessels, clogging and stiffening them. This can cause heart disease and strokes, which are the major killers among the elderly.

The two most important things you can do to boost your vitality and stave off disease is to eat the right food and burn it off through regular exercise. The best fuel for the body is the Mediterranean diet, which reduces heart disease and helps with weight loss.

For this diet, consume plenty of fruits and vegetables, eat red meats sparingly, and use canola or olive oil in salad dressings and for cooking. Replace butter with non-hydrogenated canola margarine like Canola Harvest. Eat nuts, seeds, pasta and rice, but watch total calories. Avoid the trans-fatty acids found in many pastries and cookies.

Walking or dancing as little as 10 minutes twice a day will help prevent hip fractures, reduce blood sugars and the risk of heart disease, and prevent or alleviate diabetes. If you need to lose weight, build this up to one hour at least six days a week. Be aware, though, that you’ll initially gain muscle mass while losing fat mass, so you won’t lose weight for three months or so.

Blood clots can clog vessels and lead to heart attacks and aspirin reduces clots, so should we all take an aspirin a day? Aspirin sometimes can cause serious brain or stomach bleeds, but if you’re a smoker or have hypertension, diabetes or high cholesterol that increases your risk of heart disease in 10 years to 10 percent or higher, you should take one baby aspirin a day if you don’t have a condition — like a previous case of bleeding ulcers — that unduly increases your chance for brain or stomach bleeds.

Doing this could lower your risk of heart attack by almost a third. Find your 10-year risk by going to www.intmed.mcw.edu/clincalc/heartrisk.html. If you’re on blood pressure pills and your pressure is normal (less than 140/90), you should input 140/90 as your pressure because such medication is only partly effective in reducing heart disease risk.

What about supplements? I do advise my patients to take extra calcium and vitamin D to prevent hip fractures and painful hunchback because most of us don’t get enough of either (see http://the.honoluluadvertiser.com/article/2005/Nov/24/il/FP511240309.html). Taking extra calcium also reduces polyps — lumps of tissue in the colon that sometimes become cancerous.

However, in March 2005, a randomized controlled trial (or RCT, the most accurate kind of scientific study) found that taking vitamin E at 400 IU a day for seven years didn’t reduce the risk of cancer or heart disease and actually increased heart failure. A meta-analysis of multiple RCTs in the Annals of Internal Medicine found that vitamin E at doses above 150 IU a day seems to increase the chance of dying.

Similarly, in an RCT of male smokers, the New England Journal found that taking extra beta-carotene (which turns into vitamin A in the body) increased the number of deaths from lung cancer, strokes and heart attacks. And the Iowa Women’s Health Study showed a rise in the number of deaths from strokes and heart attacks among diabetics who took more than 300 mg a day of vitamin C pills.

What’s happening? Fruits and vegetables reduce the risk of heart disease and cancers and have lots of vitamins, so wouldn’t taking extra vitamins be good for you?

There are hundreds of antioxidants and molecules in fruits and vegetables that haven’t been discovered yet; it could be that one of these or a combination of these taken in the correct proportion is the “super antioxidant” that will decrease the incidence of cancer and heart disease.

But taking extra vitamin A or E could throw off the balance of the substances you eat in the correct proportions in your diet and be harmful. And taking two, three or more vitamins might only add to their individual toxicities.

If you take vitamins, herbs, blue-green algae or anything else in amounts not present in your normal diet, it’s no longer natural; it may be harmful and is like taking drugs without a doctor’s supervision.

So forget the supplements. Eat a Mediterranean diet, get regular exercise and do the necessary screenings (see sidebar). Also make time to smell the roses and nourish the spirit. By doing this, you should live long and prosper.

Dr. Landis Lum is a family-practice physician for Kaiser Permanente and an associate clinical professor at the University of Hawaii’s John A. Burns School of Medicine. This column provides general medical information only; it is not intended to replace recommendations you would receive from your doctor after undergoing a thorough physical examination.

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Checklist of Screenings

Health screenings are as important to good health as diet and exercise.
Men and women:
• Check levels of fasting blood sugars and cholesterols — both total and good (HDL) — every five years and blood pressures every two years, more often if you’re overweight.

• Annual tests for invisible blood in the stool and flexible sigmoidoscopies every five years if you’re over 50. Or just do a colonoscopy alone every 10 years.

• Flu shot every October or November beginning at age 50 (earlier if you have a chronic illness such as diabetes or asthma).

• Pneumonia shot at age 65.

In addition, women need:
• Mammography every one to two years starting at age 40.

• A Pap smear every two to three years after two normal Pap smears for two straight years.

• Bone density test at age 65, but do it at age 60 if you weigh less than 150 pounds or have other risks.

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