Marc Joseph Nutrition - Blog

“We just fall apart,” Felix Silverstone, former senior geriatrician at New York’s Parker Jewish Institute, declares in an interesting New Yorker article on aging that’s definitely worth a read.

Aging is something we’ll all have to deal with sooner or later, whether with helping our parents or ourselves, and the article raises many of the key issues worth considering.

Why We Age

First up is the contentious question of why we age:

[S]cientists do not believe that our life spans are actually programmed into us. After all, for most of our hundred-thousand-year existence—all but the past couple of hundred years—the average life span of human beings has been thirty years or less … Today, the average life span in developed countries is almost eighty years …

… Inheritance has surprisingly little influence on longevity. James Vaupel, of the Max Planck Institute for Demographic Research, in Rostock, Germany, notes that only six per cent of how long you’ll live, compared with the average, is explained by your parents’ longevity; by contrast, up to ninety per cent of how tall you are, compared with the average, is explained by your parents’ height. Even genetically identical twins vary widely in life span: the typical gap is more than fifteen years.

The “wear and tear” model appears much more likely to determine longevity:

Leonid Gavrilov, a researcher at the University of Chicago, argues that human beings fail the way all complex systems fail: randomly and gradually. As engineers have long recognized, many simple devices do not age. They function reliably until a critical component fails, and the whole thing dies instantly. A windup toy works smoothly until a gear rusts or a spring breaks, and then it doesn’t work at all. But complex systems—power plants, say—have to survive and function despite having thousands of critical components. Engineers therefore design these machines with multiple layers of redundancy: with backup systems, and backup systems for the backup systems. The backups may not be as efficient as the first-line components, but they allow the machine to keep going even as damage accumulates. Gavrilov argues that, within the parameters established by our genes, that’s exactly how human beings appear to work. We have an extra kidney, an extra lung, an extra gonad, extra teeth. The DNA in our cells is frequently damaged under routine conditions, but our cells have a number of DNA repair systems. If a key gene is permanently damaged, there are usually extra copies of the gene nearby. And, if the entire cell dies, other cells can fill in.

Nonetheless, as the defects in a complex system increase, the time comes when just one more defect is enough to impair the whole, resulting in the condition known as frailty. It happens to power plants, cars, and large organizations. And it happens to us: eventually, one too many joints are damaged, one too many arteries calcify. There are no more backups. We wear down until we can’t wear down anymore.

Maintaining the “Machine”

Unlike mechanical machines, the human body has repair mechanisms that are constantly working to restore damage to cells and tissues. There are several factors that affect how those repair mechanisms work, including:

• Genetics
• Nutrition
• Toxin exposure
• Stress - psychological, physical

For now, you’re kind of stuck with the genetics part, but the other three factors are environmental and very much under your control.

For example, the article discusses the issue of soft-tissue calcification:

Even as our bones and teeth soften, the rest of our body hardens. Blood vessels, joints, the muscle and valves of the heart, and even the lungs pick up substantial deposits of calcium and turn stiff. Under a microscope, the vessels and soft tissues display the same form of calcium that you find in bone. When you reach inside an elderly patient during surgery, the aorta and other major vessels often feel crunchy under your fingers. A recent study has found that loss of bone density may be an even better predictor of death from atherosclerotic disease than cholesterol levels. As we age, it’s as if the calcium flows out of our skeletons and into our tissues.

Ok, but how many people actually take the easy and inexpensive preventive nutritional step of supplementing with a high-quality bone building supplement containing well-absorbed forms of calcium, magnesium, zinc, copper, manganese, boron, vitamin D, and vitamin K? How many people start doing this in their 30s, before bone loss starts, or better yet, during the critical bone-building teen years and 20s?

If people did supplement, by how much would observed rates of arterial calcification (and related conditions like heart disease and osteoporosis) potentially decline? By thousands of cases? Millions even? How much would those potential declines in disease rates improve not only individuals’ lives, but also the economical health of our society? Think about it for a second.

Are Society and the Medical System Ready?

The rest of the New Yorker article discusses the changing population demographics (”rectangularization”) and how we really haven’t thought through aging issues that well as a society:

We cling to the notion of retirement at sixty-five—a reasonable notion when those over sixty-five were a tiny percentage of the population, but completely untenable as they approach twenty per cent. People are putting aside less in savings for old age now than they have in any decade since the Great Depression. More than half of the very old now live without a spouse, and we have fewer children than ever before—yet we give virtually no thought to how we will live out our later years alone.

And goes on to bring up the equally important question of whether medicine is set up to handle the changes:

Despite a rapidly growing elderly population, the number of certified geriatricians fell by a third between 1998 and 2004. Applications to training programs in adult primary-care medicine are plummeting, while fields like plastic surgery and radiology receive applications in record numbers. Partly, this has to do with money—incomes in geriatrics and adult primary care are among the lowest in medicine. And partly, whether we admit it or not, most doctors don’t like taking care of the elderly …

… Good medical care can influence which direction a person’s old age will take. Most of us in medicine, however, don’t know how to think about decline. We’re good at addressing specific, individual problems: colon cancer, high blood pressure, arthritic knees. Give us a disease, and we can do something about it. But give us an elderly woman with colon cancer, high blood pressure, arthritic knees, and various other ailments besides—an elderly woman at risk of losing the life she enjoys—and we are not sure what to do.

With interest in and funding of gerontology training programs in decline and geriatrics increasingly viewed as economically infeasible from a Medicare perspective, the article mentions alternative approaches being considered, such as training more primary care doctors or nurses to recognize and deal with geriatric issues. These steps may help. However, whatever system of geriatric care emerges, it’s a good bet that it will be less than optimal from a patient perspective.

Taking Control

Ultimately, those people who will fare best are those do everything in their own power to control the environmental factors (nutrition, toxin exposure, and stress) that influence aging, to maintain a high functioning level, and to avoid overly relying upon the medical system.

The photo above is of Dr. Ronald Morse, a man profiled in Life Extension Foundation magazine, at age 74 (no, that is not a photoshopped picture). He takes a balanced approach to keeping the body’s repair mechanisms working well, including diet, supplementation, exercise, and stress reduction. He’s got the right idea.

Decline remains our fate; death will come. But, until that last backup system inside each of us fails, decline can occur in two ways. One is early and precipitately, with an old age of enfeeblement and dependence, sustained primarily by nursing homes and hospitals. The other way is more gradual, preserving, for as long as possible, your ability to control your own life.

Sums it up well. The choice is ours.

If you or others you know would like help putting together an organized, preventive action plan to address nutrition, toxin exposure, and lifestyle factors for aging more gracefully, please visit my main site for more information on setting up an appointment.

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Marc Joseph Nutrition

This entry was posted on Tuesday, May 1st, 2007 at 11:49 pm and is filed under Aging, Health Care. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.