YOUR REAL AGE-- THE BOOK-- 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20,

 It  is  my  pleasure  to  bring  you  the  main  points  of  this  now  "out  of  print"  book  -  Keith  Hunt

REALAGE....... Are you as Young as You  Can  Be?

An Age Reduction Programme That Can Make You Live and Feel Up to 26 Years Younger

DrDr4                                     Dr.  Michael  F.  Roizen4 Scientifically Proven Steps That Delay 

Preface

GETTING YOUNGER: FOR LIFE!

What would you do if I gave you a hundred dollars? Would you spend it? Or save it? Think of all the things you could do with it. You could buy tickets to a pro basketball game. Or a new pair of running shoes. You could buy an armful of flowers for someone special. Or just treat yourself to cappuccinos every morning for a month. Sure, you could do a lot with a hundred dollars, but you couldn't buy a condominium with it. Or a new car. You know exactly how far a hundred dollars goes. And that's one of the remarkable things about money.

Because money has concrete value, we can compare activities as diverse as spending a couple of hours watching hoops and paying the phone bill and then choose between them. We know that a hundred dollars will buy an evening out or a pair of shoes but not both. Money values allow us to evaluate our choices. I'm not going to give you a hundred dollars. Instead, I'm going to give you something better: years of life. I'm going to teach you how to add years to your life—high-quality, health-filled, vibrant years. I'm going to show you how to live younger through a method that makes health decisions as easy to understand as it is to understand what that one hundred dollars is worth.

The biggest problem with understanding health care decisions is that we have no common currency for medicine. We have no way of measuring decisions as diverse as buckling our seat belts, exercising, or taking vitamins regularly. But that's about to change.

As complex as medical science can be, there are only two real questions in medicine: How long will you live? And how healthy and vigorous will your life be while you're living it? Whether the issue at hand is eating a nutritious diet, taking calcium supplements, or wearing sunscreen, the fundamental motivation for choosing any of these behaviors is to ensure a longer, healthier life. Unfortunately, medical studies and news reports almost never make it seem that simple. RealAge unifies an array of health topics by determining exactly how they affect youth and vigor. RealAge correlates these to a common measurement—years of life.

For example, think of the neighbor who looks as if she's in her early forties, but who's really sixty. And remember how surprised you were to learn that your coworker, who you thought was in his fifties, was only forty-three? Some people are young for their age: They are physiologically and mentally as active and vibrant as someone much younger. The sixty-year-old woman may have a RealAge—that is, a physiologic age—of only forty-five. Why? Because she has learned how to slow the pace of ageing. Your coworker, on the other hand, has probably abused his body, causing it to age much faster than it should. Remember your school reunion: Even though everyone was the same chronologic age, people no longer looked the same age. Some people wore the years well, were young and exuberant, despite the passage of time. Others looked as if they had aged ten years more than everyone else—and they probably had.

Your RealAge is an estimation of your age in biologic terms, not chronologic years. If your RealAge is five years younger than your chronologic age, it means that your rate of ageing is such that you are in the same shape physiologically as the average person who is five years younger than you. Likewise, if your RealAge is five years older than your chronologic age, you have aged to the same biologic condition as someone who is five years older. RealAge measurements allow us to quantify the age difference between our calendar age and our biologic age. Using the latest and most sophisticated computer technology and statistical methodology, RealAge is able to translate health risk into years of your life.

Better yet, the RealAge program shows every single one of us just how simple it is to become one of those people who really is younger than his or her years. We really can slow the pace of ageing—and even reverse it. Although we've never been able to talk about 'getting younger' before—time moves in only one direction, forward—now we can. Even though you can't change your calendar age, you can 'make' your RealAge younger. That is, you can have the health profile of someone who is chronologically younger. Best of all, it's not that difficult to do. Slowing the pace of ageing can be relatively easy and painless. That means you can start feeling more invigorated, energetic, and healthful almost as soon as you start the RealAge program. You won't just live longer, you'll live younger.

More of us are living longer than human beings have ever lived before. Our life expectancy is increasing, and, barring unforeseen circumstances, most of us can expect to live into ripe old age—ripe old calendar age, that is. Yet, how well you live is largely up to you. Most of us don't want to live to be ninety if the last thirty years of our lives are filled with illness, restricted ability, and dependence on our families or nursing care. We want to be able to play golf, tango, or climb a mountain right until the day we die. We want all those extra years to be quality years—years in which we write the novel we've always dreamed of writing or learn how to paint. We want those years to be years when we travel the globe, visiting the far-off places we've only read about. We want to have fun with our grandchildren and enjoy our children as adults. We don't want to give up the things that make our lives worth living.

Longer lives don't mean much if they aren't active lives. That is what RealAge is all about: making simple decisions in our day-to-day lives that will stave off the biologic ageing processes that make our old age feel 'old.'

Every one of us was born with a potential—the potential of who we will become. Part of this potential is social—the kind of education you get, the job you take, the opportunities and happenstances that come your way. The other part of this potential is biologic. How long and how well will you live? How healthy will you be? For far too long, the medical community has written off ageing as something that is purely genetic, assuming that a person's whole life is 'written in the genes' with which he or she is born. The more we know about genetics, our biologic inheritance, the more we know that this assumption is not true. Studies continue to show that for most of us, lifestyle choices and behaviors have far more impact on longevity and health than does heredity. Your genes (the elements that carry inherited information) define your basic biology, but how you interact with the world around you— whether through food choices, exercise, or social connections—is how you control the way your genes will affect your body. Those interactions shape both the quality and quantity of your life. Most of us do not live as well or as long as our genes or our bodies would allow. We shortchange ourselves. By taking care of our bodies, we slow the pace of biologic ageing and capitalize more fully on our potential.

Through the RealAge program, you will learn to understand your health care decisions in terms of the one thing that really matters: your biologic age. RealAge establishes a measurement system to calculate the relative biologic age of our bodies, so that you can learn to evaluate health care decisions as diverse as putting tomato sauce on spaghetti or taking a jog, in the same terms and then make informed decisions about each habit.

RealAge calculations provide a way to interpret different types of health information and to make informed choices about our behaviors. RealAge gives a value to each of our choices, just as the price tag on a product in a store gives a value to that product. Although some of these changes are easy and some are a bit more difficult, most are relatively painless. None of us can or will do everything possible to get younger, but because RealAge breaks these decisions down into steps, every single one of us can do some things to start getting younger. We can make health decisions that fit into our particular lifestyles and decide which aspects of healthy living would affect us the most. We can decide what really matters, what's worth the effort, and what we may want to postpone. Once we understand the multiple, often unrelated, factors on which the totality of our health depends, we can start living healthier one step at a time. You make the choices about how you want to age—or not.

Getting Younger-Just the Facts

IT'S EASIER THAN YOU THINK

As a doctor, I have often felt I was fighting an uphill battle. My job is to cure people after they are already sick. But preventing illness in the first place is always the best cure. Practicing my specialty of cardiovascular anesthesiology has meant that I have spent much of my working life with patients who are among the sickest of the sick, people who need bypass surgery or emergency operations to fix potentially fatal aneurysms. After spending so much time in the operating room with patients who were so severely sick, I was frustrated by not being able to do more for them. I was grateful that I really could save lives, but at the same time, I was mad as heck. So many of these patients were sick because they had mistreated their bodies over time. Moreover, every single one of them knew better. They knew that they should exercise more, eat healthier foods, and take care of themselves, but they just weren't doing it. That seemed to me a true tragedy, not to mention a national health care crisis. Why were so many people—smart, educated, thoughtful people—not paying attention to the reports of studies that correlated good health behaviors with long, healthy lives? It would have been easy to blame it on the patients. But it wasn't their fault. Clearly, the medical community was failing to communicate its message effectively.

In my internal medicine practice and my anesthesia preoperative clinic, I told my patients again and again how they could live healthier. I told them how they could lengthen—and strengthen—their lives and how they could increase the quantity and the quality of their years. But the tide of patients coming into my office and into the operating room with entirely preventable illnesses did not stem. I felt as if all my talk was for nothing. Why did they persist in habits that were harmful to their health, even though they knew better? What could I do—what could all doctors do—to explain health better? Good health is an attainable goal, but my patients weren't listening.

RealAge: The Beginning of an Idea

One day, a friend said to me, 'Health is so confusing. One day the papers are telling you to do one thing, and the next day they're telling you to do the opposite. There's just so much information. I don't know what to do with it all.' I empathized, but I didn't know exactly how to change things. How could people measure one alternative against another?

When another friend, Simon Z., developed a severe illness, it all came together. For some reason, stepping out of my role as a doctor and into my role as a friend made the idea flash in my head: Health is like money. It has an exchange value. Health decisions and behavioral choices that you make today are capital toward living younger tomorrow. What we were missing was a common currency for health.

Simon, who was forty-nine, was afflicted with severe arterial disease. He had a terrible circulatory problem that made it nearly impossible for him to walk more than a quarter of a block without terrible pain, and he needed a major operation. His lifelong smoking habit wasn't helping any. Even though he was relatively young, his body was in the condition of someone much older. I was afraid that he might not be my friend for much longer.

Simon was a tough cookie—and an even tougher patient. A self-made man, he had a drive and determination that was hard to match. He had worked hard for everything he had ever gotten in his life, and, with a wonderful family, good friends, and a booming career, his was an American success story. Yet he was a heart attack away from losing it all. As a doctor, I wanted to cure him. As a friend, I didn't want to lose him. For all Simon's attention to detail in his job, family, and friendships, he had overlooked the one thing that made it all possible: himself.

Telling him to quit smoking didn't work. (Quite literally, I called him every single day for years to ask him if he had quit yet. The answer was always 'no.')

'Simon,' I said one day when he was in for a checkup, 'how old are you?'

'Mike, please,' he grumbled. 'You know I'm forty-nine.' 

'Simon, this isn't a joke,' I replied. 'How old are you really"

'What are you getting at?' he said, eyeing me suspiciously.

'Did you know that all that smoking has made you older?' I asked him. 'Eight years older. Right now, you may be forty-nine. But your body is as old as someone who is fifty-seven, maybe more. For all practical purposes, your age is fifty-seven.'

'I can't be fifty-seven,' he said.

'Why not?' I asked.

'Because no man in my family has ever lived to the age of fifty-eight.'

The message hit home. Simon quit smoking. He began exercising and eating right. He reduced his RealAge and began celebrating 'year-younger' parties, rather than his usual 'one-more-year-over-the-hill' birthday parties. Over time, he became younger.

Fundamental to economics is the concept of 'net present value.' Net present value is used by economists to determine the current value of investments that have future payoffs. The RealAge concept allows us to calculate the value of different types of health behaviors and choices. In biologic terms, the difference between your calendar age and your RealAge is a calculation of the net present value of your health behaviors; it is the estimate of what age you are physiologically when compared with the rest of the population. For example, when I say someone's RealAge is forty-five compared with his or her chronological age of fifty, it means that the person has the health profile of the average forty-five-year-old. In terms of age, his or her net present value is five years younger. Each behavior has a net present value and alters your RealAge by a specific number of years. Instead of considering health decisions as something that will pay off thirty years down the road, you will be able to see just how each choice is paying off in the present.

Has this been demonstrated? Is it real? Yes. The rest of the book gives you the net present value, or RealAge change, for each choice. It also examines how and why that choice affects you.

A Question of Age: What Does It Mean to Get Old?

No matter who you are, no matter what else happens in your life, one thing is guaranteed: You will get older—each and every day. It's one of life's promises, and there's no stopping it.

At least, not until now. Now we know that slowing the process of ageing, reversing ageing, is the best thing we can do to promote health. 'Younger' and 'healthier' are almost always one and the same. Most of the major diseases we confront—cancer, arthritis, heart disease—rarely occur until our bodies begin to show the signs of ageing. Indeed, these diseases are, far too often, the hallmarks of ageing, their onset defining the moment when we first feel old.

Surprisingly, no one knows why we age. Even though ageing is one of the most clearly visible biological processes—a process that's been written about as long as anyone has written about biology—there is no good scientific explanation for ageing, except to say that our bodies were designed to grow older. Ageing is built right into us, and no one can say exactly why. Scientists have at least seven major theories about why we age, and all of them have some credibility. Some scientists believe that our bodies are programmed to die—that our genes program our cells to divide a certain number of times and that once division has reached that maximum number, our bodies begin to fail. This is known as the telomere theory. (Telomeres are genetic elements that control the number of allowable cell divisions.) Others argue that there is a general degradation of neuroendocrine stimuli—that is, the neurologic and hormonal systems that regulate the organism finally wear out, making us more susceptible to a variety of diseases. A third hypothesis is the 'wear-and-tear' theory, that living itself makes us old. A fourth theory is that our bodies eventually build up so many toxins and other waste products that our systems begin to shut down. In a further elaboration of this hypothesis, many scientists believe that this waste buildup can even affect the structure of our genes. You may know this fifth theory as the free-radical theory of ageing: Our bodies build up free radical 'oxidants' that damage our organs and our DNA, causing us to age. A corollary to this theory is the glucose toxicity theory, which also has to do with waste buildup in our bodies. The final theory of ageing derives from the law of entropy: In the universe there is a continual movement from order to disorder, and in our bodies, that movement is marked as ageing.

Although no one knows exacdy why we age, we do know, at least in part, what ages. Ageing is not one thing but many things. And that's the key to RealAge. Ageing is the catchall term for all sorts of processes—everything from getting wrinkles to wearing out our hearts. Ageing doesn't happen as some mysterious metaphysical phenomenon. Ageing happens in the particulars. That is, your arteries get clogged. Arthritis flares up. Your parts start to wear down, and you don't heal as quickly as you used to. With RealAge, we go to the source; we get down to the details. We all know people who look younger than their age. And we all know people who look like they're older. The question is, How can you turn yourself into one of those people who look, feel, and—in physiologic terms—are younger than their age?

First, stop thinking about health as the prevention of disease and start thinking about it as the prevention of ageing. The chance of any of us being afflicted by any one disease in any one year is pretty slim. We read that 3 in 1,000 women will get a certain kind of cancer or that 2 in 100 men will die from a specific variety of stroke. These kinds of data aren't enough to convince us that we should really eat that salad instead of a burger and fries. These events seem too remote.

However, eating that hamburger will make you older tomorrow than if you ate that salad today. And you will be younger tomorrow if you exercise today. The better condition you are in—that is, the younger you stay—the better prepared you will be to fight the factors that age you. When you take care of your body, time slows down. You will have more time—time to be what you want to be and to do what you want to do. By quantifying how different behaviors affect the rate of ageing, RealAge lets you understand the relative value of your health choices.

Untangling Ageing:

Behavior, Genetics, and

the Ageing Process

As recently as twenty years ago, doctors largely believed that as soon as we understood genetics, we would solve many of the basic medical problems that eluded us. The overwhelming belief was that youth, health, and longevity were determined from birth and that there was nothing to be done about it. 'It's all in the genes you're born with' was the word of the day. Almost everyone, including the scientific community, believed that a person's life span was largely a matter of fate.

For diseases as diverse as diabetes, Alzheimer's, many cancers, and cardiovascular disease, we've long known that genetic components are involved in many cases. Some of us are more prone to weight gain, and some of us are more prone to high cholesterol. Those tendencies can increase the likelihood of certain kinds of diseases and ageing. Surprisingly, the more scientists have learned about genetics, the more they have learned just how much the environment, and our interactions with it, matter. We largely control how our genes affect us. We all have the genes we were born with, but how we age is primarily up to us.

Despite commonly held beliefs that ageing is mostly out of your control, inherited genetics account for less than 30 percent of all ageing effects, and the importance of genetic inheritance matters less and less the older your calendar age. By the age of eighty, behavioral choices account almost entirely for a person's overall health and longevity. People who are still able to live young even when their calendar age is old weren't necessarily born with 'good' genes nearly so much as they have made 'good' choices. They exercise, eat lots of fruits and vegetables, keep their minds engaged, and do many of the things that this book advocates to keep themselves young.

Although we tend to imbue our genes with mystery, when it comes right down to it, genes direct our bodies to make proteins. They provide information about what proteins our cells should and shouldn't produce, how much, and when. The fact that you made it into the world at all means that all your essential genes are working just fine. To develop from an egg to a fetus requires incredible genetic coordination. Simply being born means that everything pretty much went right. Since most people with severe genetic illnesses suffer in childhood, growing up to adulthood means that even more went right. For the most part, when we discuss ageing and genetics, we are talking about subtle differences. (For further information on genetics and ageing, see Chapter 5 on cancer genetics and Chapter 12 on evaluating hereditary risks.)

Separating biology and behavior is difficult, if not impossible: Children inherit not just genes from their parents but also behaviors. Those behaviors can have biologic effects, including the rate at which the children age. For example, children who eat a lot of saturated fats when they are young are more likely to die of arterial disease when they get old (or, as it may be, not so old). The behaviors learned and ingrained in youth can affect your whole life, including the rate at which you age.

Cardiovascular disease provides an excellent example of the way biologic predispositions and social behaviors interrelate. Some people are biologically predisposed to the early onset of arterial ageing. They have inherited a tendency toward high blood pressure, high cholesterol, or weight gain. Others are culturally predisposed to the disease because they are far more likely to develop such habits as eating foods high in saturated fat that can accelerate arterial ageing. Finally, we know that there is often, if not usually, a combination of both: The bad habits interact with the biologic predisposition, and cardiovascular ageing is accelerated.

By starting with good behaviors, you live as long—and as young—as your genes will allow.

Age Busters:

The Three Most Important

Factors That Affect Ageing

So, exactly what are those behavioral changes that will help keep you young? Essentially everything you do contributes to or prevents ageing. Eating a diet low in saturated fats, exercising, and quitting smoking are probably lifestyle choices you already know are good for you and, although you may never have thought about it exactly this way, prevent ageing. But did you know that flossing your teeth nightly can make a big difference in how fast you age? Flossing regularly can make your RealAge as much as 6.4 years younger (see Chapter 5). And did you know that folate can help your arteries stay young? Folate reduces arterial ageing and can make a person's RealAge as much as three years younger (see Chapter 7). Many of the choices that help prevent ageing are easy and simple to do. Learn to think about the wide variety of choices in your life as they relate to your health currency—your RealAge. Through RealAge, you are able to weigh the relative values of each and decide which changes are worth it for you. Best of all, it is much less work than you think.

Ageing of the Arteries

In no uncertain terms, you are as young as your arteries. Ageing of the arteries is the most important factor in the overall process of ageing. When your arteries are not taken care of properly, they get clogged with fatty buildup, diminishing the amount of oxygen and nutrients that can get to your cells. When this happens, not only your cardiovascular system, but your entire body, ages more quickly. Cardiovascular disease is the leading killer of adult Americans, killing more than 40 percent of us and seriously afflicting more than half of us. Having high blood pressure (a blood pressure reading over 140/90 mm Hg) can make a person's RealAge more than twenty-five years older than having low blood pressure. The better you take care of your arteries and the younger they are, the younger you will be. This book lists a whole range of things for each individual to do—everything from taking folic acid supplements to flossing your teeth—that will make your arteries younger and healthier, and that will make you feel stronger and livelier.

Ageing of the Immune System

Don't let your immune system make you old. As you age, your immune system begins to get sloppy, ignoring important warning signals and becoming negligent. You can end up with cancer or another disorder caused by a malfunction of your immune system. For example, when you are young—except in relatively rare cases—genetic controls in your cells protect your cells from becoming cancerous. If one of these cellular controls slips up, your larger immune system identifies precancerous cells in the body and eliminates them. Thus, your body has a double block against cancer, one on the cellular level and one on the organism-wide level. As you age, both the cell-based genetic controls and your immune system become more likely to malfunction, and you are more likely to develop a cancerous tumor. Many types of arthritis are examples of a breakdown of the immune system, which is why arthritis is a disease associated with ageing. By keeping your immune system fit, you do your best to avoid such diseases and prevent premature ageing. This book tells you which vitamins (and at what doses) help protect your genetic control systems and immune system. The program also describes ways to reduce the stresses in your life that can upset the balance of your immune system, and such practices as strengthening exercises that will help keep your immune system running young.

Social and Environmental Factors

How we react to our environment biologically, psychologically, and socially has a lot to do with how young we stay. The environment in which we live, the substances we put into our bodies, the risks we take, and the stresses we undergo can all contribute to ageing. Breathing secondhand smoke, eating foods high in saturated fats, working in an unsafe environment, or using a cell phone while driving can all increase the likelihood that our lives will be shorter or more ridden with illness than they would be otherwise. When we think only about disease, we forget about other factors that are outside our bodies that can make us healthy. Some choices—for example, becoming a lifelong learner by enrolling in classes, reading, or otherwise stimulating your mind—can help keep you younger longer. Having fun with your friends can do the same. In subsequent chapters, I detail the impact of these choices and show you how interacting with your environment in a particular way can keep you young.

From Science to You: Living Young

RealAge is a way of measuring the pace of ageing. By adopting the suggestions in this book, you are slowing the rate of ageing and sometimes even reversing it. In Chapter 2, I explain how we are able to calculate RealAge and discuss the science behind the numbers. I give you two options for calculating your own RealAge (using the charts provided in this book or, for a more accurate calculation, using the computerized survey on the RealAge Web site, www.RealAge.com). Both options not only provide you with an individual calculation that distinguishes you from everyone else around you, but also compare you with the health and youth average for your age group. Your RealAge calculation will weigh the risks you face against the health-related behaviors you choose. The end product is a RealAge that is uniquely descriptive of you. As you adopt behaviors that change your RealAge, you can recalculate your RealAge. With each new calculation, you can chart your progress and watch the years disappear.

How young can you become? When I told one fifty-year-old friend of mine all the things she could do to reduce her rate of ageing, she asked me, 'Mike, if I did all of those things, I could have a RealAge of twelve, couldn'?' Well, for those of us who don't want to relive our teenage years, fortunately, no. In this book, all of the chapters use calculations that reflect the greatest possible effect of each behavior when no other mediating factors are considered. Both the worksheets in Chapter 2 and the RealAge computer program use a multi-variable equation that balances each factor in relation to all the other RealAge factors. This equation evaluates how all these factors interrelate.

The more Age Reduction habits you adopt (the specific plan is described in Chapter 3), the less likely you will be to gain the maximum effect from adopting any single practice by itself. But the more good habits you adopt, the better your across-the-board protection from ageing will be, and that advantage will have a cumulative effect over time. Although none of us can be twelve again, it is relatively easy for individuals in their mid-fifties or mid-sixties to reduce their RealAge by five to eight years and only somewhat more difficult for them to reduce it by fifteen or sixteen years. The maximum amount a person can reduce his or her RealAge below his or her calendar age is about twenty-five years over an entire lifetime. And remember, the effect magnifies with age: At fifty, you may have a RealAge of forty-five, but by seventy-five, if you continue on the RealAge program, your RealAge may be only fifty-five. That means that in twenty-five years, your body may have aged as little as most people's do in ten.

Clearly, RealAge is not a guarantee of longevity. In health, there are never guarantees. But RealAge is an accurate reading of your risk. The lower your RealAge, the better the odds that you will have more years left—not to mention a younger, healthier, and more energetic life. The calculation of risk is the best approximation we have of the body beneath: The lower the risk, the younger the body. Think of your RealAge as your ageing speedometer; it is a reading of how fast you're going. With ageing, faster is not better. By making simple decisions, you can take your foot off the gas pedal and slow down your rate of ageing. How you age is largely controlled by you.

Getting Younger All the Time

Since I developed the RealAge concept, I haven't been able to keep quiet. I talk about RealAge to doctors and others all over the country. I have encouraged patients to take the RealAge computer program and have seen them make the decision to take their ageing into their own hands. I have joined people as they have celebrated 'year-younger' birthday parties and observed them becoming younger in front of my very eyes. While the response has been, for the most part, overwhelmingly positive, there have been a few naysayers. On occasion, after presenting a talk about RealAge, I have heard people grumble, 'We Americans just don't have any respect for old age. It's just youth, youth, youth.' These criticisms leave me dismayed, not to mention disappointed in myself, for not communicating the essence of RealAge so that everyone in my audience understood. The whole point of RealAge is to promote old age. Healthy, vibrant, and young old age. RealAge shows you how you can live at eighty with all the energy and vigor of a fifty-five-year-old, how you can be the ninety-year-old who still lives on your own, travels, and forcefully expresses feisty opinions—the person who leaves the 'kids' marveling, 'How does she do it?' Having respect for old age means wanting to end the suffering that so often goes along with it No one wants to be bedridden, afflicted with heart disease, or undergoing cancer treatment. Everyone wants to be able to do all the things he or she has always done and more. And that means staying young biologically, even as you get older chronologically. The data from the Fries Study of University of Pennsylvania alumni, the MacArthur-Mount Sinai study on differences in ageing between twins, and Fogel's study of longevity statistics in national health databases show that people who live healthier live longer and with less disease and disability. Those who adopted healthier behaviors not only lived seven years longer on average, but also did not suffer the onset of old-age disability until five to seven years closer to death. In other words, the period of disease and disability was shortened.

What science shows us is that enjoying a healthy and vibrant old age depends on taking the proper steps to take care of yourself all along the way. Until RealAge, health recommendations were more like promissory notes or junk bonds—something that might have a payoff in the distant future but with little or no guarantee. And who was convinced? Certainly not the 85 percent of Americans who don't get enough physical activity even though they know better. When you take steps to change a behavior now—taking the right vitamins, learning to relax, or taking up exercise—the payoff is not just that you will live longer, but that you will live younger. You slow the rate at which your body ages. The payoff is not thirty years down the line, but now. Why get old when you can stay young?

....................

This  is  all  so  very  true.  I  knew  it  from  being  a  young  teenager  and  with  the  encouragement  of  my  Dad,  taking  the  "Health  and  Strength"  course  by  Charles  Atlas [look  his  course  up  on  the  Internet  -  it's  still  obtainable] I  knew  to  live  as  his  course  teaches,  would  keep  me  young.  I  did  figure  for  myself  that  even  as  a  teen  to  use  face  cream  morning  and  evening  throughout  my  life,  would  keep  my  skin  from  wrinkles  as  I  aged  into  my  50s and 60s  and 70s. It was  common  sense;  with  washing  the  face  and  the  sun  and  wind,  the  skin  drying  up.  To  put  moisture  back  into  the  skin  was  to  me  common  sense.  Hence  I've  been  doing  it  all  my  life  since  a  teenager. The  long  and  short  of  it  all,  is  that  I've  proved  what  this  book  is  all  about.  

Now as I upload this to my blog in December 2025, I am age 83 on my birth-certificate but my real age is about 60.

My  Dad  is  another  example.  He  was  also  a  "health"  person  from  a  teenager.  He  made  one  mistake,  when  he  got  into  his  top  50s  he  developed  a  too  big  a   stomach,  but  did  everything  else  in  keeping  healthy.  It  was  not  until  he  was  90  that  he  suffered  a  minor  stroke.  He  recovered  except  for  being  able  to  walk  and  his  short  term  memory  is  all  over  the  place.  But  he's  lost  the  belly  fat.  He's  in  a  24/7  care  facility  now.  I  make  sure  he  gets  his  vitamin  and  mineral  supplements  each  day.  He  eats  all  his  meals,  pulls  himself  around  in  the  wheel  chair.  He  will  be  94  come  August  26  2014.  He  says  he'd  like  to  live  to  be  100.  I  think  he  has  a  good  chance  of  making  it.  And  if  he  had  not  allowed  himself  to  get  that  big  belly,  he  probably  would  never  had  had  that  stroke  at  age  90.

This  book  "RealAge"  is  right  on  the  bull's  eye.

Keith Hunt

Calculating RealAge

TAKE THE REALAGE TEST: WHAT'S YOUR REALAGE?

How old are you now? How young could you be? Learn how to calculate your RealAge. You can do it either by using the charts provided in this book, which will give you a good approximation of your RealAge, or by going on-line to the RealAge Web site and calculating your biologic age more accurately using the RealAge computer database. By answering easy questions about 125 health factors, habits, and behaviors, you can determine whether you are ageing more quickly or more slowly than your contemporaries. Once you know your RealAge, you will have the information you need to start getting younger. By choosing from the recommendations in this book or in your computer printout, you can develop a step-by-step Age Reduction Plan customized to your needs and lifestyle.

Now that you understand the principle of RealAge—that you can get younger—you may be wondering how you can calculate a number that accurately describes your 'true' physiologic age. How can I say that some people are

[The RealAge effects specified in all chapters other than this chapter calculate the effects of the factor being considered individually. Let's take the example of blood pressure. Many factors contribute to your blood pressure reading, such as sodium intake and potassium levels, so that some of the effects attributed to blood pressure are attributable to other things as well. For example, exercise lowers blood pressure: three of the twelve years difference in RealAge between a fifty-year-old man who has the ideal blood pressure...  and one who has a high blood pressure...  is attributable to the stamina exercise component. The changes in RealAge described in all chapters except this chapter do not take into account the covariance or interaction between factors. Please refer to the tables in this chapter or the RealAge Web site at www.RealAge.com.]

THIS  WEBSITE  MAY  NOT  BE  IN  SERVICE  NOW  FROM  THE  YEAR  2000  WHEN  THIS  BOOK  WAS  PUBLISHED,  BUT  WHAT  I  PRESENT  TO  YOU  FROM  THIS  BOOK,  WILL  INDEED  SERVE  TO  HELP  YOU  STAY  YOUNGER  THAN  YOUR  BIRTH  AGE  -  Keith Hunt

younger and others are older when their calendar ages are the same? People are so different from each other. For all those who get cancer from smoking, there is always one diehard who has smoked a pack a day since he was twelve and is going strong at ninety. So, how can I say that quitting a pack-a-day smoking habit will make you seven years younger? Or that taking an aspirin a day can make you not fifty-five, but fifty-three and a half?

For a long time, researchers saw ageing as a linear and roughly equal process. Most researchers considered all seventy-year-olds to be the same. This assumption was good for census bureau statisticians, but made for an inaccurate representation of reality. When you look at the population, it is apparent that all seventy-years-olds are not alike. Many are mobile, full of life, and living as young as fifty-year-olds. Others are homebound, bedridden, or suffering from a wide range of health complications. Not everyone ages equally.

YOUR  AGEING  IN  THE  NORMAL  PERSON  IS  DETERMINED  BY  ALL  THE  MANY  HEALTH  LAWS,   THAT  GOD  SET  IN  MOTION.  KEEPING  IN  HARMONY  WITH  THEM,  WILL   MEAN  YOU  WILL  STAY  YOUNGER  THAN  YOUR  BIRTH  AGE  -  Keith Hunt

The Nuts and Bolts of RealAge: The Science Behind the Numbers

If you chart the health, longevity, and, ultimately, youth of a 'population age cohort,' a group of people all born in the same year, you will find that with few exceptions, people age at a similar rate until they reach their late twenties or mid-thirties. With the exception of those who have inherited rare genetic disorders or have been in serious accidents, everyone is basically healthy and able. Men reach the peak of their performance curve in their late twenties, and women, in their mid-thirties. Our bodies have fully matured, and we are at our strongest and most mentally acute. Then, somewhere between twenty-eight and thirty-six years of age, most people reach a turning point—a transition from 'growing' into 'ageing.'

If you examine the population as a whole and track any one biologic function—whether kidney function or cognitive ability—performance declines as we age. In general, each biologic function decreases 3-6 percent per decade after age thirty-five. That decrease is a measure of the average for the population as a whole. Although these types of measurements have been the standards used by scientists to calculate the rate of ageing, these averages don't take into account the variation among individuals. For older populations, the variation is so great that it is often meaningless to calculate an average at all because averages are statistically meaningful only if the people or things being measured actually congregate around a midpoint. With ageing, this does not happen. In fact, if you really look at the numbers, there is so much variation among individuals that the 'average' obscures more than it shows. Rather than gathering around a mean (the center), there are people in every age group who fit into every category of function— some showing dramatic decline, others showing virtually none.

The variations in the ability to function cover the entire range of possibility. For every seventy-year-old who's debilitated from cardiovascular disease, there's another who's running road races or traveling the globe. You can see this variation. If a horizontal line were drawn across the three lines representing the rapid, average, and slow rates of ageing, you would find that people of different calendar ages fall at the same place on the curve representing ageing.

In fact, for certain functions, such as mental acuity and IQ, some people show almost no decline and even improve as they progress from calendar age thirty-five to seventy-five. The question is how can you be one of those people who stay at the top of the curve, as young at seventy-five as you were at thirty-five? And that means not just living longer, but living better, suffering less illness and disability. Studies have repeatedly shown that making your RealAge younger means that you live longer and healthier.

To understand how the numbers work, consider a real-life example—the impact of smoking on life expectancy. Statistics show that the average life expectancy is seventy-seven years for men and eighty-three years for women. These numbers include everyone who dies prematurely from smoking. If you eliminate the data for smokers from the data for the general population, life expectancy goes up substantially. Thus, we can say that smokers have shorter lives and more medical problems than nonsmokers. We can also say that non-smokers have longer lives. In our equations, the RealAge team calculate a person's RealAge with respect to smoking by contrasting the ten-year survival rate, a calculation of life expectancy, of the smoker to that of the nonsmoker. By calculating the degree of risk and prorating it to the average ten-year survival rate for that person's chronologic age group, we found the number of years that smoking can subtract from one's life and that not smoking can add to one's life. We apply this process to a whole range of behaviors and conditions, using a complex routine of statistical techniques to blend them and arrive at a number that reflects your biologic age.

A fifty-two-year-old woman who smokes twenty-four cigarettes a day has an 88 percent probability of living for the next ten years. Likewise, the sixty-year-old woman who doesn't smoke also has an 88 percent probability of living ten years. Although eight calendar years separate these two individuals, their risk of dying within the next ten years is exactly the same: 12 percent. In other words, the smoker is the same physiologic 'age' as the nonsmoker who is eight calendar years older. RealAge is a calculation of your relative risk of dying versus that of the population as a whole, based on the law of averages. If your relative risk matches that of the average person who is ten years younger, that is the same thing as saying that your RealAge is ten years younger. You are at the same risk of suffering severe ageing or a major health problem as someone that much younger. Physiologically, you are equal.

This risk-analysis calculation is the clearest measure we have for determining the rate at which you are ageing. We draw data from clinical studies calculating the risk of death for a variety of factors and integrate them into survival-table analyses (Kaplan-Meier curves). We have derived these curves to evaluate individual conditions, habits, and other factors that tend to affect physiologic age. Our computer-based equations use the most up-to-date and reliable medical information available, which is then modeled by statisticians using the best and most subtle statistical formulations for multivariate equations.

In our calculations, we start with the most general statistic: average life expectancy for American men and women. We then break each category into smaller and smaller categories. For example, we consider weight-to-height ratios.

We calculate the long-term effects of smoking. We evaluate the benefit that people get from taking aspirin regularly, exercising, or managing health problems effectively. Each breakdown allows us to refine our measurement and to consider how much of an impact each action has on the ageing process. Finally, we consider all these categories together, calculating a multivariable equation in which we are able to weigh these multiple and diverse factors together and develop a unique RealAge calculation especially tailored to each person. We integrate the risk calculations for 125 factors and arrive at a number uniquely descriptive of you.

Sounds complicated? It is. But don't worry. To participate, all you have to do is answer a set of questions that allows us to calculate your RealAge. We do the rest.

The Studies That Provide the Data: Where Do the Numbers Come From?

RealAge is an information system. Instead of providing new scientific data, it is a way of reinterpreting already published results. We use data from the most up-to-date studies done by the leaders in each field of medical research, so you are getting the best information the medical community has to offer. What we do is unify all that information: We are able to integrate specific recommendations from hundreds of studies into a general framework, so you can understand how the recommendations relate to you. Whereas most medical researchers have calculated their statistics in relation to 'risk of disease,' we have used then-data and recalculated them to determine 'risk of ageing.' RealAge translates currendy available research into information you can use—something you can integrate into your own life.

I, in conjunction with the four other medical experts who form the RealAge scientific advisory team, have pored over more than 25,000 medical studies, evaluating what they tell us about ageing, and, more important, what they tell us about the prevention of ageing. Our calculations are based on data from more than 800 of the 25,000 studies and have been checked against a very large proprietary database. Our formulas are constantly being updated as new research becomes available. As statistics relating to these and other factors change, we recalculate our equations to accommodate the change. (Our on-line computerized RealAge program is updated whenever new and important research appears. For example, because Americans are becoming progressively heavier, we have modified our weight-to-height ratios to reflect these expanding waistlines.)

Although my colleagues and I rely on all kinds of scientific information for our calculations, let me describe our major sources of data. We predominately use clinical studies of two types: large-scale, risk-factor epidemiology studies and smaller-scale randomized trials. The large-scale studies look at many people, sometimes more than 100,000 individuals, and in one instance (the Mr. FIT study), as many as 350,000. The researchers who coordinate these studies track huge populations for a certain period, looking at one behavior or testable factor, such as blood pressure, and evaluate risks associated with that behavior or factor. These studies give statistics for a large population, more accurately reflecting variations within the study sample. The drawback is that these studies do not provide very detailed information and are not controlled studies. The researchers are not able to regulate with any kind of reliability who takes a specific drug or engages in a specific behavior. That is why scientists also do smaller controlled studies. In a randomized controlled study, a study population of a few hundred to 10,000 people is randomly divided, and each group is assigned a certain task. For example, half the group may be told to take the vitamin folic acid and half may be told to take placebos (harmless sugar pills). Each participant is then tracked for a long period, and his or her health conditions are recorded. At the end of the study, the researchers compare the groups and evaluate the effect of a particular behavior or condition on the overall health of the groups.

We select only factors that have been shown to make a quantifiable difference in the profile of risk (in other words, ageing) in at least three peer-reviewed studies. We integrate and compare the various studies that have pertained to a certain isstie; calculate what each study tells us about ageing; and, finally, come up with a RealAge number that tells you in one easy-to-under-stand number—years—what the impact of each behavior is on you.

What's Your RealAge?

There are two ways you can estimate your RealAge: by taking the RealAge survey on computer or by using the charts included in this chapter. The computer program is customized to you, whereas the charts provide accurate but more general approximations of your RealAge. In the RealAge questionnaire—both the one offered here and the on-line version—we ask you detailed questions about a variety of behaviors that are known to relate to ageing. What do you eat? How often do you exercise? Do you floss your teeth? Do you own a dog? How many close relationships do you have? How long did your parents live? Indeed, we ask you questions about 125 factors that affect your health and your youth. Your answers to these questions are the raw data needed to calculate your RealAge.

.....................

TO  BE  CONTINUED

Developing an Age Reduction Plan

Dr.  Michael  F.  Roizen

.......Begin by adopting just two or three strategies. Trying to do too much at once can be overwhelming. A common problem with all health initiatives— whether diets or exercise regimens—is that we take on too much at once. Then, after a few days of playing superhero, we give up on everything, never to return to the initial plan. The patients of mine who have been the most successful at age reduction have begun by choosing only two or three strategies. They followed those strategies for three months, and after they successfully incorporated them into their daily routines, they added two or three more, and so on. They frequently go back and recalculate their RealAge and modify and update their Age Reduction Plans. One patient calls me every Monday morning. 'Mike,' she says, 'I've done such and such. What's my RealAge now?'

By adopting the steps from the Quick Fix category first, you can begin reducing your RealAge in just a few days or months with little effort. Reducing your RealAge further requires more resolve. Most of the choices are not that difficult; you just need practice. What better payoff than adding high-quality years to your life?

Losing weight, adopting a three-tiered physical activity program, quitting smoking, managing stress, managing a chronic disease, and controlling blood pressure are the decisions that require the most commitment. But the payoff is huge. The RealAge difference between two people who have the same chronologic age but different blood pressure readings  can be as much as twenty-five years. Likewise, a person who has developed strategies for stress management— including a strong support network of friends and family—can have, in times of crisis, a RealAge as much as thirty years younger than a person of the same age facing a similar crisis who does not have a support network. Remember to prioritize your plan. Which steps are easy? Which steps are difficult but important? Which are less important? Deciding that you will floss your teeth every night requires only that you buy dental floss and use it. Other decisions involve more work.

Decide what kind of a load you can handle. If you have two Age Reduction goals that are in the 'most difficult' category, you probably won't want to adopt both at the same time. Pick one Age Reduction strategy and follow it, and once you have the hang of it, pick another. Don't, for example, try to quit smoking and lose weight at the same time. Choose one, and once you have succeeded with it, adopt the other.

Break a large task into parts. If you are trying to lose weight, first begin by eating a diet that is rich in fruits, vegetables, and fibers. Then work on cutting back the amount of saturated and trans fats you eat. Don't worry about watching pounds right away; start by developing healthy eating habits. You may be surprised that the pounds come off on their own. Once you have eating under control, start to cut back on calories or begin to integrate exercise into your life. The most important thing about Age Reduction strategies is not that you start them, but that you continue them. Exercise, for example, gives no benefit once you stop. To get the years-younger benefit, you have to stay physically active for the rest of your life.

Put your Age Reduction Plan somewhere where you can easily see it. Tape it to the bathroom mirror. Look at it often and remember what you can do to get younger. Recalculate your RealAge every few months, or whenever you adopt a new Age Reduction strategy. That way you'll know just how young you have become.

Personal Age Reduction Plan

.

 What behaviors could I adopt to make myself younger?

     

    

 The Difference Between RealAge

Maximums and RealAge Interactions:

The Impact on You

As you read this book and review the choices that will help you reduce your RealAge, remember that the RealAge numbers presented in these chapters are the maximum possible effects. They presume only that a single behavior is affecting age reduction and do not take into account the interactions between the effects of several behaviors. Therefore, the numbers are not cumulative. This method has the benefit of allowing you to compare the relative value of health choices, but has the drawback of not accounting for multiple interactions.

Let's consider an example. The chapter on vitamins states that taking vitamins C and E (in food or supplements) can make you six years younger. The impact is astounding. Is it true? Yes. Is it true for you? Not necessarily. Although a person who does nothing else to protect himself or herself from ageing may well have a RealAge benefit of as much as six years simply by taking these two vitamins, most of us make many other health decisions as well. The vitamin choice is mediated by other choices, such as exercising, smoking, and eating a vegetable- and fruit-laden diet.

Indeed, none of us has only one factor affecting his or her rate of ageing. We all have multiple factors. You cannot simply add up all the years of benefits that certain behaviors provide and subtract those from your calendar age. Let's say you floss your teeth regularly (6.4 years younger), have low blood pressure (12 years younger), own a dog (1 year younger), exercise (9 years younger), and have a low weight (8 years younger). You cannot simply total these years and subtract them, to say you are 36.4 years younger than your calendar age. The RealAge concept would be meaningless as you worked your way back into childhood, even into negative years! Rather, the beauty of the RealAge calculation process .... is that it is able to consider the interrelationship between the range of behaviors and determine the impact of these interactions for you.

When you calculate your RealAge, the effect of any one behavior will depend on the other health behaviors and choices you follow. These involve complex equations and complex mathematics, which is why modern computers are required. But these complex calculations are now possible and can inform you of the relative and absolute value of your choices. This is what makes RealAge so revolutionary: It gives us the ability to calculate the effect of complex and multiple behaviors on ageing all at once. It places a value on the effects that different behaviors will have on you, providing the information you need to make informed choices about the way in which you are going to age.

RealAge Means Informed Choices

Read the rest of the book to find out why and how behaviors as diverse as taking vitamin E and enrolling in a continuing education class can help you make your RealAge younger. I will go over the studies and discuss the biologic impact of forty-four health and behavior choices. I will show you which ones help keep you young longer and provide suggestions and strategies for incorporating these changes into your life. I begin with the big three: ageing of the arteries, ageing of the immune system, and environmental ageing, showing how each one contributes to the overall ageing equation. In subsequent chapters, I explain how specific factors, such as taking the right vitamins in the proper doses, diet and weight management, physical activity and exercise, healthy everyday habits, proper medical management, and stress reduction can help you become and stay younger.

By keeping your RealAge young, you help to keep your calendar age from making you feel 'old.' What could be better than making it all the way to ninety with the youth and vigor of someone twenty-five years younger? This book gives you the value system for understanding your health choices, teaching you how to live more high-quality years with as little ageing of your mind or body as possible. I give you the information you need. You make the choices about how you want to grow old. Or stay young.

....................

TO  BE  CONTINUED

Arterial Ageing

It's this simple: Nothing ages you faster than mistreating your heart and arteries. And nothing keeps you younger than keeping your cardiovascular system healthy. More Americans—both men and women—die from cardiovascular disease than from any other cause. Current statistics predict that 50 percent of us will be seriously afflicted by cardiovascular disease and more than 40 percent of us "will die from it. Heart attacks, strokes, many types of kidney disease, and even Alzheimer's disease are largely caused by ageing of the circulatory system.

(THIS  BOOK  WAS  WRITTEN  IN  2000, BUT  SADLY  THE  FACTS  REMAIN,  CARDIOVASCULAR  DISEASE  IS  STILL  ONE  ON  THE  VERY  TOP  KILLERS;  MANY  IN  THEIR  40s  and  50s  ARE  DYING  OF  HEART  ATTACKS,  WHICH  WAS  PRACTICALLY  UNHEARD  OF  60  OR  MORE  YEARS  AGO  -  Keith Hunt)

Most of the premature ageing your arterial system undergoes is self-inflicted. You age yourself by not taking proper care of yourself. The bad news is that most of us are not motivated enough to change our behaviors to protect ourselves from arterial ageing. The good news is that you can start right now.

Your cardiovascular system is the primary system that ties your body together. Because arteries connect to every cell in the body, their health affects your health. Although we hear a lot about heart attacks and strokes, these are only the most dramatic manifestations of arterial disease. By the time a heart attack or stroke occurs, a person's arteries are almost always severely damaged; that is, they've gotten old.

Think of the cardiovascular system as a highway system. If roadways are the infrastructure of the city, the conduits that get us from here to there, then our circulatory system is the infrastructure of our bodies. Our blood vessels carry nutrients and oxygen to our cells and then carry carbon dioxide and other by-products away from our cells. Our arteries, just like streets and highways, wear down. They become clogged with fatty buildup, called plaque, or narrowed from swelling and inflammation. The older and more congested our arteries get, the more subject they are to the body's version of traffic jams— blood clots. This reduction in blood flow means that our cells are not getting the nutrients they need and suffer buildup of metabolic by-products. The heart has to work harder to get the blood where it's supposed to go, increasing blood pressure and stressing the arteries even more. Indeed, just as a major traffic jam can affect a whole city, cardiovascular disease can stress your whole body.

If you look at blood under a microscope, you will see that it consists of not just liquid, but many different kinds of cells—red cells, white cells, and platelets. It is the platelets—and sometimes white cells—that we have to watch out for when it comes to cardiovascular disease. Platelets are covered by an enzyme that, when activated, causes them to stick to other platelets and form a clot. Generally, clotting is a good thing; it is an important function that prevents excessive bleeding. As you age, however, you can develop blood clots where you don't want them—namely, on the walls of your arteries. Over the years, fat builds up on the walls of your arteries, slowing the flow of blood and causing platelet pileups—blood-vessel traffic jams— that further slow the flow of blood. These platelet pileups can form small clots in the arteries. If a clot gets too big, it can fill the entire artery, and blood can't get through at all, causing the tissue supplied by that artery to be at risk of dying. Likewise, when your arterial system comes under stress, the walls of your arteries can become inflamed and swollen, again closing off the flow of blood. In this case, oxygen and essential nutrients don't get to your organs as they used to, causing them to age more rapidly.

How can you prevent arterial ageing? 

You probably know quite a few good habits that make a difference: eating a diet low in saturated fat, exercising, and avoiding stress. Conversely, bad behaviors, like being sedentary, can cause our cardiovascular system to age unnecessarily, and bad habits tend to reinforce each other. The worse our food choices, the more likely we are to be overweight. The more overweight we are, the less likely we are to exercise, and so on. Even mild forms of cardiovascular disease can slow us down and make us feel old fast.

The most important step in your antiageing plan is to protect your heart and arteries. That is why almost every chapter in this book addresses the problem of arterial ageing. In this chapter, I show you the basics. I show you how to think about cardiac health as a conglomerate of health decisions that intersect with every aspect of your life. You will need to learn to think of cardiac health holistically: Everything you do contributes to or detracts from it. For example .... drinking a glass of red wine with dinner, and taking the right vitamins in the proper amounts are quick, easy, and painless ways to make your cardiovascular system healthier.

Blood Pressure: Lower It!

Blood pressure readings are measurements of the overall health and well-being of our hearts and arteries. That is why monitoring your blood pressure is one of the best ways of gauging your RealAge. For example, the difference between having low blood pressure rather than high blood pressure can mean a RealAge difference of more than twenty years!

Do you know how high your blood pressure is? Chances are it's too high. Eighty-nine percent of Americans have blood pressure higher than the ideal for preventing ageing..... More to the point, high blood pressure, also called hypertension, is one of the leading causes of heart attack, stroke, heart failure, and kidney failure. High blood pressure has no symptoms. Most of us live with it and feel fine. As a result, it is hard for patients to take high blood pressure seriously or to see it as an indicator of a serious health risk.

(ONE  REASON  THIS  BOOK  IS  NO  LONGER  IN  PRINT  IS  BECAUSE,  THE  AUTHOR  GIVES  BLOOD-PRESSURE  READINGS  WHICH  ARE  TODAY  IN  2014  OUT-OF-DATE.  SEE  THE INTERNET  FOR  UP-TO-DATE  SCIENCE  ON  WHAT  IS  NOW  CONSIDERED  "NORMAL"  BLOOD  PRESSURE  -  Keith Hunt)

In fact, I have patients who, even though they know about the devastating effects of high blood pressure..... Here's one story. Roger V., a longtime associate at the University of Chicago, had, over the years, asked me for medical advice. One day, he called me about his father-in-law, Jake. Jake had just retired from a lifetime career as an engineer. A World War II veteran, and proud of the fact that he' d never been sick a day in his life, he was never one to go to the doctor. When Jake had his retirement physical, it was the first time he had seen a doctor since leaving the service some forty years earlier in 1946. Jake reported that his doctor told him he had a 'touch' of high blood pressure—.....  more than a 'touch' by anyone's standards. But Jake steadfastly refused to go on any medicine or even to return to the doctor.

Jake and his wife, Sara, bought a motor home. For three years, they took trips, went to art museums and cultural events, and meandered around the country just enjoying their free time. After forty years of working hard, they were finally reaping the benefits. Jake called it the 'great life.' He told Roger and his daughter, Joyce (Roger's wife), 'Don't worry about my blood pressure. Now that I'm not working, I'm not under any stress. My blood pressure's sure to have dropped.'

Since nothing 'seemed' wrong, no one paid too much attention. Then it happened. Jake had a stroke. The stroke left him partially paralyzed and impaired his speech. He needed a walker to get around. In a matter of minutes, he had lost the 'great life' he had worked all his life to enjoy.....

Finally, his kidneys started to fail, a side effect of hypertension. Roger and Joyce brought him to see me.

Giving him the 'cold, hard facts,' I finally convinced Jake to accept blood pressure treatment. With medication, his blood pressure dropped and his kidney function improved. Indeed, he managed to live a fairly good life, remaining relatively independent for another decade, until his kidneys finally gave out entirely. Although his poststroke life was adequate and he made the best of it, it was not the life he had dreamed about. And it didn't have to happen.

(NO  THERE  ARE  MANY  NATURAL  WAYS  TO  BEAT  HIGH  BLOOD  PRESSURE.....YOUR  DIET,  AND  EXERCISE,  ARE  TWO  OF  THE  MOST  IMPORTANT  -  Keith Hunt)

What Is Blood Pressure, and How Is It Measured?

Most of us have had our blood pressure taken every single time we've visited a doctor since we were children. But what exactly does blood pressure measure? What does blood pressure tell us about our overall health?

Blood pressure is the amount of force exerted by blood on the walls of the arteries as blood flows through them. The higher your blood pressure, the more stress and strain you are putting on your body. In RealAge terms, you are burning away years faster than you need to.

The only way to measure your blood pressure is to perform a quick, painless test using an instrument called a sphygmomanometer—the rubber cuff and gauge that they strap on you the minute you walk into a doctor's office. When your blood pressure is measured, make sure to ask what it is and to write it down. Keep track of your blood pressure and how it varies over time. Your blood pressure is not always at the same level. It is often elevated when you are anxious, upset, or in a hurry. Just being in a doctor's office can raise your blood pressure ('white-coat hypertension'). When your blood pressure is measured, make sure you've had enough time to calm down, are sitting and relaxed, and aren't talking to someone about an issue you feel passionately about. If your blood pressure is high or higher than you'd like, go to your local pharmacist and buy a sphygmomanometer. Either your doctor or the pharmacist can show you how to use it. Monitor your blood pressure regularly, keeping track of any fluctuations. You will keep far more vigilant watch over your own blood pressure than anyone else will. After all, it's your body, and you have the most to lose.

(I  HAVE  A  SPHYGMOMANOMETER:  BLOOD  PRESSURE  SHOULD  BE  TAKEN [A  NUMBER  OF  TIMES  OVER  SAY  15  MINUTES]  IN  THE  MORNING  AND  EVENING.  WHEN  RELAXED  -  Keith Hunt)

Blood pressure is always presented as a fraction..... The top number in the fraction is called the systolic blood pressure, the pressure exerted on the artery walls when the heart beats. The bottom number, the diastolic blood pressure, is the pressure exerted when the heart is at rest, between beats......

As you age, systolic blood pressure (and sometimes also diastolic blood pressure) tends to increase. Why? As you age, the walls of your arteries become atherosclerotic—less elastic and clogged with buildup from fats and lipids. This arterial hardening forces the heart to work harder. The heart becomes enlarged, and the arteries become scarred and damaged. It is a vicious cycle: The more damaged the arteries become, the harder the heart has pump......

In less than 5 percent of these cases is high blood pressure caused by some underlying medical condition. In these instances, when the root cause is corrected, blood pressure returns to normal. In more than 95 percent of the cases, there is no specific cause of high blood pressure; many times it is the result of the poor care we've given our arteries over the years.

(YES  THE  BOTTOM  LINE  IS  IT  ALL  COMES  DOWN  TO  HOW  WE  HAVE  PHYSICALLY  LIVED;  HOW   WELL  AND  HEALTHILY  WE  HAVE  EATEN,  EXERCISED,  SLEPT,  AND  KEPT  OUR  EMOTIONS  IN  GOOD  ORDER - LITTLE  STRESS  IN  OTHER  WORDS  -  Keith Hunt)

How Do You Achieve Ideal Blood Pressure?

What should you do if your blood pressure is higher.....

(TODAY  THE  BENCH  MARK  OF  BLOOD  PRESSURE  IS  NOT  THE  BENCH  MARK  OF  2000  WHEN  THIS  BOOK  WAS  WRITTEN.  GO  ON  THE  INTERNET  FOR  THE  UP-TO-DATE  SCIENCE  ON  BLOOD  PRESSURE  -  Keith Hunt)

Eat a more nutritious diet that is low in saturated fat.

Get more exercise.

Lose weight.

Stop smoking.

Cut your sodium intake to less than 1,600 mg a day.

Increase your potassium, calcium, and magnesium intake.

Avoid stress and consider strategies to reduce stress, such as increasing social connections or using relaxation therapy, biofeedback methods, or yoga.

Because nutrition, exercise, and stress reduction are important components of ageing, this book has chapters devoted to each (see Chapters 8, 9, and 11). If you have higher-than-ideal blood pressure, pay special attention to the recommendations in these chapters. If your family has a history of cardiovascular disease, pay extra attention. These chapters show you how easy it is to incorporate heart-healthy eating and exercise habits into your life. Lowering your blood pressure is not an impossible task.

Talk to your doctor. He or she can help you formulate a blood pressure-reduction plan that fits you, with special consideration for your particular needs and concerns. Your doctor can help you decide if you should be on medicine for hypertension. If so, he or she can work with you to choose the medication that works best for you. Remember, there are several kinds of treatments, and some may suit you better than others, so you should ask about all of them. If you experience side effects or don't feel as good as you think you should, don't discontinue your medicine—doing so can provoke a heart attack or stroke. Talk to your doctor about possible alternative treatments.

(THE  FIRST  THING  SHOULD  BE  A  SERIOUS  LIFE-STYLE  CHANGE,  IF  YOU  ARE  ALWAYS  OVER  THE  TOP  IN  WHAT  THE  LATEST  SCIENCE  TELLS  YOU  IS  "NORMAL"  BLOOD  PRESSURE  -  USE  THE  INTERNET  -  Keith Hunt)

In addition, your doctor can tell you whether your high blood pressure is 'sodium sensitive.' Many people are sensitive to sodium; that is, their blood pressure responds to the amount of sodium they ingest. If you think that you are salt sensitive, you should cut back on foods containing salt. And if you think that getting rid of your salt shaker will do it, think again. Most of the sodium we ingest comes not from salt we add to foods, but from sodium added by manufacturers to packaged foods. There are high levels of sodium in everything from soda pop to most breakfast cereals. Learn to be a label reader. Eat fresh fruits and vegetables instead of processed food to avoid sodium.

Reducing blood pressure requires more commitment than most of the RealAge Age Reduction strategies that we talk about in this book. When you start to think it's too much work, remember that your RealAge will become 1.5 years younger for every two-point drop in systolic blood pressure and every three-point drop in diastolic blood pressure. What could be better than that?

Stopping Atherosclerosis: Open Up Your Arteries!

The second most significant sign of arterial ageing is atherosclerosis, the buildup of fats and lipids along the walls of the arteries. This narrowing of the arteries can lead to the formation of clots, which can, in extreme cases, cause heart attacks and strokes. Indeed, atherosclerosis is a primary cause of high blood pressure. High blood pressure is often the first sign that the arteries are starting to harden. The higher blood pressure rises, the more quickly fats build up, causing even more atherosclerotic ageing, and so on. It's a vicious cycle. What causes fats to build up? We're not sure. Scientists postulate that either inflammation of the blood vessel walls or an excessive and accelerated bombardment of blood against the arterial walls—the very same conditions high blood pressure causes—triggers this process. Moreover, the higher your total blood cholesterol—specifically, the higher your LDL cholesterol—the worse the problem becomes. There are two common types of cholesterol, low-density lipoproteins (LDL) and high-density lipoproteins (HDL). I always remember L for 'lousy' and H for 'healthy' because LDL cholesterol accelerates fatty buildup in the arteries, whereas HDL cholesterol actually helps inhibit such buildup. That's why you want to have a low LDL reading and a high HDL reading. If you have a high total cholesterol reading, have your doctor determine the levels of each. 

Men are more likely to suffer from arterial ageing than women and at an earlier age. Women usually don't undergo arterial ageing until after menopause. Also, some population groups and families are more prone to arterial ageing than others. For example, if you are a man and a number of close relatives (a father, a brother, or an uncle) have had heart attacks or strokes, especially under age sixty-five, you, too, could be at risk of atherosclerosis at an early age. You will need to pay particular attention to arterial ageing. The same would be true of people who are significantly overweight; those who have high LDL cholesterol readings; and, of course, those who have high blood pressure.

All of us can do simple things that will help keep our arteries young..... In Chapter 7, learn how vitamins C and E protect your arteries. Taking both of these substances in the recommended doses can reduce your RealAge by more than six years. Be sure to read the section on folate because taking folate regularly will help keep lipids from building up in your arteries. Note in the section on ageing of the immune system that you should be careful to brush and floss your teeth to avoid periodontal disease. The bacteria that cause periodontal disease are believed to trigger an immune response that, in turn, causes inflammation, or swelling, of the arteries. An area can then form along the arterial wall, creating a niche in which fats can accumulate, causing the arteries to become atherosclerotic.

When it comes to arterial youth, there are the additional big three: nutrition, exercise, and stress. These are so important that a chapter is devoted to each. Think of them as being interrelated. By eating a diet that is rich in nutrients and low in saturated fats, you will be able to reduce your RealAge by more than ten years. By exercising regularly (it's not that hard!), you can reduce your RealAge by more than eight years. Pay particular attention to Chapter 11, which gives tips for managing stress, because stress and emotional upheaval can cause significant arterial ageing.

Now let us consider two factors that can specifically keep your arteries free from clots—taking an aspirin a day and hormone replacement therapy.

.......................

I'M  NOT  INCLUDING  HERE  WHAT  IS  SAID  ABOUT  ASPIRIN  AND  HORMONE  REPLACEMENT  THERAPY.

THERE  IS  A  LOT  OF  PROS  AND  CONS  ON  BOTH  SIDES.  YOU  SHOULD  TRY  EVERYTHING  ELSE  FIRST,  BEFORE  RESORTING  TO  ANY  KIND  OF  DRUGS.  SORRY  TO  SAY  BUT  OFTEN  DRUGS  ARE  USED  BY  MANY  AS  A  QUICK  ANSWER,  TO  AN  UNWILLINGNESS  TO  MAKE  MANY  LIFESTYLE  CHANGES,  THAT  WOULD  SOLVE  THE  HIGH  BLOOD-PRESSURE  PROBLEM.

NOW  HERE  IS  ONE  INEXPENSIVE  WAY  THAT  HELPS  KEEP  YOUR  ARTERIES  CLEAN.  WHEN  MY  DAD  RETIRED  AT  63  AND  CAME  TO  CANADA;  THE  FIRST  YEAR  HERE,  HE  READ  AN  ARTICLE  IN  A  LOCAL  PAPER  BY  SOME  DOCTOR,  WHO  SAID  IF  YOU  TAKE  ONE  LECITHIN  TABLET  A  DAY,  IT  WILL  KEEP  YOUR  ARTERIES  CLEAN.  MY  DAD  STARTED  TO  DO  SO  IMMEDIATELY.  AND  HE  STILL  DOES  AT  AGE  94  COME  AUGUST  2014.

HE  PACKED  UP  AND  WENT  BACK  TO  WALES  AT  AGE  85,  THINKING  HE'D  FINISH  HIS  DAYS  IN  THE  VILLAGE  WHERE  WE  ARE  FROM.  HE  WAS  IN  A  CLINIC  GETTING  A  HEALTH  TEST.  THERE  WERE  PEOPLE  LAYING  ON  SMALL  BEDS  WITH  TUBES  IN  THEM.  THEY  TOOK  A  BLOOD  SAMPLE.  THEY  CAME  OUT  AND  ASKED  HIM  IF  HE  HAD  EVER  HAD  A  "WASH  OUT"  -  HE  REPLIED  NO.  THEY  CAME  AGAIN  THE  SECOND  TIME  AND  ASKED  HIM  THE  SAME  QUESTION.  HE  AGAIN  REPLIED  NO.  THEY  CAME  OUT  THE  THIRD  TIME  AND  ASKED  HIM,  "ARE  YOU  SURE  MR.  HUNT  YOU  HAVE  NEVER  HAD  A  WASH  OUT?"  MY  DAD'S  REPLY  WAS  "IS  THIS  WHAT  THESE  PEOPLE  ARE  HAVING  LYING  HERE  WITH  TUBES  IN  THEM?"  THE  NURSE  SAID  YES.

"I  HAVE  NEVER  HAD  ANYTHING  LIKE  THIS  EVER."

"WELL  MR.  HUNT,"  SAID  THE  NURSE,  "WE  HAVE  NEVER  EVER  SEEN  ANYONE  YOUR  AGE  WITH  SUCH  CLEAN  ARTERIES.  WHAT  HAVE  YOU  BEEN  DOING?"

I'VE  ALREADY  TOLD  YOU  WHAT  HE  HAD  BEEN  DOING  SINCE  HE  WAS  63  YEARS  OLD.

HE  RETURNED  TO  CANADA.

MY  DAD  HAS  ALWAYS  BEEN  HEALTH  MINDED;  ATE  A  BASIC  GOOD  DIET [OVERDID  SOME  THINGS  BECAUSE  HE  GAINED  A  BELLY  ON  HIM  THAT  WAS  TOO  LARGE];  DID  REGULAR  EXERCISE  IN  MANY  DIFFERENT  WAYS;  AND  WAS  WITHOUT  MUCH  STRESS  ALL  OF  HIS  LIFE.

HIS  TOO  LARGE  A  BELLY,  FINALLY  CAUGHT  UP  ON  HIM,  BUT  NOT  UNTIL  HE  WAS  90  YEARS  OLD;  THEN  HAD  A  MINOR  STROKE,  WHICH  HAS  LEFT  HIM  IN  A  WHEEL  CHAIR,  AND  A  SHORT  TIME  MEMORY  THAT  IS  ALL  OVER  THE  MAP.  HE  IS  NOW  IN   A  24/7  CARE  FACILITY.  I  MAKE  SURE  HE  GETS  HIS  VITAMINS  AND  MINERALS,  AND  INDEED  HIS  LECITHIN  TABLET.  HE  HAS  LOST  HIS  BELLY,  AND  SO  FAR  DOING  FINE.  SURE  IN  YOUR  90s  YOU  NEVER  KNOW  WHEN  YOUR  TIME  IS  UP,  BUT  SO  FAR  HE  TELLS  ME  HE'D  LIKE  TO  LIVE  TO  BE  100.  I  TELL  HIM  HE  MAY  JUST  DO  SO.

I DAD DID NOT BUT LIVED TO BE 94. HE DIED IN JUNE 2014. 

Keith Hunt

TO  BE  CONTINUED

Immune to the Years #1

SLOWING AGEING OF THE IMMUNE SYSTEM AND PREVENTING CANCER

As you age, so does your immune system, the system that protects you from diseases. Keeping your immune system young and strong helps keep cancer at bay. Cancer is the second leading killer in the United States and may soon surpass heart disease as number one. It is far easier to prevent cancer than to cure it. This chapter explains how cancer works and discusses strategies for prevention. A normally functioning immune system also helps prevent arthritis and even heart disease. Protecting your immune system can make your RealAge as much as six years younger.

• Prostate cancer kills more men than anything but heart disease and lung
cancer: 250,000 new cases are diagnosed a year, and 40,000 men die from
prostate cancer annually. Yet, in the war against prostate cancer, tomato
paste—yes, that red stuff on pizza and pasta—and green tea may be a
winning combination. These two simple substances can make your
RealAge as much as 0.8 years younger.

(Remember  the  stats  are  from  the  year  2000  when  this  book  was  published  -  KEITH HUNT)

Difficulty rating: Moderately easy

• Although we read all the time about the risk of cancer from sun exposure,
that doesn't mean we should avoid the sun altogether. To produce an
adequate amount of vitamin D, we need to spend some time catching rays
(or, as suggested in Chapter 7, taking vitamin D as a supplement). Vitamin
D appears to strengthen the immune response and helps prevent certain
kinds of cancers. Learn how to strike a balance between too much sun and
not enough. Just taking simple precautions can make your RealAge 1.7
years younger.

Difficulty rating: Moderately easy

If you thought taking care of your teeth was just cosmetic, think again. By avoiding periodontal disease, you can make your RealAge 6.4 years younger. In contrast, people with acute periodontal disease are 3.4 years older than their chronologic age. Why? Because the bacteria that cause periodontal disease appear to trigger an immune response that causes inflammation, throughout the body. A side effect seems to be inflammation of the arteries, a major precursor to heart disease. Although the exact cause and effect are not well understood yet, people who floss may live younger longer.

Difficulty rating: Quick fix

Now that you've read about how to prevent arterial ageing, I know the next question you're going to ask. I hear it every time I give a lecture. 'If we prevent arterial ageing and lower our risk of heart attacks, strokes, and other forms of cardiovascular disease, won't we just die from something worse?' The Big C? Cancer? We've all got to die from something, don't we?

Yes. We will all die sometime. But then again, why invite it? Although most of us feel that we are helpless in the face of cancer, just remember that 80 to 90 percent of cancers are linked to environmental causes. That means cancer isn't just fate, but something you can do a lot to prevent. How? By controlling your environment. Despite the recent stir about cancer genes, fewer than 10 percent of all cancers are linked to genetic inheritance. Although I can't say that 80 to 90 percent of cancer can be prevented, I can guarantee that by making yourself younger, you can stave off your risk of cancer by as much as twenty RealAge years. By controlling your environment, you can minimize the ageing of the immune system, making your RealAge younger. Think of it this way: Although all of us have to die of something, there is no reason not to reduce your risk of getting cancer at calendar age fifty to that of the typical forty-year-old. You can choose to keep your immune system youthful and, by doing so, greatly reduce your risk of getting a life-threatening cancer or other disorder of the immune system.

If the cardiovascular system is the body's transportation system, the immune system is its security system. The immune system protects the body from outside invasion by locating and destroying potentially harmful bacteria and viruses. It protects the body against insurrection from within by rooting out cells that have become abnormal or malignant. As we age, our immune system begins to fail us. There are two fundamental ways in which your immune system can fail. It can become negligent, allowing abnormal cells— either infectious agents or cancer cells—to grow unchecked. Or it can become overzealous, turning on the body and attacking normal tissues, as occurs in such autoimmune diseases as many forms of arthritis, connective tissue diseases, and allergies. Since the immune system is so complex, it can go in both directions at once. Your immune system can be negligent—as in cancer—and overactive—as in arthritis—at the same time.

Protecting our cardiovascular system is relatively straightforward, but keeping our immune system in working order is more complex. The immune system is made up of millions of free-floating cells that roam the body in search of abnormalities. All these cells need to coordinate with each other to provide adequate protection. And the state of our immune system—the youth of our immune system—depends greatly on how well we care for it.

For example, we know that people who exercise have higher concentrations of certain immune system cells that identify and destroy potentially hazardous toxins and invading organisms. We know that taking antioxidants, such as vitamin C and vitamin E, helps improve the immune response. We also know that hazardous chemicals, too much sun, and radioactivity can age your immune system and increase your risk of cancer. Stress clearly weakens our immune response—the death of a loved one, for example, measurably decreases the number of T cells in a person's bloodstream for as long as a year after the event. And, of course, there is AIDS (acquired immunodeficiency syndrome), a disease that directly attacks the immune system. Throughout the following chapters, there will be sections that address ageing of the immune system. Pay attention to the sections on this subject in the chapters on environmental hazards (Chapter 6), vitamins and supplements (Chapter 7), food and nutrition (Chapter 8), exercise (Chapter 9), and stress (Chapter 11) and learn how to make your RealAge younger by keeping your immune system younger.

Cancer: An Ounce of Prevention Is Better Than a Whole Lot of Cure

Cancer is the most ironic of diseases. Except in rare cases, it is not caused by an invasion of some external agent, such as a bacterium or virus. Nor is it caused by wear and tear on the body or by parts breaking down. Rather, it is a disease of one's own body gone awry. Cancer begins with one cell that, instead of keeping in line with the cells around it, suddenly begins growing, dividing, and dividing again, forming a mass of malignant cells—a tumor. If the tumor gets large enough or spreads (metastasizes), it can be fatal. Cells are usually subsumed to the good of the organism, but when a cancer appears, the organism becomes subsumed to the cell.

Cancer is the second leading cause of death in the United States, accounting for 22 percent of all mortalities annually. More than a million Americans are diagnosed with cancer each year, and more than half a million die from cancer. Another 800,000 develop small situ (noninvading) cancers and various mild kinds of skin cancers; both types, for the most part, do not spread and can be easily removed. These in situ cancers are not generally counted in the annual cancer statistics, but are cancers nonetheless. For women aged thirty-five to seventy-four, cancer is the leading cause of death. For men of the same age range, cancer is second only to cardiovascular disease as the leading cause of death. Despite the high incidence of cancer and the enormous amount of effort put into fighting it, cancer remains one of the most pernicious human diseases.

(THE  LATEST  STATS  IS  THAT  CANCER  IS  SPREADING  WORLDWIDE  -  WE  ARE  LOOSING  THE  FIGHT  AGAINST  CANCER,  IN  THE  OVERALL  -  Keith Hunt)

Even though newfound cancer genes have been the subject of much speculation, most cancers arise from our interactions with the world around us. Astoundingly, almost one-third of all cancers diagnosed in Europe and in the United States can be linked to tobacco use and account for more than 150,000 deaths in the United States each year. Food choices are thought to contribute to another third of cancers, especially stomach and colon cancers. People who eat diets that are low in saturated fats and rich in nutrients have a significantly lower incidence of cancer. Thinner people are at lower risk of breast, prostate, and uterine cancer, perhaps because such cancers are linked—at least some scientists postulate—to high exposure to the sex hormones oestrogen and testosterone, and these hormones are stored in fat. People who drink excessively have higher levels of mouth and liver cancer. And people who have spent too much time in the sun, especially before age thirty, are more likely to develop skin cancer. Occupational hazards—exposure to such toxins in the workplace as asbestos and formaldehyde—account for about 5 percent of all cancers.

In the early 1970s, President Nixon announced a 'War on Cancer,' hoping that a big monetary investment and a redoubled effort by America's scientists would lead to the cure. Twenty-five years later, we are still not much closer to that cure. If a tumor is found early and can be removed surgically, it will not regrow in about 50 percent of the cases. Much of the time, treatment delays the spread of a cancer. Once a cancer has metastasized, the likelihood that radiation or chemotherapy will actually stop the disease is only about 10 percent—not especially promising. Although several new gene-targeting drugs and drugs targeted to stop the blood vessel growth that is necessary for the growth of tumors appear promising in stopping the spread of cancer, they are still in development and years away from being a standard treatment procedure. Indeed, the key words in cancer therapy today are avoidance and early detection. And 'early detection' by no means compares with 'cancer-free.' Although someday there may actually be a cure that works, at present, the best way to fight cancer is to avoid getting it in the first place.

How are we to keep cancer at bay? There are two ways. First, by avoiding exposure to known cancer-causing agents, you can reduce the odds that a cancer will ever develop. Second, by taking steps to strengthen your immune system, you can better prepare your body to fight off any early cancer that does develop, destroying it before it even gets started.

Understanding Cancer: What It Is and How It Works

One of the reasons scientists haven't yet found a cure for cancer is that the causes are often extremely complex. In fact, the term cancer describes the phenomenon—the growth of tumors—and defines a general category that contains a broad range of diseases. Cancers can be caused by radiation, viruses, carcinogens, random mistakes in the cell cycle, an inherited genetic predisposition, or just plain chance. In many cases, cancers can develop because of a combination of factors. For example, although no one doubts that smoking increases the incidence of lung cancer—nearly 90 percent of lung cancers are linked to cigarette smoking—some smokers appear to be even more susceptible to cancer than other smokers. Some people appear to produce higher levels of the enzyme that makes smoke carcinogenic; thus, their genetic predisposition, combined with their behavioral choices, contributes to an even greater risk of lung cancer. This effect is a good example of how cancers can be caused by both environmental factors and inherited tendencies.

The risk posed by smoking can be compounded by other factors as well. For example, asbestos and radon are known carcinogens (cancer-causing agents). Smoking greatly amplifies the risk of either, since smokers have significantly higher sensitivity levels than nonsmokers to these carcinogens. Although nonsmokers exposed to asbestos are five times more likely to develop lung cancer, smokers exposed to asbestos are ninety times more likely to develop lung cancer! Cigarettes and heavy drinking are another volatile combination, causing more cancers and more ageing when used together than either cause alone.

Now that I have told you that most cancers are brought about by environmental causes, I am going to seem to contradict that statement: All cancers are genetic. When I say that, I do not mean that they are hereditary, although they sometimes are. Five to 10 percent of all cancers are thought to stem from a strong predisposition to the disease inherited in our genes. The other 90 percent are caused by genetic mistakes that develop spontaneously over the course of a lifetime. Although a person can inherit a genetic tendency for a specific kind of cancer, the vast majority of cancers occur because of mutations in our DNA (deoxyribonucleic acid) that occur after we are born. We do not inherit these mutations, we accumulate them.

Cancer is a disease of our DNA, the substance that regulates the growth of the body, and that is contained in every cell we have. Think of DNA as your body's instruction book. It contains information that guides all your growth and physiologic changes from the time you are born until the day you die. Your DNA determines what color eyes you will have, how tall you will be, that you will have an arm where you are supposed to have an arm, and even that you will have arms instead of wings. You inherit your initial set of DNA from your parents—half from your mother and half from your father—when the egg and sperm fuse. Since each of our cells contains an identical set of DNA, as we grow, this DNA is duplicated with every single cell division. Each of us starts out as a single cell, but by the time we are adults, our bodies contain 75 trillion cells. That means trillions and trillions of cell divisions during your lifetime.

Cells fall into one of two basic types: germ line cells and somatic cells. Germ line cells are our reproductive cells—eggs in the female and sperm in the male. All the other cells in the body are somatic cells, which form more than 99 percent of the feody. The somatic cells are living, changing cells; they grow, divide, die. As long as you are alive, your body replaces these cells continuously. During your lifetime, you replace virtually all the somatic cells in your body, except brain and nerve cells, thousands, if not hundreds of thousands of times. Your stomach lining, for example, is in an almost continual state of cell division, making new cells every day. Most cancers stem from mutations of somatic cells.

When a cell divides, the DNA in that cell is copied and passed on to the new cell. But the DNA in any one cell can become damaged. Pieces of the instructions on the genes can get knocked out or changed—mutated. If the mutation occurs in the wrong place—in an active gene, for instance—it can disrupt the function of the cell, causing it to die. Or it can cause the cell to begin dividing wildly, becoming a cancer.

We get mutations in two ways. First, mutations can arise through mistakes in the cell-division process. Second, mutations can occur when the DNA in a cell is damaged by an irritant like radiation or free radicals. In either case, these mutations, if they do not kill the cell, get passed on when a cell divides. How many of these mutations will you undergo in your lifetime? Probably millions.

....................

TO  BE  CONTINUED

REALAGE - IMMUNE  SYSTEM  AND  CANCER #2

If you consider the vast number of divisions necessary to maintain 75 trillion living cells, the chances are that sometime, somewhere, something will go wrong. And it does. Sometimes the DNA contained in each cell, which must replicate itself completely before each cell division, becomes damaged. Sometimes it doesn't copy correctly. When the cell divides, the new daughter cells can contain this error, a mutation.

Luckily, most of these mutations do not matter. They do not occur in sections of the DNA in which there are active genes or do not disturb the action of a gene. The body doesn't even notice them. In contrast, lethal mutations are so significant that they kill the cell right away, at which point the mutation disappears and is not passed on. Probably 99.9 percent of all the mutations you undergo belong to one of these two classes.

Between the harmless and the lethal mutations is a third class of mutations, a tumor-causing mutation. These are the rare cancer-causing mutations that tell the cell to begin growing and dividing uncontrollably. Your body has a regulatory system that keeps the number of cells in your body at a more or less constant level. The genes that regulate this process are known as cell-cycle genes because they tell the cell when to divide, to grow, and to divide again. Some of these cell-cycle genes are known as 'proofreader' genes: they scan the DNA when it replicates, ensuring that no mutations have been acquired. If a mutation has occurred, the proofreaders either fix it or kill the cell. A few of these cell-cycle and proofreader genes are also known as oncogenes (cancer genes) because mutations in these genes are tied to the development of cancers. If a gene that is supposed to tell a cell to stop growing stops working— that is, mutates—then the cell grows uncontrollably, dividing faster than it should. Moreover, its daughter cells also inherit the mutation and grow out of control themselves. The effect multiplies, and soon there is a mass of rapidly dividing, quickly growing cells, a tumor, 'the Big C.'

Generally, your body is able to recognize abnormal cells and destroy them before they cause harm. By means of the proofreader genes and other anticancer genes, most abnormal cells are rooted out and excised. The general immune system also destroys many precancerous and early cancer cells. The exact mechanisms of this response are poorly understood: the immune system is not always able to recognize the differences between cancer cells and normal cells. However, it has long been known that people with healthier immune systems are less likely to develop cancers and that precancerous cells are often rooted out by the body. Research is increasingly showing the role that the general immune system plays in cancer prevention. Hence, your body prevents cancer by a double mechanism—one genetic, one immunologic. Cancers— the life-threatening kind—occur when a mutation develops, coupled with a failure of both protective systems, when each has 'aged' too much to stop the cell from taking over as a cancer.

The longer you live—that is, the more divisions your cells undergo—the more likely it is that you will undergo a mutation in a cell-cycle gene. It's the law of averages. A mutation assaults your first line of defense—the line of defense within the cell that protects the body. By exposing your body to harmful chemicals, radiation, or the buildup of free radicals, you increase your rate of mutation exponentially. The odds that you will undergo a mutation in the wrong place increase dramatically.

As you age, your second line of defense, your immune system, tends to be less vigilant and does not as readily detect and destroy these abnormalities. The weaker your immune system, the more likely that it will not provide the necessary backup. The longer you live, the more likely that you will get improper cell divisions, the more likely that the DNA in a specific cell will contain a mutation, and the more likely that your immune system won't be there to catch a mistake. The most important thing to remember is this: You can slow, and even reverse, the rate of ageing of the immune system.

The RealAge strategy for keeping your immune system young and avoiding cancer is twofold: (1) decrease your exposure to factors that increase DNA damage in your cells and (2) adopt behaviors that strengthen your immune response. You keep your RealAge young by avoiding exposure to factors that cause mutations and by boosting your immune system so it scavenges those mutations as well as possible. Doing all the things you can do to keep your immune system youthful can make your RealAge over twenty years younger.

Cancer Genes: What Do They Mean to You?

Although the vast majority of cancers are thought to stem from environmental causes, it is worth considering those people who have an inherited genetic predisposition to the disease. Almost every week a major news story reports the discovery of a new cancer gene. 'Researchers have identified the breast cancer gene.' 'Scientists announce the discovery of the colon cancer gene.' Most of these genes—or, more precisely, genetic mutations—run in families, isolated populations, or ethnic enclaves. They are mutations that lie in the germ line cells—that is, in the egg and sperm—and that get passed down from parent to child. They are often identified in populations that are endogamous, that is, in which people marry within the same group. The propensity for these specific genetic mutations occurs in such populations because the more closely related people are, the less their genetic variation. Since many of these mutations are recessive, appearing only when both parents are carriers, the trait is more likely to show up when both parents have a similar genetic background. Also, it is easier for researchers to trace genetic predisposition to a disease when they can trace a cultural and historical context, linking family histories with biologic events.

If you belong to a population that is at risk of a genetically linked cancer, the discovery of a gene can have an immediate impact. You can be tested for the gene to learn whether you have inherited it. Although this sounds ominous, and getting such tests can be frightening, there is a more positive way of thinking about it. By getting tested, you will know whether you have the gene. If you don't have it, you can quit worrying. If you do have it, you can minimize the risks and the ageing it can cause.

If you do not belong to the group at risk, the news about cancer genes is less immediate but no less important. By identifying mutated forms of a gene, researchers are better able to understand what a gene does when it functions normally and they are better able to target specific gene pathways that are implicated in specific forms of cancer. By understanding the biochemical processes by which a cancer grows, scientists get closer to understanding how we might prevent such cancers. Because all cancers are genetic—whether they are caused by an inherited mutation or an acquired one—the more we learn about the genetics involved in the development of cancers, the better prepared we will be to treat all cancers—and to prevent them.

Another thing: Inheriting a cancer gene does not mean that you will get cancer—it means that you have an increased risk of getting that particular type of cancer. People who inherit a form of a gene that causes cancer in 100 percent of the cases rarely survive childhood. When scientists say that they have 'found' a cancer gene, they mean that they have found a gene that, when mutated, increases a person's risk. For example, even though scientists refer to the recendy discovered BRCA-1 gene as the breast cancer gene, they are not being accurate. No woman really has a breast cancer gene—a gene whose function is to cause cancer. Instead, she may have inherited a copy of a gene that contains a specific mutation affecting the ability of that gene to function properly. The side effect is to increase her predisposition toward breast cancer.

Many of the so-called cancer genes are two-hit genes. Because we inherit chromosomes (DNA) from each parent, in many instances we have two working copies of a particular gene. If one doesn't work, the other covers for it. In many genetically linked cancers, a person inherits a working copy of the gene from one parent and a nonworking copy from the other. The odds of that person getting an acquired mutation in the one working copy in a particular cell of the body are much higher than the odds for people who have two working copies of the gene. People with two working copies would need to get two acquired mutations—a mutation in each copy of the gene in the same cell—to develop the same cancer. Other cancers require two mutations in two different genes, or the same copy of a gene. One mutation usually won't cause the cancer, but two will. This is true, for example, with certain eye cancers called retinoblastomas. Because there are millions of cells in the eye, the chances of an acquired mutation occurring in any one cell is relatively high. The chances of two acquired mutations occurring in exactly the right places is relatively low. However, we know that certain people are born with one of the mutations already. Hence, the odds of their developing another mutation over their lifetimes are extremely high, making them genetically predisposed to developing this type of cancer.

Recently, inherited links have been discovered for certain types of breast and colon cancers, allowing us to identify people who are predisposed to developing each of these diseases. Such mutations account for a minority of all such cancers. For example, in breast cancer, genetic predisposition is thought to account for less than 4 percent of all cases. However, genetic predisposition is implicated in nearly a third of all breast cancers that develop in women under age forty, showing just how much having one of these genes can affect one's risk.

Testing positive for a cancer gene can make your RealAge dramatically older, as you would then have the same likelihood of developing cancer as a much older person. For example, a thirty-five-year-old woman who tests positive for the BRCA-1 breast cancer gene and whose mother and sister both developed breast cancer before age forty has a RealAge that is seventeen years older. That is, her RealAge would be fifty-two. By knowing she has the gene, she can make choices that make her RealAge younger. The dilemmas involved in this scenario are extremely complex, and individual counseling is recommended.

Identifying cancer genes is a big step for science. Unfortunately, this research is still in the beginning stages. The more we understand about genetically inherited cancers, the more we will understand about cancers in general. For example, the recent identification of a specific mutation in a gene linked to an increased risk of colon cancer among Ashkenazi Jews has helped researchers identify a gene pathway that is believed to be implicated in as many as 90 percent of all cases of colon cancer. That discovery opens numerous doorways for treatment and prevention. There are numerous other examples. The more we learn, the better prepared we will be to stave off the ageing that cancer can cause.

What If You Get Cancer?

How Does It Affect Your RealAge?

No doubt some of you are cancer survivors and most of us know someone who is. How much effect does a positive diagnosis have on a person's RealAge? Well, that depends. Clearly, some cancers are much more harmful than others. They attack the body much more quickly and aggressively. On the other hand, some cancers grow slowly, resulting in little damage. The removal of a tumor, chemotherapy, radiation, and other therapies can often stop the spread of a cancer throughout the body. Some people have a tumor removed in their thirties and live until their eighties. The effect of the disease on your ageing depends on the type of cancer you have, how it is treated, and how long you are free from cancer after treatment.

Let's use the breast cancer example again. A fifty-eight-year-old woman who has had a malignant lump removed from her breast without indication of significant spreading in the lymph nodes has a RealAge of sixty-five. If that same woman undergoes chemotherapy and still shows no signs of tumor growth in the next five years, her RealAge will shift from being seven years older to being only two years older. In general, the longer a person goes disease-free after treatment, the less effect a cancer diagnosis has on his or her RealAge.

The best thing, of course, is to avoid cancer altogether, and that means avoiding cancer-causing substances and strengthening the immune system so it can act as it did in your youth and effectively scavenge early cancers. By becoming as young as you can be, your immune system will be in better condition and more able to wipe out any possible cancer cells in your body. Fortunately, there are foods, supplements, and behaviors that can help you keep your immune system young.

Let's consider some of those elements. Diet, vitamins, exercise, and preventing stress are all key ways of slowing ageing of the immune system. In fact, these are so important, I have devoted whole chapters to those topics. Here, though, let's consider three examples of immune system ageing— prostate cancer, skin cancer, and periodontal disease. As diverse as they are, they have something in common—the failure of the immune system.

Let's start with prostate cancer. Here are two things that may help men prevent it.

Just for Men: Tomato Paste and Green Tea Help to Keep You Cancer-Free

Ask any man what he fears most about ageing, and he may tell you heart disease or cancer, but, in his heart of hearts, what he fears most is impotence. Impotence is psychologically and emotionally devastating. Since virility is a sign of youthful manhood, losing the ability to perform is something that makes men feel most acutely that their bodies are failing and that they are getting old. There are four major causes of impotence: arterial disease, stress, psychological upsets, and prostate problems. Of the four, prostate enlargement and cancers are by far the most common—and predictable—reasons for the loss of sexual function.

The prostate is a small gland at the base of the penis. As men age, the prostate tends to become enlarged and often cancerous. In fact, most older men show signs of having microscopic cancers in their prostates. The enlargement, from cancers and other causes (called benign prostate hypertrophy when it is not associated with cancer), can be painful and uncomfortable. A swollen prostate cuts off urine flow, increases the need to urinate, and often makes urination painful. Sexual performance can become limited. And that ages us—physiologically and psychologically. Although drugs can be given to reduce the size of an enlarged prostate, they are not especially effective and have side effects, such as impotence or an increased risk of cancer. Fortunately, there are ways of preventing prostate cancer and the ageing it causes.

Prostate cancer is the most common cancer found in men. Some 250,000 new cases are diagnosed each year, and it causes 40,000 deaths annually— second only to lung cancer among cancer fatalities for men. More than 60 percent of men over age eighty will develop cancerous prostate cells. For those of us who plan to live into our eighties—healthily, heartily, vibrantly, and as young as sixty-year-olds—we need to be especially careful to protect ourselves from this kind of cancer. The best weapon against prostate cancer, or any cancer, is to avoid getting it in the first place.

Treatments for prostate cancer—surgery, chemotherapy, and radiation— are just as devastating as all cancer treatments but have an added side effect: Almost all the therapies are associated with a significant loss of sexual function in more than 50 percent of the cases. Despite this grim news, there is something that can give us hope—the tomato.

Tomatoes and Lycopenes

Studies have shown that the risk of developing prostate cancer is as much as one-third lower among men who frequendy eat foods containing tomatoes or tomato paste than among men who rarely eat such foods. Men who eat tomato products ten or more times a week have significandy lower levels of prostate cancer—a 34 percent reduction in severe metastatic prostate cancers—than do men who eat tomatoes less than twice a week.

The reason appears to be the antioxidant power of tomatoes. A substance found in tomatoes—lycopene—apparendy helps retard or reverse the ageing of cells in the prostate that can promote cancer growth. Lycopene is one of several kinds of carotenoids that are known for their antioxidant properties (see Chapter 8). Carotenoids, pigments found primarily in yellow, orange, and red fruits or vegetables, are similar to vitamins in that they help facilitate specific chemical reactions. Unlike vitamins, we do not require them to survive. A key function that carotenoids perform is to attach to free radicals, packaging them so they can be washed out of the body and preventing them from damaging our cells and chromosomes. Since the prostate is especially vulnerable to damage from environmental factors, it is especially vulnerable to damage from free radicals. Hence, the importance of the antioxidant powers of lycopene.

A study investigating a wide range of populations in Hong Kong, Tokyo, Milan, New York, Chicago, and Albuquerque, found that the incidence of microscopic prostate cancer was the same for all groups, no matter their geographic location or genetic heritage. The chances that these microscopic cancers would develop into full-blown prostate cancer varied wildly across locations, with the number of fatalities due to prostate cancer differing significantly. The areas of the world with the lowest levels of severe, or metastatic, prostate cancer are Mediterranean countries, especially Greece and Italy—where tomato-based foods are central to the diet. In areas where tomato-based foods are not common, the risk of cancer increased markedly.

A long-running question about prostate cancer has concerned the increased risk of the disease for African American men. It is interesting to note that studies have found that African Americans are less likely to eat tomato-based foods. Although no studies have been undertaken to show with certainty that dietary differences account for the higher incidence of prostate cancer for this population group, the data suggest that such could be the case.

Tomato paste, raw tomatoes, and cooked tomatoes all contain lots of lycopene. Our bodies, however, cannot absorb lycopenes except in the presence of fat. Drinking a glass of tomato juice by itself or eating slices of raw tomato without salad dressing does not provide us with lycopene. Some experts question whether we can absorb lycopene from raw tomatoes even in the presence of fat. Tomatoes cooked lightly in oil—as in tomato paste or pasta sauces—result in a two - to threefold rise in lycopene concentrations in the bloodstream the day after ingestion. In contrast, people who drink lots of tomato juice do not show this rise in lycopene-levels because the juice lacks the fats that help the body absorb the nutrients. Although slight cooking appears best, raw tomatoes with a little olive oil, sun-dried tomatoes in oil, and probably even tomato juice eaten with a bit of cheese or other fat may also increase lycopene levels.

Studies have found that most men get their lycopene from tomato sauce on pizza. Although that is certainly one way of getting lycopene, pizza with cheese, not to mention pepperoni and sausage, tends to be extremely high in saturated fats. Ways of getting tomato products without so much fat include eating tomato sauces on pasta, eating a roasted tomato with a drizzle of olive oil as a salad, eating tomato-based soups, putting salsa on meats or salads, and even eating ketchup. 

For Women

A diet rich in carotenoids—the antioxidants found in tomatoes and other red, yellow, and orange vegetables—has many beneficial effects for everyone. Therefore, even though women cannot receive the lycopene benefit for prostate cancer, they should still eat a diet heavy in carotenoid-rich fruits and vegetables. 

Lycopene appears to have other benefits as well. A 1997 reanalysis of the data gathered in the historic EURAMIC study found that men and women with the highest levels of lycopene in their bodies had the lowest risk of arterial ageing. Although there has only been one study to date, the reduction in mortality from atherosclerosis was 65 percent. Translated into RealAge terms, that would make ten helpings a week of tomato paste produce more than a five-year younger benefit for the average fifty-five-year-old man.

If you are trying to build up lycopene levels in your blood, do not eat potato chips or other foods containing the new fat substitute olestra (brand name, Olean). This fat 'fake' leaches fat-soluble vitamins, such as D and E, from your system and dramatically reduces the amount of lycopene in the body. One study found that eating just six olestra chips every day for a month reduced the amount of lycopene in the body by 40 percent, and eating sixteen chips a day reduced lycopene by as much as 60 percent.

Green Tea: A Cure for Prostate Cancer?

Another substance that appears promising in the prevention of prostate cancer is green tea. Several East Asian studies found that men who consume large amounts of green tea appear to have lower rates of prostate cancer. Studies at the University of Chicago have isolated the hydroxy '8' molecule in green tea that retards prostate cancer in laboratory animals. This molecule is reputed to be one of the most powerful antioxidants yet discovered, even more powerful than vitamins E and C. However, the green-tea molecule is notoriously fragile. The freezing and dehydration processes that imported green tea must undergo destroy the chemical compound that is linked to the reduction of the growth of prostate cancer cells. Unfortunately, to get any benefit from green tea, a person must drink as much as fifty cups a day. So far, there are no commercially available pills containing the green-tea extract in its proper form. While doubt remains, green-tea extract may well be an aid in preventing prostate cancer. Keep your eyes open for any new information on the subject. An extract supplement may be available soon if the studies continue to show promising results. Other preliminary research indicates that green tea—and black tea, too—may have other cancer-fighting abilities.

In both examples of the prevention of prostate cancer, a nutrient in our diet can affect our risk of getting cancer. Eating is one way we interact with our environment and one way we can lessen the impact of environmental factors on our risk of developing cancer. Another environmental cause is, as most of us know, sunshine. How exactly does the sun age you?

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TO  BE  CONTINUED

REALAGE

Sunny Skin: How Much Sun Is Too Much?

There is no temptation like the sun. Although that tan may look great now, we all know that in the long run, it can cause wrinkling and, worse, skin cancers. Wrinkles not only make you look and feel older than you want to be, but are actually signs of skin damage and ageing. Wrinkles show that your skin, one of your most important organs, is losing the elastin that keeps it young and healthy. Some forms of skin cancer make your RealAge significantly older very fast.

Everyone needs some sun each day. Sun allows our bodies to turn specific kinds of food-derived cholesterols into vitamin D, an important nutrient that helps decrease ageing of the cardiovascular and immune systems. In turn, the liver and kidneys convert vitamin D into vitamin D3, the active form of the vitamin. In fact, ten to twenty minutes of sunlight a day appears to be the optimal amount of exposure to the sun that each of us needs and can make your RealAge 0.7 years younger. If you do not get some sun every day, substitute vitamin D daily. Studies on mood elevation show that sunlight and exposure to broad-spectrum light help improve our mood. Seasonal affective disorder (SAD) and other types of depression can be improved by exposure to sunlight. So, some sun is good, but how much sun is too much?

In general, your risk of skin cancer is determined by how much sun exposure you received in your youth. People who had severe sunburns as children are at much higher risk of skin cancers than those who never burned. Since most skin cancers are slow to develop, the sun exposure you get later in life is less damaging than the exposure you get in childhood. That doesn't mean you shouldn't be careful. If you plan to be in the sun for more than ten or twenty minutes a day, you should take precautions.

Exposure to ultraviolet light not only ages your skin by destroying elastin and promoting wrinkles, but also damages the chromosomes in your skin cells. Chromosomes are the strands of DNA contained in each cell in your body. If you look through a microscope at sun-damaged skin cells, you can see actual breaks in the chromosomes where they have been damaged by solar radiation. This chromosomal damage can lead to cancers. Amazingly, the sun can even damage the chromosomes in cells not directly exposed to sunlight.

There are essentially three major kinds of skin cancers: basal cell cancers, squamous cell cancers, and malignant melanomas. Ninety percent of the roughly 400,000 reported cases of skin cancers each year are either basal or squamous cell cancers. Although these forms are rarely fatal and can usually be removed surgically without major repercussions, they are often disfiguring. In contrast, malignant melanomas are very serious and can be fatal. Approximately 34,000 cases of malignant melanomas are reported each year. Although Caucasians suffer skin cancers at somewhat higher rates than Asians, Hispanics, or African Americans, anyone can get skin cancers. More important, skin cancer rates are increasing annually among all population groups.

People who are at a particular risk are those with a family history of skin cancers and those who were excessively exposed to the sun, especially those who had severe burns, during childhood. If you have moles or a family history of moles, you need to be especially attentive to skin cancers. Look for changes in the color, size, or shape of moles. If you note any changes, see your doctor immediately. A mole that looks irregular, has variable colors, or is larger than a quarter of an inch in diameter should be examined by your doctor. Do self-examinations regularly. And have a family member, spouse, or friend check the places that are hard for you to see for any suspicious moles or changes in moles.

Use sunscreen. If you plan to be in the sun for more than twenty minutes, you should use a sunscreen of at least SPF-15. SPF stands for 'sun protection factor,' and the number fifteen means that you get fifteen times the level of protection that you would get if you wore no sunscreen at all. Everyone under the age of thirty should use at least that level of protection, no matter how long he or she is in the sun. Likewise, SPF-30 means you get thirty times the protection. But SPF is only the beginning. More important, you need broad-spectrum protection.

There are three kinds of ultraviolet (UV) rays. Ultraviolet A (UVA) rays, the rays with the longest wavelength, are the rays that cause you to tan. They are the safest of the ultraviolet rays but can cause cancers and definitely promote wrinkles. Ultraviolet B (UVB) rays are somewhat more dangerous and are the most common cause of sunburn and skin cancers. Ultraviolet C (UVC) rays—those with the shortest wavelength—are the most dangerous, causing high rates of cancers. Luckily, the ozone layer blocks out most of these UVC rays, although in such Southern Hemisphere countries as Australia and New Zealand, where the ozone layer is damaged, you need to be particularly careful and use sunscreen that protects against exposure to UVC.

Different sunscreens use different chemicals to block out rays. Some use PABA; others use benophenones or parisol 1789. Each composition is better than the others at blocking a particular type of UV ray. Studies on albino rats show that mixing all three—thus getting protection from all the kinds of UV rays—provides the best overall protection. Consider using two or three different sunscreens at once, a PABA-based one, a benophenone-based one, and a parsol 1789-based one. If you are going to be out a long time, you should also use zinc oxide on areas particularly vulnerable to skin cancers, like the lips and nose. If you are planning on exercising or being in the water, make sure to apply water-resistant products or, better yet, waterproof products. Finally, apply products liberally and often. The consistent use of sunscreen helps preserve your skin, preventing skin cancers and wrinkling.

Don't think that you need to cover only your face. Skin cancers can appear anywhere on the body, even on areas that have not had excessive exposure to the sun. Although cancers are more likely to occur in areas that the sun has reached, it has recently been shown that too much sun can cause cancers anywhere on the body. For example, construction workers who get tan only on their necks and arms can develop skin cancers on parts of their bodies that have never been exposed to the son.

Finally, avoid tanning beds, which emit a lot of UVA rays. Remember that UVA rays cause wrinkling. If you decide to use a tanning bed, do not expose yourself for more than ten minutes a day and wear a physical block sunscreen like titanium dioxide or zinc oxide on such vulnerable areas as the lips, nose, ears, and shoulders. If you insist on having a tan, consider using the no-sun tanning cream dihydroxyacetone. It poses no known risks, and most experts believe that it is safer than baking in the sun.

So, remember, some sun is good. It helps to promote the production of vitamin D and to prevent certain kinds of depression. Just be careful about getting too much sun. Overexposure can make your RealAge 0.9 years older. Also, don't neglect to take vitamin D supplements and to eat a diet rich in vitamin D  because the sun probably won't give you enough.

(PREVENTING  WRINKLES:  COMMON  SENSE  SHOULD  TELL  YOU  THAT  AIR,  WIND,  SUN,  AND  WASHING,  DRIES  OUT  THE  SKIN.  YOU  NEED  TO  PUT  BACK  MOISTURE  BY  USING  A  SKIN  CREAM,  AT  LEAST  TWICE  A  DAY,  MORNING  AND  EVENING.  IT  HAS  ALSO  BEEN  SHOWN  VIA  TV  "INVESTIGATIVE  PROGRAMS"  THAT  SPENDING  MORE  THAN  $25  FOR  SKIN  CREAM,  IS  THROWING  YOUR  MONEY  DOWN  THE  TOILET  -  Keith Hunt)

Now that we've talked about cancers and environmental risk, let's consider other kinds of immune system ageing. Did you know that flossing your teeth is one of the best and easiest ways to keep your immune system young?

Keep Smiling:

Keeping Your Teeth—

and Heart—Young

If I asked you to list things that mark the transition to old age, I bet that the word dentures would be near the top of the list. In all the cartoons and stereotypes, the typical 'old' person wears dentures. Tooth loss, through cavities and disease, makes us feel and look old like almost nothing else. But it's not just our vanity that's at stake. Dental disease and tooth loss don't just make us look older, they make us older. Indeed, periodontal disease can make our RealAge more than 3.4 years older.

Two major studies and another smaller study confirm that the presence or absence of cavities doesn't seem to make a difference in your overall health or longevity, although cavities do lead to dentures faster. The presence of gum disease, called gingivitis, or diseases that destroy the underlying jawbone, called periodontal diseases, do affect the rate of ageing. These studies show that the presence of periodontal diseases, diseases most common in people with tooth loss, actually affects longevity. The best of these studies, done at Emory University in conjunction with the Centers for Disease Control, indicated that people with gingivitis and periodontitis have a mortality rate that is 23 percent to 46 percent higher than those who don't. When translated into RealAge terms, these dental diseases make you more than 3.4 years older.

Why? They are linked to increased rates of cardiovascular disease and strokes, as well as to an increase in mortality from other causes, such as infections. Conversely, the absence of periodontal diseases makes you 6.4 years younger than the median person. 

When I first read these studies, I couldn't believe the findings. Why would dental health affect arterial health? I've never been one to savor a visit to the dentist, and I had always regarded dental health as primarily a cosmetic issue. We want healthy teeth because a nice white smile looks good. I assumed that the correlation between dental disease and higher death rates was due to confounding factors: I assumed that people with other bad health habits—smoking, overeating, too much alcohol consumption—would also be more likely to develop dental disease. But I was wrong, very wrong. Flossing your teeth daily can make your arteries younger. The probable reason: Flossing helps keep your immune system young. For example, men under age fifty who have advanced periodontal disease are 2.6 times more likely to die prematurely and three times more likely to die from heart disease than are those who have healthy teeth and gums. Why would this be so?

Although the data remain sketchy, a plausible hypothesis is that the same bacteria that cause periodontal disease also trigger an immune response, inflammation, that causes the arteries to swell. The swelling of the arterial walls results in a constriction of blood flow that can lead to a higher incidence of cardiovascular disease. Inflammation and constriction cause a buildup of lipid deposits along the arterial walls. Furthermore, this inflammation destabilizes already existing plaques. Indeed, a bacterial strain commonly found in tooth plaque has also been found in the fatty deposits that can clog your arteries. Other studies have shown that periodontal disease leads to a higher white blood cell count, which is an indicator that the immune system is under increased stress.

Hence, it appears that the same plaque that causes tooth decay—the sticky coating of bacteria, salvia, and food deposits—also needlessly ages both your immune system and your arteries. Whether the arterial-swelling theory is true, my 'confounding-factors' theory was disproved. All the major studies done on dental disease and longevity had adjusted for the very confounding factors I was worried about, such as smoking, alcohol, and cholesterol levels, and still found a distinct relationship between the incidence of periodontal disease and a shortened life span. Poor oral hygiene and particularly increased tooth loss are important indicators of your risk. (The fewer teeth you have, the greater your risk of gum infections.)

What should you do to prevent this unnecessary ageing? Do the things you already know you should do. Brush your teeth with a fluoride toothpaste several times a day, especially after eating. (Some studies suggest that it may be more effective to brush with no toothpaste, but these findings are still preliminary.) If you cannot brush after a meal, chew sugarless gum instead. When you brush, make sure to brush your tongue, to get rid of bacteria that can cause gum disease and bad breath. Also, floss every day. Flossing is perhaps the most important thing you can do to prevent periodontal disease and the element of our daily routine that we are most likely to skip.

Other factors that appear to increase the incidence of periodontal disease are smoking and stress. So there's yet another incentive to quit smoking and to learn to manage stress. Finally, go to the dentist at least once, but preferably twice, a year to have your teeth cleaned and examined. And keep smiling, because each time you floss, you are making yourself younger.

(MY  DAD  USED  TO  BRUSH  HIS  TEETH  AFTER  EVERY  MEAL [TOOK  A  TOOTH  BRUSH  WITH  HIM  TO  WORK]. HIS  DENTIST  ON  ONE  VISIT  SAID  TO  HIM,  "YOU  ARE  BRUSHING  YOUR  TEETH  TOO  MUCH,  YOU  ARE  BRUSHING  AWAY  THE  ENAMEL."  TOOTH  AND  GUM  AND  JAW  BONE  STRENGTH  IS  FROM  YOUR  DIET  AND  GETTING  PLENTY  OF  CALCIUM  AND  VITAMIN  D.  AN  OVERALL  HEALTHY  BODY  MEANS  YOU  WILL  HAVE  HEALTHY  GUMS.  MY  DAD  WOULD  ALSO  WASH  HIS  MOUTH  OUT  WITH  "LISTERENE"  OR  SIMILAR  MOUTH  WASH,  ONCE  A  DAY - Keith Hunt)

The Immune System:

The Final Word—

Or Just the Beginning

This chapter has been an introduction to the immune system. The rest of the book tells you even more about the ageing of the immune system and, more important, what you can do to prevent it. More and more, we are learning that our choices and behaviors change this rate of ageing. All of us can do things to keep our immune systems strong and young, and there's no better way to prevent cancer and the myriad other autoimmune diseases that age us.

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TO  BE  CONTINUED

REAL  AGE

Environmental Hazards

JUST  BECAUSE  IT'S  A  TOUGH  WORLD OUT  THERE  DOESN'T  MEAN  IT  HAS  TO MAKE  YOU  OLD

Living young means living smart. And that means planning ahead to avoid situations that can cause ageing. Simple decisions like choosing the nonsmoking section of a restaurant or having safe sex help you to stay young. Accidents and unintentional poisonings are the third leading killer in the United States. Even though we don't equate traffic, domestic, or work-related accidents with ageing, they can temporarily or permanently disable you and cause a decline in your quality of life. In RealAge terms, accidents will age you. Environmental toxins—whether from cigarettes, pesticides, or air pollution— are major contributors to cancers and other diseases. Learn to be proactive in spotting potential dangers before they make you older. Whether it's quitting smoking, avoiding drugs, or having safe sex—lots of it!—you can help keep yourself young. Learning how to live safely in the world around you will make your RealAge as much as twelve years younger.

No surprises: Smoking makes you get old fast. Indeed, smoking can add eight years to your RealAge. Secondhand smoke causes ageing, too. Just one hour in a smoke-filled room is the equivalent of smoking four cigarettes. Whatever the source, smoke increases your risk of heart and lung disease, weakens your immune system, and is a proven carcinogen. If you're a smoker, learn tricks that can help motivate you to quit once and for all. Celebrating 'year-younger' parties, taking walks at lunchtime, and making bets with other 'quitters' can help you resist the urge. Learn how to manage the roller coaster of stopping and starting while on your way to becoming smoke-free. The Real Age benefit of quitting smoking: You get back seven of the eight years that smoking has taken from you. Heavy exposure to secondhand smoke can age you almost seven years, too.

Difficulty rating: Most difficult

Eighty percent of all accidents are avoidable. Taking proper safety precautions in everything you do, whether at home or on the job, can help make your RealAge one to six years younger.

Difficulty rating: Moderately easy

What, you ask, do seat belts and helmets have to do with staying younger? By taking routine safety precautions, like wearing a seat belt when driving, or wearing a helmet when biking, you can make your RealAge 0.6 to 3.4 years younger. Although avoiding accidents has nothing to do with biologic ageing per se, it has a lot to do with the length and quality of our lives.

Difficulty rating: Quick fix

Air pollution, exposure to toxic chemicals, and living in houses with high levels of radon or asbestos can increase your cancer risk to the level of someone five to ten years older. Learn how to recognize potential environmental hazards and how to avoid exposure to toxins that can make your RealAge 2.8 years older.

Difficulty rating: Moderately difficult

Sex and drugs, the symbols of wild youth, can keep us young or make us old, Fast. By enjoying sex within the confines of a mutually monogamous relationship or practicing safe sex during casual sexual encounters— avoiding high-risk partners and knowing their sexual histories, and always using a condom, and using it correctly—you can make your RealAge as much as 0.9 years younger. Better still, having lots of sex may prevent ageing even more. Having sex more than once a week, the national average, can reduce your RealAge, too. Although these data are preliminary, several studies indicated that having sex frequently is associated with a RealAge that is two to eight years younger. By not using drugs and seeking counseling if drug use is a problem, you can make your RealAge more than eight years younger.

(FOR  THE  CHRISTIAN  SEX  IS  ONLY  IN  MARRIAGE.  YES  SEX  CAN  MAKE  YOU  YOUNGER,  THE  EXERCISE  AND  FLOODING  THE  BODY  WITH  GOOD  HORMONES,  HELPS  TO  KEEP  YOU  YOUNG;  BUT  AS  THERE  IS  MUCH  MORE  TO  STAYING  YOUNG  THAN  HAVING  SEX.  YOU  CAN  STILL  BE  YOUNG  WITHOUT  SEX.  I'VE  BEEN  SINGLE  SINCE  1987,  AND  NO  SEXUAL  RELATIONS  WITH  ANYONE [A  CHRISTIAN  CANNOT  UNTIL  MARRIED]  AND  I'VE  STAYED  MIGHTY  YOUNG  FOR  BEING  NOW  AS  I  WRITE,  71  YEARS  OLD  -  Keith Hunt)

Difficulty rating: Moderately easy to difficult

Anything that keeps you healthy keeps you young. You don't exist outside the world but in it, and everything with which you come in contact affects the rate at which you age. The three leading causes of death and disability are arterial ageing; immune system ageing; and environmental hazards, such as accidents and unintentional injuries. It is easy to understand how damaging your arteries or weakening your immune system may make you older. But how do preventing accidents, avoiding environmental hazards, and reducing the risk of injuries keep you young?

Environmental factors affect your health and the length of your life much more than inherited genetics do. Your environment consists of everything that is not the body itself: the air you breathe, the city or town you live in, the food you eat, and the people you know. Learning to navigate through the world around you so it doesn't harm you is one of the keys to staying young. And that means using some common sense.

Although we don't tend to think about things like wearing seat belts or bicycle helmets as factors related to ageing, I think they should be regarded as such. The ageing caused by accidents isn't cumulative but sudden. Many accidents, particularly auto accidents, are fatal—and these fatalities can often be avoided. This is the kind of  'instant ageing' all of us hope to avoid. An injury from an accident can trigger a chain reaction in which you give up other Age Reduction strategies as well. For instance, you get into a car accident. Because you don't wear your seat belt, you injure your back. That prevents you from staying active and exercising. When you quit exercising, you gain weight, so your cholesterol and stress levels increase and your arteries begin to show signs of age. The injury prevents you from keeping active and involved. All of a sudden, you are living the life of someone much older. Just because you forgot to buckle that seat belt.

The same is true for toxins in the environment around us. Whether it's cigarette smoke in the office or radon in your home, these toxins can lead to increased ageing. Avoiding exposure to known carcinogens, whether they are pesticides or asbestos, can help keep you young longer. Not smoking, abusing drugs, or having unprotected sex are all behaviors you can adopt to keep yourself from ageing too fast. By choosing to protect yourself against the risks you face in the world around you, you are building your own youth-protection plan.

Tobacco:- Where There's Smoke, There's Fire

Not even the tobacco companies deny it: Smoking kills. There is not a soul who doesn't know smoking is bad for health, not a soul who doesn't know that it causes cancer and lung disease. Smoking can be blamed for nearly half the premature deaths each year, more than four hundred thousand. Smoking remains the greatest public health hazard we face.

Even if it doesn't kill you, smoking will make you older. A lot older. The effects are not something that show up thirty years down the line. Smoking makes you older right now. Today. You see it as new wrinkles in your face; tobacco smoke ages the skin prematurely. You notice it as shortness of breath; smoking decreases the amount of oxygen that gets to your cells, causing them to age faster than they should, causing emphysema and a high incidence of respiratory illnesses. You also feel it as a loss of stamina and energy. Smoking damages your cardiovascular system, causing high blood pressure and clogging of the arteries.

If you look at the American population as a whole, smoking makes us more than 250 million years older than we need to be. At 350 billion dollars in settlements, the tobacco industry is getting off cheap. If we valued each year of life lost to cigarettes at fifty thousand dollars, the tobacco companies would owe us fifty times that amount. If you're a smoker and have a pack-a-day habit, stop right here and add eight years to your RealAge. Think you're fifty? How does fifty-eight sound? Think you're forty? Try forty-eight on for size. Even if you smoke just four cigarettes a day, barely any at all, your RealAge is 2.6 years older. Even if you don't smoke, but live with a smoker or work in a smoke-filled environment just four hours a day, your RealAge is almost seven years older.

To start smoking is easy, to quit is hard. Cigarettes are both physiologically and psychologically addictive, and the habit is very hard to kick. That's why nearly one out of three Americans smoke—some 33 percent of men and 28 percent of women—continue to smoke despite the warnings and despite repeated attempts to quit.

If everyone stopped smoking tomorrow, 30 percent of all cancer-related deaths, 30 percent of all cardiovascular disease-related deaths, and 24 percent of all pneumonia and influenza-related deaths would be eliminated. Unfortunately, it's not easy. Of the 50 million Americans who smoke, 70 percent want to quit, and more than a third of them try each year. Only about 3 percent actually succeed.

Why? In large part, because of the highly addictive nature of cigarettes. But that is only part of it. We often see the risk of cigarettes as something far off in the future. 'It may hurt me some day, but what's one more cigarette today?' smokers often say. That's the wrong way to think about it. Thinking about the diseases or risks associated with smoking makes the job of quitting too onerous.

Instead, start thinking about smoking as a choice—a choice you make about how fast you will age. Every cigarette you smoke is a choice you make to get older faster. Every cigarette you don't smoke—every time you fight that urge and win—is a choice you make to get younger.

As I mentioned in Chapter 1, 1 first developed the RealAge concept to help a friend quit smoking. Those eight extra years caused by smoking were enough to make him sit up and take notice, and he kicked the habit. In the past thirteen years, Simon has gone from a RealAge that was fourteen years older than his calendar age (when all factors, including smoking, were considered) to one that is five years younger than his calendar age. Back then, he was forty-nine with a RealAge of sixty-three; now he's sixty-two with a RealAge of fifty-seven. And the effect: He lives younger now than he did thirteen years ago, with much more vigor and energy than he ever could have imagined. If you are a smoker and give up the habit, you will get younger, too. 

Miraculously, the effects of smoking are largely reversible. Although smoking a pack a day makes a person eight years older in RealAge, the cessation of smoking can win back seven of those years. The net effect of being a former smoker is that a person is only about one year older in RealAge. And the benefits of not smoking start almost immediately. Within just twelve hours of quitting, the body begins to get younger. Carbon monoxide levels decrease, and the blood can carry more oxygen to the cells in the body. In only a few weeks, damaged nerve endings in the mouth and throat begin to regenerate, and the bronchial tubes begin to open.

Go just two months without a puff and you can celebrate your first year-younger party. After five months, you pass the point where you feel worse because you quit, since the nicotine cravings subside, and you start feeling better overall. The immune system will show signs of being stronger. You will be at a lower risk of getting colds and other kinds of respiratory tract infections. The gain: two years younger. Within eight months, your lungs will be clearer and your stamina will increase. After one year of not smoking, you will be three years younger. How's that for a New Year's resolution? Three years younger in just one year. In two years, your risk of having a heart attack and stroke will decrease considerably, and after five smoke-free years, your level of arterial ageing will return almost to that of people who have never smoked. The risk of developing cancer and other forms of immune system ageing will equal the average risk of nonsmokers. Another way of saying it is this: If you give up a pack-a-day habit, you will become a year younger (and can celebrate year-younger parties) at two, five, eight, thirteen, twenty-two, thirty-two, and sixty months from the time you quit.

When Mary Jane came to run the library in my department, she had been a smoker for thirty-five years. Her smoking habit was causing her enormous harm. She was asthmatic, diabetic, and sixty pounds overweight. Her once-an-hour run for a smoke outside had slowed to a walk, with lots of pauses to catch her breath. She also routinely missed more than her allotted number of sick days, suffering recurrent bouts of upper respiratory tract infections.

As often as she considered the idea of quitting, she couldn't actually quit. Many mornings she'd say, 'I'm never going to smoke again.' Usually by the next day, she'd be puffing away again. Then she found she needed to have a major operation. Her diabetes and asthma were both out of control, and her health was in a crisis state. Finally, she decided she had to quit. 'In life you have to make choices. I had to make the choice: Was I going to live or die? When you realize that the alternative is dying, quitting's not that hard.'

Mary Jane had her doctor prescribe nicotine patches and pills that helped ease her cravings. She walked a lot. She avoided situations in which she knew she might encounter smokers.

Giving up smoking was one of the hardest things Mary Jane ever had to do. Those first few months were especially difficult. Today, she hasn't even had a puff in more than three years. No longer smoking made her RealAge six years younger. And this is not even the best part. She's also managed to get her diabetes and asthma under control, and she lost sixty-five pounds. 'I feel one hundred percent better,' she told me proudly. 'I can't imagine going back to smoking again.'

We celebrated Mary Jane's first year-younger party just two months after she smoked her last cigarette. A year later, at her third year-younger party, the department gave Mary Jane some of those days she used to take as sick days as vacation days—her reward for all the new energy she was putting into her job and for sticking to her commitment to kick the habit once and for all.

Beyond the Smoke Screen: How Smoking Ages You

If you're a smoker, you don't want to hear preaching. You know it's bad for you. Maybe you've even tried to quit. Most of all, you're tired of the self-righteous attitude that nonsmokers can have. I don't blame you. My intent isn't to preach, but to give you the facts and let you decide. That's how I've helped seventeen of the last eighteen smokers I've worked with kick the habit. I'll simply present the studies and explain scientifically how smoking ages you. The choice to quit is yours, and all the credit for quitting will be yours, too. The whole point of RealAge is that the age you are—how young you are and can be—is in large part controlled by you.

So, what are the facts? How, exacdy, does smoking cause the body to age? Smoking affects the whole body, ageing all of its major systems and organs. It causes arterial and heart disease and is responsible for more than 80 percent of all deaths from heart disease in those under fifty. And, of course, as we all know, it causes cancer, lung disease, and emphysema. In addition, smokers have more colds, cases of pneumonia, and other infections than do nonsmokers.

Smoking and Cardiovascular Disease

To understand the physiologic effects of tobacco smoke, let's consider one example—cardiovascular disease. For decades, doctors have known that smokers suffer considerably more heart attacks than nonsmokers. Heavy smokers are ten times the risk of a heart attack as nonsmokers. Studies have reported that as many as 40 percent of all stroke victims are smokers. How exactly does smoking cause cardiovascular ageing?

Cigarettes contain more than four thousand identifiable contaminants besides nicotine, which is generally considered to be the addictive component in tobacco. Since cigarette smoke increases carbon monoxide levels in the blood, the delivery of oxygen to the heart and other tissues decreases. Cigarette smoke also inhibits the ability of the breathing tubes to clear secretions properly, increasing the number of infections.

As I discussed in the chapter on arterial ageing, the elasticity of the arteries (their ability to dilate) is directly tied to their youthfulness. The more elastic your arteries, the younger you are. Components of tobacco smoke inhibit the ability of the arteries to dilate. When exposed to the contaminants in cigarette smoke, the arteries are unable to expand properly and remain unnecessarily narrow, a condition that increases the likelihood that they will become clogged. Why does this happen? Scientists speculate that the toxins in cigarette smoke damage the lining of the arteries (the endothelium) and may inhibit the body's production of the chemical component that allows the arteries to expand when the flow of blood increases—for example, when you're exercising. Even in 'passive smokers'—people who don't smoke but are often exposed to secondhand smoke—the ability of the arteries to dilate is less than 50 percent of that in people who are never exposed to tobacco smoke. But this is just the beginning.

To make matters worse, smoking also increases the amount of atherosclerotic plaque, the fatty buildup that clogs arteries. Exposure to the toxins in cigarette smoke makes the platelets in the blood more prone to clotting. As if all that were not enough, studies have found that plaques are more likely to rupture suddenly in smokers than in nonsmokers. If a plaque ruptures, it can create a rough surface on which a clot can form or flow through the bloodstream, potentially causing a heart attack or stroke. In addition, the nicotine in cigarette smoke, when present in the bloodstream, raises blood pressure, significantly affecting the rate at which the arteries age. For reasons that are unclear, smoking reduces the level of HDL ('healthy') cholesterol in your bloodstream.

One study found that women who smoked a pack and a half a day had five to seven times the risk of heart attack as women who had never smoked. But don't kid yourself: No level of smoking is safe. Even women who smoked only one to four cigarettes a day had a risk of heart attack that was 2 times higher than that of nonsmokers. Keep in mind that the impact of cigarette smoking is not gender specific: Both men and women suffer from the arterial ageing smoking causes.

Smoking and Cancer

Then, of course, there's cancer. Lung cancer is the most common cause of deaths from cancers, accounting for 34 percent of the fatal cancers in men and 18 percent of the fatal cancers in women. Smoking can be blamed for nearly 90 percent of all lung cancers in the United States and more than 130,000 deaths from lung cancer deaths annually. Among the four thousand chemical compounds that are commonly found in cigarettes, more than 40 percent are known to interact directly with DNA to cause genetic changes that lead to cancer.

Many of the components of tobacco smoke are oxidants, which increase the number of free radicals in the body. Free radicals, you will remember, are the waste products of 'oxidant' metabolism that have extra or unbalanced electrons that damage our organs and DNA. These free radicals accelerate ageing by causing premature cellular ageing and by promoting cancers. Exposure even to low amounts of cigarette smoke can measurably increase the amount of free-radical damage to the DNA within your cells. For example, in animal studies, dogs that were exposed to the smoke of just one cigarette—not enough to increase their heart rates, blood pressure, or other physiologic measures—had twice the amounts of free-radical damage as dogs not exposed to cigarette smoke. Hamsters exposed to the secondhand smoke equivalent of just six cigarettes a day had twice the number of antioxidant enzymes in their lungs—an indication that their bodies were gearing up to repair significant free-radical damage.

Tobacco ages the immune system in two ways. First, it contains toxins that damage DNA, causing cancers. And, as I mentioned in Chapter 5, two protective systems fight ageing of the immune system and cancer in particular. Smoking knocks both of those systems out of kilter, making the immune system less vigilant about catching cancers. And it is not just lung cancer. Smoking increases the risk of mouth, throat, kidney, and bladder cancers, as well. A Danish study found that women who had smoked for more than thirty years were 60 percent more likely to develop breast cancer than nonsmokers.

Some people seem to be more susceptible than others to the carcinogenic effect of smoke because they have higher levels of specific enzymes that activate the carcinogens contained in smoke. Nitrosamines, by-products of cigarette smoking, interact with the body's own enzymes to create a new chemical that is highly carcinogenic, or damaging to DNA. Some people have much more or much less of the human acetylator enzyme that helps the body remove certain carcinogens from the body. The people who produce less of this enzyme than others, called 'slow acetylators,' are predisposed to breast cancer, as well as other kinds of cancer. Don't bank on the fact that you may have better genes for fighting cancer. The ingestion of any tobacco products, whether through smoking, chewing, or inhaling secondhand smoke, increases immune system ageing.

Smoking and Emphysema

To add to the list of dangers associated with smoking, it is also the primary cause of emphysema, the premature ageing of the lungs. More than 2 million people in the United States (and possibly many more than that) suffer from emphysema, the fourth leading cause of death in the United States. Emphysema occurs when the air sacs in the lungs die. Scientists have long suspected that emphysema is caused by an autoimmune response, a chemical reaction in the smoker's body that causes the body to kill its own lung cells and air sacs. Normally, the immune response is well gauged to react to the low-level assaults of everyday living. The immune system habitually kills off single cells that show signs of distress. When the lungs are exposed to the constant irritation of cigarette smoke, this normally protective system overreacts. When many, many cells show signs of distress, the body begins to kill off its air sacs en masse. And when many of the cells needed for taking in oxygen and expelling carbon dioxide are gone, the smoker is barely able to breathe.

Smoking and Other Ageing Effects

As if cardiovascular disease, cancer, and emphysema were not enough, smoking has been tied to other kinds of ageing effects as well. For example, since smokers have a decreased immunity to disease, they suffer many more respiratory infections. Smokers were more than twice as likely as non-smokers to become impotent or unable to experience orgasm, and report reduced sexual pleasure. Heavy smoking also leads to an increase in macular degeneration, an eye disease commonly associated with old age, at a rate more than 2V2 times that of nonsmokers. Smokers are twice as likely to get diabetes, and diabetics age at twice the normal rate if the disease is not properly managed (see Chapter 12). For people with mild thyroid disorders (more than 10 percent of Americans), heavy smoking can trigger failure of the thyroid gland, seriously raising cholesterol levels and further accelerating arterial ageing.

Unfortunately, smoking amplifies other risk factors disproportionately. For example, in families with a history of heart and arterial disease, smokers have fifteen times the risk of heart attack as nonsmokers from the same families. When people with high cholesterol levels are compared, the smokers have thirty-five times the rate of heart attacks as the nonsmokers. Alcohol and cigarettes are another deadly combination: People who drink alcohol and smoke are at a much higher risk of mouth, throat, and liver cancers than people who do either one or the other. Alcohol causes the body to make enzymes that metabolize tobacco smoke into highly carcinogenic substances.

Not a very pleasant picture, is it? By triggering all these responses in the body, cigarette smoking is triggering an ageing response. Most of what I have just described is probably a restatement of facts you already know, but there is still the big sticking point that keeps most smokers smoking: How do you beat the addiction?

No More Cigarette 'Buts': Kicking the Habit

If you are really serious about quitting, this book is probably just the beginning. Or, better said, one more beginning. For most smokers, quitting is an on-again, off-again routine. You stop. You struggle with it for a few days, weeks, or months. Then the craving gets you, and you decide, 'What's one cigarette?' You light up, and you're back to square one, a smoker once again. Since this book is about the effects of ageing, rather than the techniques for beating an addiction, I am not going to go into all the details here. There are many, many services and information sources that help smokers quit—everything from high-priced inpatient clinics to free support groups at community centers. If you are serious about quitting, talk to your physician, search for smoking-ces-sation programs and support groups in your area, buy a few books about kicking the habit, and consider nicotine patches or chewing gum and pills to help ease your cravings. Different methods work better for different people. Thinking about quitting in terms of ageing may be just the ticket for you: Eight years is a lot of time to give up to just one habit.

There is no question that cigarettes are psychologically and physiologically addictive. For example, laboratory mice used in smoking studies learn what times of day they will be exposed to smoke and race expectantly to the side of the cage where the smoke comes out at the appointed hour. They need their smoke! To be fair, it's hard for me even to imagine what it's like to quit since I've never been a smoker. But having watched friends and my patients struggle through it, I know that it's a major battle. People who successfully quit and stay away from cigarettes deserve a lot of credit.

Years of research on cigarette smoking have brought us closer to understanding the biochemical processes by which the body becomes addicted to nicotine. Brairi-scan studies have shown that smoking triggers a release of dopamine in the brain. Dopamine, a chemical that dulls the body's response to pain and makes you feel pleasure, is involved in everything from muscle control to emotional state. Many addictive drugs, including cocaine and even caffeine, trigger a dopamine reaction, too. The more you smoke, the more your body adjusts to a higher level of dopamine release. These elevated levels become your body's normal state. When you quit, the body goes into withdrawal. The question is, How can you beat the cravings long enough for your body to readjust to its smoke-free state?

If you are a typical smoker, you will quit smoking. Again. And again. And again. You will kick the habit, start up anew, and then have to kick it all over. Almost no one can quit in one try. But don't become disheartened—just keep trying. One of the problems with quitting is that at first you feel worse. For the first several weeks, you feel intense cravings and, since nicotine is a stimulant, rather sluggish. After a few weeks, those feelings will subside. Just stick to your guns.

Only 2 percent of smokers can successfully quit the first time. Using nicotine patches doubles the success rate to 4 percent. One study found that combining the patch with anticraving pills boosted the effectiveness to almost 60 percent. In my own practice, the success rate has been much higher—seventeen of the last eighteen patients who tried to quit did so. Many had been pack-a-day smokers for a decade or more. By combining the patch and the pills with RealAge planning, they stopped smoking and started getting younger. (For my patients, I prescribe bupropion—100 mg of the slow-release formula of Wellbutrin, twice daily, the dosage adjusted to body weight. Three days later, I advise them to apply a nicotine patch, throw away all cigarettes and cigarette items, and begin additional exercise. Talk to your doctor about the best regimen for you.)

If you are a smoker, don't try to quit 'cold turkey.' See your doctor and develop a plan. Ease the physiologic cravings by getting patches and pills and ease the psychologic urge to smoke by developing a support system that will keep you away from cigarettes. And don't forget to include 'year-younger' parties in your plan: You need to celebrate your successes.

Changing little day-to-day habits can make quitting easier. For example, increasing the amount of exercise you get helps reduce the craving for cigarettes. Avoid environments where smokers congregate and, instead, frequent places where smoking is prohibited—museums, libraries, or theaters. Regimented programs provided by smoking-cessation clinics and community support groups give some people the willpower and supportive environment they need to stop smoking.

Smoking and the Weight Gain Blues

One of the biggest fears that people have about quitting smoking is the weight gain that often follows. On average, men gain about ten pounds within six months of quitting, and women, about eight pounds. Weight gain should be the least of your worries. The risk of smoking is far greater than the risk of being overweight. And the weight gain is often temporary. For example, women commonly lose six of the eight pounds that they gained in the first six months within the next eighteen months. With careful planning you can prevent the weight gain altogether. Here are some tips:

Chew sugarless gum. It can help ease the oral cravings.

Have lots of chopped vegetables and low-fat snacks on hand. Popcorn without butter is good to munch on. Fruits, especially small ones like grapes or berries, are another great snack.

Integrate regular exercise and walking into your daily routine. It will help fight the cigarette urge, as well as help keep off the weight.

Don't quit smoking during the holidays. All that rich food will only increase the temptation to overeat.

Find something to do with your hands. Many smokers find comfort in having something to hold. Buy yourself a bunch of desk gadgets or other objects to fiddle with and divert all that nervous energy.

When you feel the temptation to smoke, close your eyes and take a deep breath. Remember all the reasons you quit smoking in the first place. Keep a list of those reasons and add the new benefits of being a reformed smoker to the list as you discover them: more energy, fewer colds, years younger.

Don't downplay your accomplishment. Reward yourself for quitting. You deserve those year-younger parties. Buy yourself a present or give yourself a special treat. Being smoke-free is something to celebrate.

Other tips: Stay busy. It will help keep your mind off cigarettes. Also, throw away all cigarettes and smoking paraphernalia. Avoid coffee, alcohol, and other drinks or food you associate with smoking. Instead, drink lots of water, fruit juices, and herbal teas. Eating small meals instead of one big one keeps blood sugar levels constant, which helps quell the nicotine craving. Avoid behaviors and situations you associate with smoking. If you used to smoke after meals, try to do something else at that time—take a walk, do the dishes. Do positive things that boost your self-image. Go to the dentist and have your teeth cleaned. Have your smoky-smelling clothes cleaned at the dry cleaners. Reward yourself.

If you start smoking again, don't become disheartened. It's not a catastrophe, just a temporary setback. Remember that each time you quit, the easier it will be to quit the next time. And each time you'll get closer to your goal.

One final note: It's never too late to quit In fact, the older you get, the more important it becomes to quit. Smoking causes relatively more ageing among smokers aged forty to seventy-five than younger ones. Smoking is to ageing what putting the gas pedal to the floor is to driving. Smokers in their fifties have more than seventeen times the risk of having a major health event than smokers in their thirties because the rate of smoking-induced ageing has accelerated. That acceleration is measurable at least through age seventy-five. (Beyond that age, there may not be enough smokers still living to say with any accuracy what happens to ageing.) Even if you've smoked for ten, fifteen, or twenty years—or especially if you have—you should quit. Do not think, 'Well, I've smoked this long, why quit now?' Quit now, precisely because you've smoked this long.

Cigar Smoking

Cigars have become the new chic. In the past several years, cigar smoking has tripled in the United States; more than 3 billion cigars were sold in 1996 alone. Cigar bars are opening all over the country as baby boomers take up a habit that was once reserved for the 'old fogy' set.

Since cigar smokers smoke less frequently and do not inhale to the same degree, they believe they are at a lower risk than cigarette smokers. But they are wrong. Cigars are a particularly dangerous form of tobacco. They produce more carbon monoxide and more particulate matter than cigarettes do. Just like cigarettes, they produce benzoapyrene, hydrogen cyanide, and ammonia. Cigars produce more particulate matter, making them more dangerous, not just for the smoker, but for those around him or her as well. Cigars produce a more toxic form of secondhand smoke than cigarettes, so don't think that sitting in that cigar bar without smoking is not doing you harm. Although cigar smokers claim not to inhale, this claim is often untrue. Most former cigarette smokers continue to inhale when they take up the cigar habit.

Cigar smokers are at greater risk of cancers of the lip, mouth, pharynx, and esophagus than cigarette smokers and at about six times the risk of nonsmok-ers. Such cancers are often fatal and, even when nonfatal, can age and disfigure you. No comments, please, about long-lived cigar smokers like Winston Churchill or George Burns. Although we don't know why these people lived so long (good genes or good habits), we do know that other cigar smokers, such as Babe Ruth and Ulysses S. Grant, died young from throat cancers caused by cigar smoking. Smoking one cigar a day makes your RealAge 2.6 years older. Smoking five cigars a day makes your RealAge eight years older.

Passive Smoking

You should not tolerate an environment in which you are exposed to passive smoke. If you live with a smoker, ask that person to go outside to smoke. You'll be giving the message that it's time to quit. Although it may feel like you're being intolerant or uncaring, what you're really saying is that you care enough to make it a whole lot of hassle to smoke. Remember, you're not doing you or your partner any good when you become the passive recipient of that person's smoking habit.

If people smoke around you at work, talk to them to see if there is a way for them to smoke somewhere far away from you. Generally, a solution can be worked out. If your office doesn't have a provision to ensure that you are not exposed to secondhand smoke, talk to your boss or office manager about implementing some kind of policy to ensure a smoke-free environment. If there appears to be no solution to the workplace smoking problem, talk to your local board of public health or Better Business Bureau to find out if there is a city or state no-smoking ordinance. The federal Americans with Disabilities Act requires employers to provide a work environment that will accommodate employees having a variety of disabilities. That means employers must provide a smoke-free environment if they have employees who have either asthma or allergies to smoke.

If you work in certain environments—restaurants or bars, for example—it may be hard to avoid secondhand smoke. See about installation of air filters that recycle the air and decrease particulate matter. This will be good not only for you, but for all the customers, even the smokers.

To minimize your exposure to secondhand smoke, avoid smoke-filled bars, and at restaurants ask to sit in the no-smoking section. Many hotel chains now offer no-smoking rooms, and car rental companies offer no-smoking cars. If you spend more than four hours a day in a smoke-filled environment, your RealAge may be as much as 6.9 years older.

(SOCIETY  HAS  NOW  FOR  SOME  TIME,  SEEN  THE  LIGHT  ON  SECOND-HAND  SMOKE.  THERE  IS  JUST  ABOUT  NO  PUBLIC  OR  WORK  PLACE  WHERE  SMOKING  IS  ALLOWED  -  Keith Hunt)

Smokeless Tobacco

Dip, chew, spit? More than 5 million Americans use smokeless tobacco, and its use is on the rise. Over the past twenty-five years, its use has increased tenfold, making it the fastest-growing segment of the tobacco market.

Many tobacco users think they are avoiding the risk of tobacco by using it in its smokeless form, as snuff or chewing tobacco. They are wrong. Although the risk of lung cancer is lower among people who use chew or snuff, the risk of other cancers is considerably higher.

Smokeless tobacco causes mouth and throat cancers, dental problems, cardiovascular disease, and nicotine addiction, just like smoking does. And just like smoking, it's hard to kick the habit. In fact, the amount of nicotine and other chemicals found in the blood of people who chew is even higher than that found in the blood of smokers.

....................

TO  BE  CONTINUED

AIR POLLUTION....STILL a MAJOR problem!!

YOUR  REAL  AGE

The Air You Breathe: Age Pollutants

According to a report published in 1991 by the Environmental Protection Agency (EPA), 164 million Americans, fully two-thirds of the population, live in areas where the air quality does not meet federal air-quality standards. That means that the majority of us are affected by ageing that is due to pollution. Just how much? That depends on where you live.

The effects of pollution are difficult to quantify because air quality varies so much from area to area, even block to block, and day to day. If one were to generalize about the effect by determining the difference in deaths from all causes in areas with heavy pollution versus areas with little pollution, the RealAge differnce would be 2.8 years.

That statistic, though, can be misleading, as different health effects are brought about by different pollutants. (in addition, heavily polluted areas may have other kinds of factors that affect mortality as well, like higher population density or increased crime.) Nevertheless, pollution appears to have a measurable ageing effect. The different kinds of pollutants include sulfates, ozone, large particulate matter, small particulate matter, lead, asbestos, and aerosols.

Air pollution can aggravate arterial and respiratory problems. A study published in the British Medical Journal found that changes in the level of air pollutants, specifically ozone and black smoke, led to an increase in mortality from all causes, primarily because of an increase of as much as 5 percent in cardiovascular and respiratory ageing. Air quality may also significantly influence the development of asthma, a disease affecting as 15 million Americans. Researchers suspect that some people have a genetic predisposition to asthma, which manifests when the body is confronted by the wrong stressors. Asthma rates are increasing in intensely urban areas, such as in the inner cities of New York and Chicago, suggesting that poor air quality may trigger the onset of the disease. Air quality also affects the number of sinus infections and respiratory illnesses people suffer.

Air quality is measured in particulate matter (PM). The higher the concentration of particulate matter of a certain size, the more likely you are to suffer from premature ageing from heart and lung disease. The smaller the particle, the more potentially injurious. Particles that are 10 microns (PM-lOs) or less in diameter are the most easily (and therefore the most commonly) measured particles for analysis of air pollution. (See Tables 6.3 and 6.4.)

Air pollution does not occur only outdoors. Generally, it has been shown that indoor air pollution parallels that of the air outside. Sophisticated air-filtration systems don't seem to make much difference. Sometimes the indoor air quality is actually worse. 'Building sickness,' essentially a malady caused by poor indoor air quality, is a real illness. Those who work in poorly ventilated buildings have more respiratory infections and complain of fatigue, headache, and nausea more often. If you work or live in a building you think could be causing you health problems, have the building checked.

A particularly notorious indoor pollutant is radon, a naturally occurring gas that is a known carcinogen. Radon, the product of decaying radium and uranium in the soil, seeps into houses from the ground below. A 1995 report in the Journal of the National Cancer Institute estimated that exposure to radon contributed to as many as 10 percent of the deaths from lung cancer. A more recent report by the National Research Council (NRC) boosted that figure to 12 percent. The report also said that smokers are at a particular risk because smoke and radon interact. The NRC report estimated that 6 percent of American homes had excessively high levels of radon. How do you know if your home is one of them? You can buy a radon-testing kit at your local hardware store for about fifty dollars. Choose one that is certified by either the EPA or the state. The best variety are the 'alpha-trak' or 'electret' versions, which are used for ninety days. These versions give a better reading than short-term monitors that do not track changes in gas levels, which can vary over the year. If your house has high levels of radon (over 4 picocuries per liter of air), call the local public health board or the EPA hot line (800-426-4791) to find out how to fix the problem. The usual remedies include having the basement foundation properly sealed and having appropriate ventilation systems installed.

Asbestos is another indoor pollutant, and one that has been associated with higher incidences of lung cancer and other cancers. Asbestos is found in many houses and apartment buildings, especially those built in the 1940s through the 1970s, when asbestos was a major component of many building materials. It is found in insulation, such as that used to wrap water pipes; in certain kinds of flooring; textured paints; old roofing materials; and other sources. Asbestos is not a risk as long as it is contained in a properly sealed wrapping. However, those protective wrappings can crack with age, causing asbestos fibers to leak into the air. As airborne fibers, asbestos particles are extremely carcinogenic. Since it is so expensive to have asbestos removed from your home, most experts recommend leaving it alone unless it is exposed. There are ways of sealing asbestos-containing materials so they present no health risk. For more information, call your local health board or the EPA at the number provided earlier.

Other air pollutants that can cause ageing are smoke and carbon monoxide. These are a particular risk at home. Some toxic fumes are specific to your choices at home: household cleaning fluids, laundry detergents, exterminator pesticides, garden sprays, and dry-cleaning and rug-cleaning fluids. Others are more generalizable. About 15 percent of all deaths of adults from poisoning are due to the inhalation of such vapors as carbon monoxide and gas. Buy a smoke detector and keep it in good working order, with fresh batteries. Smoke detectors have been shown to reduce the risk of death and injury from smoke inhalation by as much as 70 percent in home and apartment fires. Having a carbon monoxide monitor in the home is another quick and easy way to protect your youth. A recent study by the Centers for Disease Control found that having a functioning and well-maintained carbon monoxide monitor could cut the risk of inadvertent carbon monoxide poisoning in half. Since deaths from carbon monoxide poisoning and smoke inhalation are relatively rare, the RealAge benefit is just six to ten days. Nevertheless, why risk that kind of ageing when having two silent monitors can protect you?

We've considered what you can do to minimize ageing from toxins, pollution, and accidents, but that's no fun! Let's look now at the RealAge risks and benefits of sex and drug use. Although drug use makes you age, sex (safe sex) makes you younger. The more, the better!

(THE  ONLY  WAY  WITHIN  THE  LAW  OF  GOD  FOR  MORE  SEX  THE  BETTER  IS  WITHIN  MARRIAGE.  THERE  ARE  MANY  OTHER  WAYS  TO  KEEP  YOUNG  OTHER  THAN  SEX.  I'VE  BEEN  DIVORCED  SINCE  1997  AND  HAD  NO  SEXUAL  RELATIONS  SINCE.  I'M  STILL  MIGHTY  YOUNG  LOOKING,  AND  VERY  FIT.  SEE  MY  FACEBOOK  TO  SEE  PHOTOS  OF  ME  TODAY  -  Keith Hunt)

Table 6.3

The RealAge Effect of Air Pollution

For Men

	Of Exposure to the Following Concentration of Air Pollution Particles per Cubic Meter of Air (ug/m3)*
	Less              9 to             15.6 than9            15.5           to 20.7	20.8             More to 28.4       than 28.4
Calendar Age	RealAge
35	34.2             34.7               35	35.2             35.4
55	52.8            54.4              55	55.2             55.6
70	68.8            69.2              70	70.2             70.7
	For Women

Of Exposure to the Following Concentration of Air Pollution Particles per Cubic Meter of Air (uglm³)*

	Less than 9	9 to 15.5	15.6 to 20.7	20.8 to 28.4	More than 28.4
Calendar Age			RealAge
35	34.5	34.7	35	35.1	35.3
55	53.0	54.6	55	55.1	55.5
70	68.9	69.3	70	70.2	70.7

*In these tables, the concentration of air pollution has been expressed as the amount (in micrograms) of particles that are smaller than 2.5 microns in diameter, per cubic meter of air (ug/m'). You can obtain the numbers for your specific area by consulting the PM-10 pollution numbers at the Web site of the Environmental Protection Agency (www.epa.gov/oar/oaqps/greenbk/pr/state.html) or the 1996 publication of the National Resources Defense Council: Breathtaking: Premature Mortality Due to Particulate Air Pollution in 239 American Cities (see Web site www.nrdc.org/nrdcpro/bt).

Table 6.4

The Ten Worst Metropolitan Areas in the United States (1990-94)

Highest Concentration of Air Pollution  (PM- 10s	or smaller)
	Average Annual
	PM-10 Concentration
	(ug/m3)
Visalia-Tulare-Porterville, California	60.4
Bakersfield, California	54.8
Fresno, California	51.7
Riverside-San Bernardino, California	48.1
Stockton, California	44.8
Los Angeles-Long Beach, California	43.8
Phoenix, Arizona	39.5
Spokane, Washington	38.7
Reno, Nevada	38.5
Las Vegas, Nevada	38.3
Highest Annual Per Capita Death Rates Attributable to Air Pollution
	Deaths Per 100,000
Visalia-Tulare-Porterville, California	123
Bakersfield, California	122
Fresno, California	115
Riverside-San Bernardino, CA	95
Stockton, California	93
Los Angeles-Long Beach, California	79
Steubenville, Ohio/Weirton, West Virginia	78
Las Vegas, Nevada	76
St. Joseph, Missouri	76
Phoenix, Arizona	74

Other cities and areas among the top fifty for premature deaths attributable to particulate-matter air pollution include: Spokane, Washington (ranking, 14); Cleveland, Ohio (20); Reno, Nevada (20); Tampa-St. Petersburg (22); Philadelphia (25); Pittsburgh (28); San Diego, California (28); Providence, Rhode Island (32); Omaha, Nebraska (34); St. Louis, Missouri (34); Chicago (37); Detroit (37); Nashville, Tennessee (37); Atlanta, Georgia (44); and Mobile, Alabama (46).

....................

THE  ABOVE  CHARTS  ARE  OF   COURSE  OUT  OF  DATE  AS  THIS  BOOK  WAS  PUBLISHED  IN  2000.

BUT  ON  THE  NEWS  TONIGHT  [MARCH  25 - 2014]  WAS  THE  NEWS  THAT  AIR  POLLUTION  WORLDWIDE  IS  EPIDEMIC  -  1  IN  8  DEATHS  WORLDWIDE  ARE  CONTRIBUTED  TO  AIR  POLLUTION.  EVEN  IN  A  SMALL  POPULATION  OF  CANDA [ABOUT 33  MILLION]  THEY  SAY  10  MILLION  ARE  EFFECTED  BY  AIR  POLLUTION;  TOO  MANY  CANADIANS  LIKE  TO  LIVE  NEXT  TO  ROADS - SMALL  AND  MAJOR  ROADS.

Keith Hunt

REAL  AGE

Accident Prevention: Protect Your Youth

In 1994, approximately 150,000 Americans died from injuries; 61 percent of these deaths were considered accidental, and 80 percent of those accidental deaths were preventable. For American adults age thirty-five to forty-five, accidental poisoning (primarily drug overdoses), motor vehicle accidents, and firearm accidents are the first, second, and third major causes of death, according to a report by the National Center for Health Statistics. Motor vehicle accidents are the third leading cause of death among Americans under age sixty-five, resulting in over 45,750 deaths and 500,000 serious injuries each year.

(THESE  STATS  ARE  OLD  AS  THE  BOOK  WAS  PUBLISHED  IN  2000  -  Keith Hunt)

Although we tend not to think of avoiding accidents as something we can do to stay young, it is a quick and easy way to do just that. Not only do we risk death in traffic accidents and such accidents as falls (the second leading cause of accidental death), the injuries we sustain are likely to cause ageing because they can make us less mobile, less likely to be active, and more prone to chronic pain. And accidents not only directly cause physical disability and impairment from the injury, they also cause ageing from stress.

As a doctor, what I find maddening about the accident statistics in the United States is that so many accidents are preventable. For example, drunk driving is a leading cause of car accidents, accounting for about 40 percent of all traffic deaths and 9 percent of all injuries (see Chapter 10 on alcohol use and abuse). Although we all know better than to drink and drive, too many of us still do so. The cost of a cab is nothing compared with the cost of your life. But we persist. The question is, Why tempt fate?

I ask that question every time I see a patient who gets hurt because a loaded gun was stored in the house. Or because he thought it would be a good idea to climb out on the roof to clean the gutter but slipped and fell. Or when I see someone in a cast from a ski injury received when playing the daredevil. Although so many accidents are one of a kind in their particulars, they often have something in common: no common sense. If that little voice in your head says, 'Don't do it,' don't do it. If something 'feels' risky, don't risk it. Promptly fix potentially hazardous situations. Don't let the accident-waiting-to-happen become the accident that happened. It's one of the best ways to keep yourself young.

Remember, it's not just at home but at work, too, that you need to pay attention to safety. Most Americans between twenty-two and sixty-five (more than 120 million of us) spend 40 percent of their waking hours at work. Most jobs carry a certain amount of risk from accidental injury. Whether it's the risk of developing carpal tunnel syndrome from typing at a computer or lung cancer from breathing toxic fumes in a factory, your job can be dangerous. Each year, 6,500 Americans die from work-related injuries, and 13.2 million suffer nonfatal injuries. Think about the risks you face on the job and what steps you can take to avoid them. Make choices that help protect your youth. No job is worth getting older for.

These are the general statistics, but what about the particulars? What safety advice should you follow? Let's consider the biggest cause of accidents: transportation. Whether it's a car, bike, or motorcycle, you can get younger while getting from here to there.

Seat Belts: Buckle Up, Youngster! 

As an anesthesiologist, I think about car safety all the time. Every month, I see the victims of auto accidents as they are rushed into the operating room for emergency surgery, clinging to the last thread of life. Perhaps nothing brings it into focus like seeing one of your own there. This past summer, a colleague of mine almost died. Her child did die. A summer vacation in the mountains that should have been perfect but wasn't. It was raining, and the road was slick. Their rented van was winding up a curvy mountain road when a flash flood hit. The van hydroplaned and plummeted over a precipice. Everyone in the van was wearing a seat belt, except my colleague and her child, who were thrown from the van. The child was killed, and my colleague suffered serious internal injuries and broken bones. The fact that she survived at all was a miracle. No one wearing a seat belt was hurt at all.

This is a shocking story that has a very real point. The moral is to buckle your seat belt. It can save your life. And it will make you younger. A recent study estimated that seat belts and air bags reduce a person's risk of severe injury by 61 percent. Simply using a three-point seat belt—one that crosses over both the lap and shoulder—reduces your risk by as much as 45 percent.

Because seat belts have a proven safety record, most states now require that you wear one whenever you are riding in a car. Strap on a seat belt every time you get in a moving vehicle, whether it's your car or a cab or anything else with wheels. Wear a seat belt even if you are sitting in the backseat and make sure that every seat belt has both a lap and a shoulder harness. Keep all seat belts in good working condition. If you have an older car, make sure that the seat belts are up to standard, even if you have to replace the old ones. If you are under 5 feet 2 inches tall, have a small frame, or have children who regularly ride in the car, check to make sure the shoulder harnesses fit properly. If they don't, go to a service dealer and have them adjusted. Don't deliberately slip out of the shoulder strap, either. The shoulder strap significandy reduces the amount of damage to internal organs that would occur if you get into an auto accident.

Also, have your car inspected annually or every five thousand miles. Have the oil, tires, and engine checked. If you are about to go on a long trip, have a mechanic look the car over to make sure it's in good working order. Finally, by making safety a priority when you shop for a car, you are choosing to get younger. Look for cars with a strong safety record. It's worth a little more money for the added youth protection such a record provides.

New cars are required to have air bags. If your car doesn't have them, consider trading it in for a car that does. Air bags reduce the risk of death by 9-16 percent among drivers who use seat belts and by as much as 20 percent among drivers who do not wear seat belts. Experts estimate that air bags have prevented some 1,600 fatalities from head-on collisions over the past six years.

Despite the recent furor over air bags, they still, car per car, accident per accident, save lives. The concern has been that, in rare instances, air bags have deployed rapidly, hurting and even killing the passengers they were supposed to protect. Air bags have been shown to pose risks for only two groups: young children and adults (almost exclusively women) who are shorter than 5 feet 2 inches. Almost all of the adults who died in accidents involving deployed airbags were not wearing seat belts.

Another auto safety youth rule: Drive within five miles an hour of the speed limit; it can keep you three years younger in RealAge. Although it sounds easy, this one is far easier said than done. In developing the RealAge concept, I have run hundreds of people through the computer program that calculates their RealAge. At the end of the run, the computer gives a RealAge reading and makes suggestions for reducing that age even further. A vast majority of people who have taken the test admit to speeding on a regular basis. When the computer asks them if they would be willing to modify their behavior, most of them say, 'No way!' Indeed, more people say that they would rather give up smoking than speeding! It is amazing that so many people refuse to budge on this one: Slowing down and staying close to the speed limit is a reliable way to keep your RealAge younger. Indeed, for drivers under age thirty-five, the most frequent cause of auto accidents is speeding (see Table 6.2). For drivers over age seventy-five, the most frequent cause is unsafe or ill-timed left turns against traffic. Finally, if you can do so, use a cell phone only when you are not driving. Using a cell phone while driving focuses your attention on the conversation; this diversion of attention increases the accident rate.

(IT  IS  BECOMING  A  LAW  IN  MOST  PLACES  THAT  YOU  CANNOT  DRIVE  AND  USE  A  CELL-PHONE - TALKING  AND/OR  TEXTING  -  Keith Hunt)

Motorcycles: Don't Forget the Helmet

We associate motorcycles with wild youth. The truth is, few things can age you so quickly. Five seconds is all it takes to go from 'young' to 'dead.' A motorcyclist is thirty-five times more likely to be killed on the road than the typical car owner. And it is not surprising that most motorcycle deaths and serious trauma come from head injuries. Emergency room doctors have been known to refer crudely to motorcyclists as 'organ donors' because so many victims arrive at the emergency room brain dead, the rest of the body's vital organs intact. Although it sounds harsh, the point is well taken. The risk of death aside, motorcyclists who do survive accidents often endure injuries that are disabling or crippling, including paralysis from spinal cord injury, loss of limbs, and severe and multiple fractures.

Although that youthful urge to hit the road may grab you, choosing to ride a motorcycle is choosing to get older. If you do decide to ride one, try to avoid roads with lots of traffic, go at moderate speeds, wear protective clothing, and make the most important choice for youth—wear a helmet. Comparisons of helmeted and nonhelmeted riders have found that the use of helmets decreased the number of fatalities by as much as 27 percent and that nonhelmeted drivers had two to four times the number of head injuries. Helmets

Table 6.2

The RealAge Effect of Speeding For Men

Driving the Following Miles Over the Speed Limit

Less than 5 mph

5to9mph 9 to 14mph

15 mph or more

Calendar Age			RealAge
35	34.8	35.7		36.6	43.1
55	54.9	55.2		55.3	59.2
70	69.8	70.1		70.2	72.7

For Women

Driving the Following Miles Over the Speed Limit

	Less than 5 mph	5 to 9 mph	9 to	• 14 mph	15 mph or more
Calendar Age			RealAge
35	34.8	35.3		35.5	42.1
55	54-9	55.1		55.1	56.9
70	69.8	70		70.1	71.2

don't make motorcycle riding safe, just safer. After California passed a mandatory helmet law, serious head injuries from motorcycle accidents decreased by 34 percent. In the year after passage of a helmet law in Texas, the number of motorcycle fatalities due to head injuries decreased by 57 percent, and the number of severe injuries to the head in motorcycle accidents declined by 54 percent.

Other safety tips: Keep your headlights on at all times. The risk of fatal daytime crashes decreases by 13 percent simply by keeping the lights on. You should also wear heavy leather boots and such thick clothing as heavy jeans and a leather jacket when riding, to keep your arms and legs covered. This habit helps prevent injury to the feet, legs, and arms. I was shocked to learn from a television sports producer who had covered motorcycle races that professional motorcycle racers rarely finish their careers without losing at least part of a foot. That's not something to look forward to as you age.

Of course, never ride a motorcycle when under the influence of drugs or alcohol. True to the rebel image we associate with motorcycle riders, the rates of driving under the influence are much higher for motorcyclists than for those who drive cars and other types of motor vehicles. More than half of those injured in motorcycle accidents have elevated blood alcohol levels, and more than 40 percent test positive for marijuana use.

Bicycling: A Hardhead for Youth

So you think that taking your bike out for a ride will help lower your RealAge? Indeed it will. You burn more than 450 calories an hour just riding at a moderate pace. Incorporating this type of stamina-building exercise into your life can reduce your RealAge by as much as six years (see Chapter 9). On that same bike ride, you can do something else that will help make you even younger. Wear a helmet. Wearing a helmet can help make your RealAge 0.4 years younger than that of nonhelmeted riders (when calculated at a rate of fifty days per year of bike riding).

Each year more than half a million Americans end up in emergency rooms because of bicycle accidents. Head injuries account for one-third of these emergency room visits, two-thirds of the hospitalizations, and three-fourths of the deaths. And cyclists who suffer head injury are twenty times more likely to die than are those who are injured elsewhere. A recent study found that the use of helmets by bicyclists reduced the risk of head injuries by as much as 85 percent and reduced the risk of brain injury by more than 88 percent. The 'take-home message'? Choose youth. Wearing your helmet will help reduce your risk of injury and will keep your RealAge young.

Does wearing a helmet mean that you won't get a head injury? No. But it does make it less likely. Communities that have promoted extensive bike-safety education and encouraged the use of helmets have seen a 50 percent increase in the use of helmets and a corresponding decrease in head injuries requiring emergency or hospital care. In the event you do bump your head, with or without a helmet, see a doctor. Many cyclists who fall and hit their heads but don't have any other injury requiring medical care, often do not go to the doctor. Remember, head injuries can be very serious and often don't produce symptoms right away, sometimes not for months or even years. If you receive a hard knock on the head, it is always best to have a physician look you over.

Also, if you have an accident while wearing a helmet, replace the helmet. Even though it may not look damaged, it might be. Many manufacturers have a crash-protection guarantee, agreeing to replace a helmet for free if you are in a crash. Once you buy a helmet, treat it carefully. The helmet can be damaged by extremes of hot and cold. Consider replacing your helmet every five years because helmets can begin to deteriorate internally with time and use. The quality of helmets has improved so much in the past five years that we can assume that the helmets manufactured five years from now will provide even better protection.

Finally, take these extra safety steps for youth: Make sure your bike is in good working order. Have it tuned up regularly and make sure that you have good tires; that the brakes work; and, of course, that the bike fits you properly. Try to ride on bike paths and avoid roads with heavy traffic. Wear reflective clothing when you ride on roads where there is automobile traffic, especially at night, and have reflectors or lights on the bike itself. You might even consider getting a light for the back of your bike. If you're biking to reduce your RealAge, you might as well take a few steps to make your RealAge younger still.

Other Precautions: Making Safety an Issue

Driving, motorcycling, and biking are obvious activities in which we might get injured. Other activities have risks, too. If you participate in an adventure sport—whether downhill skiing or scuba diving—make sure you have the proper equipment and proper training. No matter what the activity, if there is a reasonable chance of a head injury, wear a helmet. If you play a racket sport or basketball, wear eye protection. All you have to do is look at professional basketball players with their wraparound glasses or professional bikers with their helmets on to know that the people at the top take safety seriously. Even sports like in-line skating require safety precautions. Enter an emergency room on any nice spring Saturday afternoon, and you will see it packed with skaters who forgot to put on their knee pads, wrist guards, and helmets. Boating accidents are another common source of injury, often because people forget that drinking-and-driving rules apply to the waterways, too.

....................

TO  BE  CONTINUED

REAL AGE

Sexually Transmitted Diseases: The Downside of Sex

Because of the AIDS crisis, we hear a lot in the media about safe sex. When it comes right down to it, most information isn't as explicit as it needs to be. We still have a Puritan streak, which often keeps us from talking about the actual mechanics of sex. But that doesn't help anyone because there are important issues that need to be explained, such as which diseases we are really at risk of contracting or how to use a condom properly.

The safest sex is with a disease-free partner in a mutually monogamous relationship......High-risk groups include men who have sex with men, intravenous drug users, and former prisoners and their sex partners—no matter what their sex..... Remember, too, that younger partners aren't necessarily less risky. Quite the opposite. Two-thirds of STDs are diagnosed in people under age thirty-five.

Although AIDS is clearly the biggest worry, we shouldn't forget about other diseases as well. The Centers for Disease Control estimates that 20 million Americans will contract some form of STD each year. Others estimate a more conservative 12 million. A study by the Allan Guttmacher Institute in the early 1990s estimated that one in five, or over 50 million Americans, have had some kind of STD.

How much does having an STD age you? Statistically, only 0.9 years. But this statistic is misleading. Contracting HTV is a way of becoming old overnight. A thirty-five-year-old man who contracts HTV experiences twelve years of ageing from the disease in a short period and more ageing as the disease progresses. His risk profile changes to that of a much older man as soon as HTV is diagnosed. In light of the current improvement in treatment for HTV, the ageing effect correlates directly with the quality of care. Other diseases are more uncomfortable than life threatening, but they can lead to long-term ageing of the immune or cardiovascular system.

Unfortunately, data on the relationship between safe sex and ageing is hard to correlate, partly because STDs are so different. One of the biggest problems with getting statistics on STDs is that it is virtually impossible to do controlled studies on sexual behavior. Researchers can't create the kind of double-blind study populations that we can create for studies like drug tests. We can't tell a group of people that half of them should have lots of casual sex and the other half should be monogamous. We can't even divide the monogamous group into two subgroups and tell one to have sex only once a week, and the other to have sex every day.

More important, statistics are only general trends. For example, although the group having the highest incidence of STD infection consists of unmarried people under age thirty-five, STDs can affect anyone. Either through divorce or widowhood, a lot of people find themselves back on the 'dating scene' when they hit their forties and fifties. If this is you, play it 'safe.' Don't risk an STD.

AIDS-HIV infection is clearly the biggest risk, as it is a fatal disease for which we have not found a cure. Although the new, better drugs have made it possible for many HIV-positive patients to live symptom-free for years after infection, it appears that these drugs only delay the onset of full-blown AIDS; they do not prevent it. Moreover, this delay is achieved only when HIV-positive patients rigorously maintain a complicated and expensive medication schedule. If you believe that you may have been exposed to the disease or are changing sex partners, it's a good idea to get an HIV test. If you think you've been exposed, early treatment can prevent permanent infection (by early, I mean within one to four hours).

Although HTV is a fairly difficult disease to contract, exposure to other STDs reduces the immune system's defenses and increases the likelihood that HTV will actually infect a person who has been exposed. Estimates are that a person with genital lesions (for example, from syphilis or herpes) is one hundred times more likely to contract HIV during a single sex act than someone who has never had an STD......

If you are in a monogamous relationship and making the decision to switch from condoms, first talk about it. Then, both you and your partner should go to a doctor for a full workup of tests. That way each of you will know the facts. If one of you tests positive for an STD, then you can make an informed decision about the best way to proceed.

Women who are pregnant or considering getting pregnant should get checked for the presence of any STDs, since these diseases can sometimes be harmful to the developing fetus or newborn. Usually, an STD doesn't interfere with pregnancy; rather, extra precautions are taken to prevent mother-to-child infection.

Wear It, Wear It Right

Studies of condom use consistently show that people just don't get it right. There are six essential steps to using a condom properly, but most people perform only three or four of the six steps correcdy. Don't assume you know. I admit I felt a little silly when I used a banana to show my son how to use a condom, but, silly or not, I am reassured that he now knows exacdy what to do.

Buy only latex condoms and use a new condom for each episode of intercourse—even if you don't ejaculate each time. Make sure you use condoms that say they protect against STDs. Joke or novelty condoms may not provide protection. Make sure that the condoms have not passed their expiration date, that the foil pack is intact, and that the condoms have not been left too long in some place where they could get damaged (for example, in the sun—or in a wallet!).

Open the package carefully and be sure to avoid damaging the condom with either your fingernails or any other sharp object.

Place the condom on the erect penis prior to any intimate contact (some STDs, such as gonorrhea, can be transmitted even without penetration). Roll the condom down to the base of the penis, where the penis connects with the body. Make sure the fit is snug.

Leave a space at the tip of the condom and remove any air pockets from that space.

Use only water-based lubricants, such as KY jelly or spermicidal foam or gel. Never use oil-based lubricants, such as petroleum jelly (for example, Vaseline), lotions, or mineral oil, because they destroy the latex. Also, many condoms are treated with nonoxynol-9, a spermicide and lubricant that seems to provide some added protection against HTV and other types of STD infection. It is probably a good idea to use this type of condom, since it will give you some added protection just in case.

Withdraw immediately after ejaculation, while the penis is still erect, holding the condom firmly against the base of the penis.

The following are the most common sexually transmitted diseases:

AIDS-HIV

Human immunodeficiency virus infection—the infection that causes or is presumed to cause AIDS—has traditionally been associated with gay men and intravenous drug users. However, its incidence is growing in other sectors of the population. Between half a million and a million people in the United States are infected with HTV, with six times as many men being infected as women. Infection rates are higher in the African American and Latino communities, presumably because of other associated risk factors, such as higher rates of poverty and drug use. In nine major American cities, AIDS is the number one cause of death for women aged twenty-five to forty-four. Since women are more susceptible to contracting the disease than are men, experts expect AIDS to increase among women.

The reason that AIDS spread so quickly among gay men in the 1980s was that many had sex with multiple partners without using condoms, and many engaged in practices that are now known to increase the likelihood of disease transmission, notably anal sex. Studies consistently show that people who have sex with HIV-infected partners but use condoms are at minimal risk of contracting the disease.....HTV-AIDS is a two-stage disease. A person who is infected with HTV can remain virtually symptom-free for years, but nevertheless is infectious. AIDS is the disease stage of HIV infection. By rendering the immune system basically useless, the disease destroys the body's primary line of defense. Infections, cancers, and other immune diseases then can attack the body, causing horrible and painful illnesses. A person goes from a young healthy adult to a disease-ridden old person in a matter of months or years.

Because of recent advances in HTV treatment, people who are infected with HTV who get a proper regimen of medications can stay virtually symptom-free for years. If you discover that you are HIV-positive, seek medical care immediately. Proper management of the disease can add years to your life. Each year, more effective treatments for the disease emerge, so the longer an infected person survives, the better the odds of living until a cure is discovered.

Chlamydia

Chlamydia is the most common bacterial STD in the United States. The greatest problem with chlamydia is that its symptoms are largely 'silent.' Seventy-five percent of those who are infected show no symptoms. Primarily affecting women, chlamydia can cause internal scarring of the fallopian tubes, ectopic pregnancy, and infertility. Symptoms, when they do occur, include painful urination, vaginal discharge, and abdominal pain. Although men are usually not affected by the disease, they should seek treatment if they are exposed because they can transmit the disease to their partners. Ask your gynecologist or general physician to include a chlamydia screen in your routine battery of tests, particularly if you have recently changed sex partners. Fortunately, chlamydia can easily be treated with antibiotics.

Gonorrhea

'The clap' can affect anyone. Although as many as two-thirds of women and 40 percent of men who are infected with gonorrhea are asymptomatic, painful urination, unusual vaginal discharge, and menstrual spotting can be signs of infection. Gonorrhea is highly contagious and can be transmitted simply through genital contact, even without penetration. It can cause ectopic pregnancy or infertility in women and seems to increase a person's susceptibility to HTV. Nonoxynol-9, the spermicide most often used on condoms, helps block the transmission of gonorrhea. Untreated, the disease can cause cardiovascular ageing. Gonorrhea can usually be treated with antibiotics, although some antibiotic-resistant strains are appearing. Infections from these strains can be cured with a more vigorous and difficult series of treatments.

Hepatitis B

Hepatitis B is not officially classified as an STD, but its most common mode of infection is through intercourse. Hepatitis B can cause severe damage to the liver. There is no effective treatment, although many people recover on their own. A hepatitis B vaccine is available (see Chapter 12), and getting vaccinated is a quick, easy way to help yourself stay young, particularly if you are sexually active and plan to have more than one sex partner in your lifetime.

Herpes

Estimates are that one in five sexually active Americans has genital herpes, an increase of 15-20 percent since the mid-80s. This increase has occurred despite 'safe sex' education and programs that encouraged the use of condoms. Many people who have been infected remain asymptomatic and unaware of the disease, yet they are still infectious and spread the disease to their partners. Within the first week or two after infection, symptoms can include fatigue, muscle aches, and itching. Ten days or so after infection, a small blister usually emerges in the genital region. The blister can burst and remain for several weeks, causing pain and discomfort. Once the initial outbreak heals, victims remain infected for the rest of their lives and may suffer recurrent outbreaks. Although herpes can be both painful and embarrassing, it is not life threatening and has no particular long-term health consequences. Creams and antiviral medications can treat the symptoms and reduce the number of outbreaks but cannot cure the underlying infection, which remains within a person for life. Although transmission is most common during outbreaks, transmission can occur between outbreaks as well, in a process known as 'viral shedding.' Women are more likely than men to contract the disease from an infected partner, and herpes can cause more serious consequences if they become pregnant.

Human Papillomavirus

Human papillomavirus is the most commonly transmitted STD. Some experts have estimated that as many as 80 percent of the sexually active population is infected with the virus. However, little is ever said about this disease. In general, the virus is benign. Since it increases a woman's risk of developing cervical cancer considerably, we can say it accelerates ageing of the immune system. Some strains cause small genital growths or warts that can be uncomfortable, but these growths can be easily removed. If you have had more than two sex partners in your lifetime or your partner has had more than two sex partners, chances are you have been exposed to the virus. In general, human papillomavirus infection doesn't do much, and there are no treatments. Once you have it, you have it.

Women who have been exposed to the virus are more likely to develop cervical cancers. In fact almost all women with positive results on a Pap smear show evidence of having been exposed to the virus. For men, exposure seems to have little effect, and penile cancers are rare. Men can transmit the virus to their partners and can develop growths or warts, sometimes inside the urethra, which can cause discomfort. Recent studies have found that the virus may be implicated in some anal and rectal cancers, as well as in some oral cancers. Women should remember to get annual Pap smears, which can detect precancerous cells. Treatments can then be given to prevent the development of full-blown cervical cancer. Positive Pap smear results do not mean you have cancer. Most positive results merely identify an increased risk of developing cancer. If you do get a positive result, you will want to be especially careful about having the condition monitored. Your gynecologist may recommend biannual or quarterly Pap smears or treatments to remove precancerous cells.

Syphilis

If gonorrhea is the 'sailor's disease,' syphilis is the disease of kings. Famous in the eighteenth and nineteenth centuries because of its ravages on the European aristocracy, syphilis is once again on the rise. The incidence of syphilis has doubled since the early 1980s. Symptoms include genital lesions, aches, fevers, rashes, hair loss, and skin and mouth sores. If untreated, syphilis can infect the eyes, heart, brain, and other organs, causing irreparable structural damage. In addition, it accelerates the rate of arterial ageing. Syphilis is easily treated with antibiotics and, if detected early, leaves no lasting damage.

Sex is a great thing. The more, the better. There's no way to get younger that's more fun! Just remember: Be safe. Use a condom, get tested, and pick your partner carefully.

Illegal Drugs: Staying Young Without Them

Illicit drugs may be illegal, but that doesn't mean that people aren't taking them. About 40 to 50 percent of Americans aged fifteen to fifty-four admit to having tried an illegal drug at some point in their lives, and over 15 percent say they have done so in the past year. Estimates suggest that 5 to 10 percent of the population use illegal drugs regularly, and many admit being addicted. The more than $3 billion spent each year on drug rehabilitation programs is just a small part of the major impact that drug use has on our society. Although we tend to associate drug use with teenagers, rock stars, or inner-city poverty, it's not an accurate picture. People from all segments of society use and abuse drugs. And drug use, it is not surprising, accelerates ageing.

Drug addiction is a serious problem that has physiologic and mental effects. The problems associated with drug use are complicated and warrant more discussion than I can provide here. For the purposes of this book, there is only one question: How does illicit drug use contribute to ageing?

Most hard drugs are illegal for a reason: They're dangerous and addictive. Cocaine, crack, heroin, and a whole array of hallucinogenic (mind-altering) drugs can cause serious health problems. Unnecessary ageing associated with drug use can be as much as eight years. Drugs like heroin and cocaine top the list. They can kill a person almost instantaneously. An overdose, if not fatal, is always serious and puts a person's life at risk. Although trying a drug once probably won't do much damage by itself, it may cause addiction. Many people crave more and then are on the path to drug addiction. Addiction affects a person's physiology, making him or her more likely to suffer real physical ageing that is manifested in many ways. The mental effects of drug use tend to disrupt social ties, often causing users to lose their friends, families, and jobs.

People who use drugs are more likely to make bad decisions. They are more likely to get into accidents and have unsafe sex. For example, cocaine and crack use are associated with higher rates of HIV transmission, not because using the drugs increases susceptibility to the HIV virus, but because users take risks (unsafe sex, needle sharing) that make them more likely to be exposed to the virus.

Marijuana, by far the most popular illegal drug, is less immediately dangerous or addictive than other drugs. Smoking 'pot,' even if you 'didn't inhale,' makes your RealAge older. Marijuana contains 50 percent more carcinogens and four times as much tar as cigarettes. Studies show that the heavy use of marijuana can cause residual neurologic effects that decrease cognitive functioning. Heavy users actually experience ageing less from the drug itself than from the behaviors it tends to induce, most notably a lack of motivation. For example, users are less likely to exercise or eat a healthy diet or to maintain the kinds of social networks that can help protect against stress. They are also more likely to engage in risky behaviors, such as unsafe sex or driving under the influence of either drugs or alcohol.

(AS  OF  2014  ONLY  TIME  WILL  TELL  THE  TRUE  FACTS  ABOUT  MARIJUANA. ONE  STATE  HAS  LEGALIZED  IT.  SO  IN  THE  NEXT  FEW  YEARS  WE  SHALL  LEARN  IF  SMOKING  MARIJUANA  IS  AS  DANGEROUS  AS  SOME  LIKE  TO  CLAIM  IT  IS  -  Keith Hunt)

When it comes to illicit drugs, the best advice is not to start. If you do use drugs, consider quitting. If you find you can't stop 'cold turkey,' you have an addiction problem and need to seek help. Although overcoming a drug addiction is difficult, addiction is one of the most pernicious agers of the body, and ending a habit of drug abuse will make you younger and, consequently, feel better. It could even save your life.

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ON  THE  SEX  TOPIC.  GOD  HAS  THE  ANSWER  TO  SEXUALLY  TRANSMITTED  DISEASES  -  NO  SEXUAL  INTERCOURSE  OUTSIDE  OF  MARRIAGE,  AND  OF  COURSE  REMAINING  SEXUALLY  FAITHFUL  TO  YOUR  MATE  IN  MARRIAGE.

Keith Hunt

REAL  AGE

Take Your Vitamins

TURNING VITAMINS AND SUPPLEMENTS INTO AGE REDUCERS

Can vitamins make you younger? Yes. The right nutrients in the proper amounts help protect your body from needless ageing. Although we often hear about the recommended daily allowance (RDA), the minimum needed to prevent disease from deficiency, we should start thinking instead about the 'RealAge Optimum' (RAO), the dose you really need to stay as young as you could be.

• Hundreds of vitamins, minerals, herbs, and supplements are available for
sale. Learn some general guidelines for taking those that can keep you
young and avoiding those that will make you older. Taking the wrong
combination of vitamins or needless vitamins can make you 1.7 years older.

Difficulty rating: Quick fix

• Antioxidants are all the rage because of their supposed antiageing effect.
This section investigates those claims. What is oxidation? How does this
bodily equivalent of 'rusting' age your body? Vitamin C and vitamin E,
when taken together, work as an antioxidant team, keeping your arteries,
immune system, organs, and bones young. When taken consistently, these
vitamins can reduce your RealAge by as much as six years.

Difficulty rating: Quick fix

• Frail bones and arthritis are hallmarks of ageing. The danger of these
conditions can be reduced by getting the proper levels of calcium and
vitamin D. Getting 1,200 mg of calcium and 400IU (International Units)
of vitamin D a day can help make you 1.1 years younger.

Difficulty rating: Quick fix

Despite the hype over cholesterol, you may have to worry about something else even more: homocysteine. Homocysteine is an amino acid that is a by-product of various metabolic processes. High homocysteine levels correlate with the early onset of heart and vascular disease more than almost any other factor. But not to fear—by getting adequate amounts of folate (folic acid) daily, you can make your RealAge more than 1.2 years younger.

Difficulty rating: Quick fix

We would all like to eat a balanced diet, but not all of us can or do. The hectic pace of real life interferes. If you do not eat a regularly balanced diet, including six to eight servings of fruits and vegetables each day, you can get all the vitamin and mineral nutrition you need by taking a multivitamin daily in addition to the other supplements recommended in this chapter.

Difficulty rating: Quick fix

Besides vitamins E, C, and D; calcium; and folate, what should you be getting in your diet? Here we consider some of the latest nutrient fads. What are the possible benefits or side effects of such highly touted micronutrients as chromium picolinate and selenium, and such herbal remedies as echinacea? Avoiding inappropriate supplements and fads will make you one to four years younger.

Difficulty rating: Quick fix

Vitamins, vitamins, vitamins. How many times have you been told to take your vitamins? Your mother told you to eat your vegetables to get your vitamins. Now, more than likely, you take vitamins out of a bottle. But do you really know what and how much you should be taking?

Walk into a health-food store or down the vitamin aisle at your local drugstore, and you will see shelves overflowing with vitamins of all sorts, not to mention minerals and a whole panoply of supplements. There are multivitamins, individual vitamins, vitamin cocktails, stress vitamins, energy vitamins, herbs, minerals, pills, capsules, and drops; the same vitamins in different dosages and different formulations; and no clear instructions about what you should take, how much, or how often.

In the 1960s, Nobel Prize-winning chemist Linus Pauling asserted that by taking high doses of vitamin C, you could prevent the common cold. His assertions became a kind of folk remedy, and people readily began to take vitamin pills. Now 25 percent of all adults in the United States gulp down vitamin supplements regularly, and half take them occasionally.

I didn't realize exactly how consuming and confusing all this could be until Frank T. walked into my office one day, opened up a bag, and began pulling out bottles. Brown bottles, blue botdes, small bottles, big bottles. When he was done, he had thirty-five containers of vitamins, minerals, and supplements lined up on my desk.

Incredulous, I asked,' You take all of these every day?'

'Absolutely,' he replied. 'Some of them I take twice a day.' In all, he took some fifty tablets daily. Clearly, here was one organized man. This was a full-time job. At fifty-four, Frank was in good shape. He exercised vigorously and often, was trim, enjoyed a happy marriage, and was at the peak of his career. Recently he'd had a prostate scare, and that made him worry. He began reading up on his health and asking people at the health-food store. The results of his research—all thirty-five bottles worth—were now spread out in front of me like a Thanksgiving feast. Now he wanted to know what I thought.

'Fifty pills a day is too much,' I told him. 'Some of them are good for you, but some of them could be bad for you.' Then I gave Frank some basic guidelines for taking vitamins and outlined a specific plan that could do exactly what he wanted—keep him young.

General Rules About Vitamins

Before getting into the details of what vitamins you should take and which ones you shouldn't, I think it's worth pointing out some general considerations that apply to vitamin usage. To say that there is a difference between the practices advised by medical doctors and those advised by practitioners of alternative medicine would be an understatement. There has been a long history of debate between the two sides. Since this is clearly a controversial issue, let me make some points that can help you understand and untangle the debate. It's not so much that medical practice has dismissed alternative medicine outright—not at all—but, rather, that medical doctors, for the most part, like to have strong and convincing evidence that treatments help their patients before they advocate those treatments.

For doctors, one of the most frustrating aspects regarding the vast array of vitamins and supplements available is not that they don't work, but that we have no idea if they actually do work. With the exception of a few basic vitamins (C, D, E, B, and A) and a few minerals (calcium and iron), we have limited scientific information about the role and optimum dosages of most of the supplements on the market. Although for many minerals and vitamins, we have basic information about the minimum amounts of essential nutrients that we need to survive or prevent deficiency diseases (the recommended daily allowance, or RDA), we know much less about the optimum doses we need for health and youth. Most of what you learn in health-food stores has not yet been proven. It may prove right, it may prove wrong—we just don't know.

There have been few or no scientific studies on the vast majority of vitamins and supplements on sale in any local health-food store. Most of these supplements are sold without any description of what they are, why they are good for us, or how we should take them. Many of them are unnecessary— and some can even be harmful. Comfrey, for example, long given as a cough suppressant, can actually cause severe and irreversible liver damage—a big price to pay for easing a cough. For most herbs, as well as most minerals and other food supplements, the research has just not been done.

Nutritional supplements—because they are classified as food products and not medicines—aren't regulated by the strict standards governing the sale of prescription and over-the-counter drugs, so manufacturers can sell them in any quantity or combination they want. Nor does the law require that they do any scientific studies to back up their claims, as they would have to do for any new medicinal drugs. There are no industry standards or federal requirements. Different brands of the same supplement might contain very different elements. It is not uncommon to find bottles containing ingredients and even contaminants not listed on the ingredient list. When you do buy vitamins or supplements, make sure you buy them from a large and reputable manufacturer. In addition, do not take any supplement without getting a recommendation from a reputable source.

Another caveat: I advise against taking any supplement 'cocktail' sold at a health-food store, from a vitamin aisle at a store, or from a catalog (many are sent from Canada where the laws are even more lax). These supplement cocktails are mixtures of herbs, vitamins, and minerals. I do not object to 'cocktails' in principle, just in practice. For one thing, they claim to provide everything from 'prostate cancer prevention' to 'menopause ease' to 'muscle building' but often don't even list what they contain—or how much of any one ingredient is included—since the companies that sell them aren't required by law to do so. You—the consumer—could be taking all kinds of things that you don't want. Most of these wonder pills are probably harmless, but we cannot say for sure. I can guarantee that they are not 'wonder' pills. If you are trying to be smart about Age Reduction, don't start taking a pill or cocktail just because a store clerk or infomercial tells you to do so. If you don't know what it is, don't take it.

That said, what do we actually know about vitamins, minerals, and supplements? Which ones should we take? And which ones should we definitely not take? In general, if you eat a balanced and healthy diet, with four servings of fruits and five servings of vegetables a day and plenty of grains, you should get all the nutrients you need. However, that's not always realistic. Most of us have busy lives and hectic schedules, which means that it's not always easy to eat a balanced and nutrient-rich diet.

(REMEMBER  THIS  BOOK  WAS  WRITTEN  IN  2000.  CANADA  HAS  LAWS  THAT  ALL  INGREDIENTS  IN  VITAMINS  ARE  TO  BE  PUT  ON  THE  BOTTLE  LABEL.  UNLESS  YOU  ARE  EATING  BASICALLY  ORGANIC  FOODS,  TODAY  BECAUSE  OF  POLLUTED  FOODS,  YOU  NEED  TO  TAKE  A  GOOD  MULTI-VITAMIN/MINERAL  SUPPLEMENT,  AND  MAYBE  SOME  OTHERS  LIKE  D3  IF  YOU  DO  NOT  GET  MUCH  SUN - Keith Hunt)

To make up for such inconsistencies, I recommend taking a multivitamin every day, in case you have missed out on a little bit of one mineral or the other. Choose a multivitamin without added iron, and one that has less than 8,000 IU of vitamin A. If you are worried about whether you are eating a balanced diet rich in vitamins and nutrients, talk to your doctor or schedule a session with a clinical nutritionist to review your eating habits and to develop basic dietary guidelines. Vegetarians and others on special or restricted diets should be vigilant to ensure that they are getting the basics.

What other nutrients and vitamins should we be getting? What do they do for us? What shouldn't we take?

Oxidants and Antioxidants: rustproofing your body

One of the biggest trends in vitamins these days is the use of antioxidants, because they purportedly can help prevent the oxidation damage that has been linked to cancers and other types of ageing. It's true: Taking the right amounts of antioxidants can make your RealAge as much as six years younger. Many people, however, wrongly believe that if a little bit of antioxidant is good, a lot is better. Too many antioxidants—especially of the wrong type—can actually cause oxidation damage. My recommendation: antioxidation in moderation. Eat a balanced diet, with four servings of fruits and five to six servings of vegetables a day. Then, each day, take 600 milligrams (mg) or more (up to 2,000 mg) of vitamin C in divided doses separated by at least six hours, plus 400 IU of vitamin E. That should give you all the antioxidation, antiageing protection you need. Here's why.

To understand antioxidants, let's first think about the oxidant, oxygen. We all know that oxygen is necessary for our bodies to function at all. Breathing is fundamental to living. When we breathe, oxygen enters our bloodstream and is transported to our cells. Once it enters our cells, oxygen forms the basis of many of our cells most fundamental processes. You probably learned these facts in elementary school, but what you probably didn't learn was that this same oxygen, in the form of oxygen radicals, can oxidize our tissues. In a sense, it can cause those tissues to rust. Oxygen waste products, called lipo-fuscins, build up in organs like the heart and brain, leaving brown discoloration on the tissues. These spots are signs of ageing. The older you get, the more prevalent they become.

Why? Imagine apples. If you slice an apple and leave it out in the air, it will soon turn brown. Exposed to air, the surface of the apple oxidizes. The process is similar to what happens when oxygen radicals build up in your body. If you were to take that same apple and sprinkle lemon juice on the slices, they would stay white. The apple does not turn brown because lemon juice is full of vitamin C, which works as an antioxidant. Lemon juice stops the oxidation process and keeps the apple from 'rusting.' In your body, antioxidants like vitamin C and vitamin E do the same thing.

Think of your body as an exclusive club. Free radicals are the visitors who crash the scene without an invitation. They are so pesky, the body can't get rid of them without some help. Antioxidants function as a kind of security system, the bouncers. They seek out the roving oxygen radicals and bind to them—a kind of chemical handcuff. Bound together, the free radicals and the antioxidants form an entity that the body can then flush out. As long as you have enough bouncers, free radicals and lipofuscins won't build up in the body.

How does this 'rusting' affect us? Mainly, oxidation ages your arteries. As you get older, your arteries are more likely to become clogged with fat deposits. These clogs contain high levels of oxidized lipids—that is, fats that have been chemically altered through interaction with high levels of free radicals. Therefore, oxidation plays a significant role in the ageing of our arteries. Oxidation affects us in other ways, too.

Oxygen free radicals are an unstable form of oxygen that cause genetic damage. Each cell in your body contains DNA (deoxyribonucleic acid) that instructs the cell what to do and when to do it. Every time your cells divide, DNA is copied into the new cell. Oxidation interferes with this process, causing DNA damage. This can lead to cancer arid the premature ageing of solid tissues. It can also damage the immune system, your body's backup security system to ensure that cancer cells don't spread (see Chapter 5 on immune system ageing). Finally, oxidation ages our eyes. It can damage the lenses (promoting cataracts) and the retina. The gradual loss of sight is one of the very first things that can make us feel old.

There are still many gaps in what we know about oxidation, and a lot of what we do know is based on circumstantial evidence. We do know that people with lots of buildup of oxidized fats in their bodies have much higher rates of heart disease and that their bodies appear to age more quickly in other ways, too. The hypothesis is that there is a connection between ageing and oxidation—although we still can't verify it completely. Regardless of the exact reasons why oxidation seems to age us, we know that people who consume the antioxidants vitamin C and vitamin E at the levels I recommend have substantially lower rates of coronary disease, cancer, and other forms of ageing. Let's consider why I recommend that you take vitamin C and vitamin E supplements, but not vitamin A, for antioxidation.

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TO  BE  CONTINUED

I  WAS  BORN  IN  1942.  GROWING  UP  IN  THOSE  DAYS  WAS  LESS  POLLUTION  IN  THE  AIR  AND  FOODS,  MORE   ORGANIC.  WE  HAD  FREE  MILK  AT  SCHOOL  WHERE  THE  CREAM  ROSE  TO  THE  TOP,  AS  IT  WILL  ORGANICALLY.

DURING  MY  TEENS  AND  INTO  MY  20s  I  ATE  THREE  GOOD  BALANCED  MEALS  A  DAY,  FRUITS,  VEGIES,  WHOLE  GRAINS, ORGANIC  MILK,  NUTS,  SEEDS  OF  VARIOUS  KINDS,  BAKED  POTOTO  A  FEW  TIMES  A  WEEK;  AS  WELL  AS  PROTEIN  IN  EGGS,  CHEESE,  BEEF,  TURKEY [PROTEIN  IS  IN  NUTS  AND  MILK  ALSO].

DURING  THOSE  YEARS  I  TOOK  PRETTY  WELL  NO  VITAMIN  SUPPLEMENTS.

IN  MY  30s  I  STARTED  TO  TAKE  "BEEN  POLLEN"  DAILY,  ONE  OF  THE  MOST  COMPLETE  FOODS  IN  NATURE.

WHEN  I  REACHED  40  MY  BODY  METABOLISM  CHANGED,  AND  EATING  AS  ABOVE  STARTED  TO  GAIN  WEIGHT.  I  REDUCED  MY  DIET,  AND  STARTED  TO  TAKE  A  MULTI-VITAMIN  SUPPLEMENT.  

AT  AGE  60  MY  METABOLISM  CHANGED  YET  AGAIN,  I  HAD  TO  REDUCE  MY  DIET  FURTHER  AND  CUT  OUT  ALTOGETHER  CERTAIN  FOODS. 

I  NOW  TAKE  OTHER  VITAMINS  AS  WELL  AS  A  MULTI-VITAMIN/MINERAL  SUPPLEMENT.

SOME  I  TAKE  FOR  PROSTATE  HEALTH;  OTHERS  FOR  BONE  AND  JOINT  STRENGTH.

I  WAS  RECENTLY  TOLD  BY  MY  DOCTOR  TO  INCREASE  MY  D3  TABLET  INTAKE,  UPON  A  RECENT  BLOOD  ANALIS  TEST.

YES  I  TAKE  C  AND  E.  YOU  CAN  NOW  BUY  ORGANIC  MILK [COW  OR  GOAT]. 

MY  DOCTOR  TOLD  ME  TO  TAKE  "OATS"  AS  A  CERIAL. 

BLUEBERRIES  AND  CHEA  SEEDS  ARE  KNOWN  NOW  AS  WONDER  FOODS,  WHICH  I  EAT.

YOU  CAN  NOW  BUY  ANTI-OXIDENT  FRUIT  DRINKS  WITH  NO  ADDED  SUGAR.

FRIED  TOMATOES  IN  VIRGIN  OLIVE  OIL  OR  COCONUT  OIL,  ARE  BETTER  FOR  YOU  THAN  EATING  RAW;  THERE  IS  A  CHEMICAL  CHANGE  WHEN  FRYING,  PRODUCING  A  SUBSTANCE  VERY  GOOD  FOR  YOU,  THAT  IS  NOT  THERE  IN  THE  RAW  TOMATO.  FOUND  THAT  OUT  FROM  DR.  MERCOLA  RECENTLY.

YOGUT  AND  SAUERKRAUT  IS  GOOD  FOR  YOUR  GUT  AND  INTESTINES.

I  HAVE  LOOKED  AFTER  MYSELF  IN  DIET  AND  EXERCISE,  7 TO 9  HOURS  OF  SLEEP  DAILY.  I  SWIM  TWICE  A  WEEK;  RIDE  MY  HORSE  3  TIMES  A  WEEK;  LIFT  MY  DUMB-BELLS  3  TIMES  A  WEEK.

I  HAVE  NO  FACE  WRINKLES,  NO  BAGS  UNDER  MY  EYES;  A  FIRM  NECK [FROM  DOING  NECK  EXERCISES].

PEOPLE  GUESS  MY  AGE [WHO  DO  NOT  KNOW]  AT  20  YEARS  YOUNGER  THAN  MY  BIRTH-CERTIFICATE  AGE.

YOU  CAN  SEE  WHAT  I  LOOK  LIKE  ON  MY  FACEBOOK  PAGE,  WHICH IS ----

KEITH HUNT, CALGARY, ALBERTA, CANADA.

Keith Hunt

REAL  AGE

The Daily Basics:Vitamins C and E

The two most important Age Reducing vitamins are C and E. These vitamins exert powerful antioxidant activity. Taken together, they help keep your cardiovascular system healthy by reducing the amount of harmful buildup on the walls of your arteries. In addition, vitamin C strengthens the immune system, improves both eye and lung function, and helps the body heal. Vitamins E and C, taken in combination, help keep the arteries relaxed and elastic. Taking 600 mg or more (up to 2,000 mg) of vitamin C a day as supplements (in divided doses of no more than 500 mg in any six hours) and 400 IU of vitamin E a day, in addition to eating a balanced diet with lots of fresh fruits and vegetables, can reduce your RealAge by more than six years! What could be easier?

Vitamin C and vitamin E are powerful antioxidants that complement one another. Vitamin C is water soluble, whereas vitamin E is fat soluble. What does that mean? Your cells are made up of two components: the cell membrane and the cell interior. The cell membrane, the outer casing of the cell, consists of lipids, or fats. Since vitamin E dissolves in fat, it works to prevent oxidant-induced ageing in the membrane. It is in the cell membrane that you see the buildup of lipofuscins, those brown spots. In contrast, the inside of the cell is made up mostly of water. Since vitamin C dissolves in water, it can enter the center of the cell and collect the free-radical oxidants lurking there. Together, these two vitamins keep oxidants from damageing your cells, both inside and out (see Table 7.1).

Table 7.1

The RealAge Benefit of Vitamins C &E

For Men

Of getting the RAO" dose of vitamin C:

At age 55: 2.8 years younger At age 70: 3.2 years younger

Of getting the RAO dose of vitamin E:

Age 55: 2.5 years younger Age 70: 2.8 years younger

For Women

Of getting the RAO dose of vitamin C:

Age 55: 2.2 years younger Age 70: 2.6 years younger

Of getting the RAO dose of vitamin E:

Age 55: 1.5 years younger Age 70: 2.2 years younger

The Daily Dose, at the RAO Level

Vitamin C:

600 mg or more as a supplement, plus five servings of fruits and vegetables, to total 1,200 mg/day, in divided doses, separated by at least 6 hours (not to exceed 2,000 mg a day)

Vitamin E:

400IU (international units)

*The RealAge optimum, the dose recommended for the greatest Age Reduction.

Vitamin E

As mentioned, vitamin E is fat soluble. That makes it an especially vigorous antioxidant. Vitamin E goes right to work on oxidized lipids that clog the arteries, shrinking their size and preventing the initial buildup in the first place. It hampers the attachment of dangerous LDL cholesterol along the arterial walls.

Vitamin E can lower the risk of heart attack in women by as much as 40 percent and in men, by about 35 percent. If a person already has arterial disease, but not fibrotic or permanently hardened arteries, vitamin E can decrease the risk of heart attack by as much as 75 percent. That's an astounding impact! Something as simple as taking 400 IU of vitamin E a day will give you a younger, healthier cardiovascular system and all the vigor and energy that goes along with it. Moreover, like aspirin, vitamin E thins your blood, making clots less likely to form. The quinone in vitamin E has powerful anticlotting powers.....

Recent claims have also been made for vitamin E as a preventive against lung and prostate cancer and other cancers as well. The antioxidant properties of vitamin E are believed to help stop the immune system from ageing. Further studies still need to be done on the exact details of the cancer-vitamin E connection, but the evidence appears promising. Vitamin E may also help the body build muscle strength. Finally, as I mentioned, vitamin E has been shown to help prevent cataracts, and preliminary studies suggest it might help prevent macular degeneration, the leading cause of visual impairment associated with ageing.

There are several caveats you should be aware of before taking vitamin E. This vitamin therapy works only to reduce the size of fatty buildup before the arteries have become fibrotic, or permanently hardened (that is, when there is fat buildup but no irreversible changes). Vitamin E seems to help reduce the size of small or medium-sized lesions in your arteries but not severe ones. That is why you want to start taking these vitamins as soon as possible—to foil ageing before it begins.

How much vitamin E should you take, and where is it found? Vitamin E is found in fatty vegetables, such as avocados, and in some vegetable oils. It is also found in nuts, leafy green vegetables, and some grains. It is virtually impossible to get the necessary antiageing dose of vitamin E from foods. The RDA is only 12 to 15 IU a day; that is, 12 to 15 IU are all you need to survive without showing signs of deficiency disease. But the RAO—the RealAge optimum—is 400 IU. To prevent ageing, you need 400 IU daily. Since most multivitamins tend to follow RDA recommendations and contain only 15 to 30 IU, do not rely on multivitamins to get your vitamin E; the level of vitamin E in most multivitamins is usually 370 IU short of the anti-ageing optimum.

How often do you need to take vitamin E? Since vitamin E is fat soluble, it resides in your body for quite a while. One tablet a day is just the right dose. There is little risk of a vitamin E overdose unless you ingest more than 1,200 IU a day, and vitamin E is probably safe up to 3,000 IU a day. If you have high blood pressure, get the high blood pressure treated, and start slowly with 200 IU of vitamin E a day. After a week or so, increase the dose to the 400 IU level. One additional note: Several studies have noticed an increase in bleeding when vitamin E and aspirin are used in combination, a condition implicated in both ulcers and strokes. It is rare, but discuss this risk with your physician, especially if you have a history of ulcers or other blood-clotting problems.

Vitamin C

Have you ever noticed that the minute you get a cold, everyone from the checkout man at the grocery store to your mother starts telling you to take vitamin C? That is the legacy of Nobel Laureate Linus Pauling. All of us know that vitamin C is good for us, but most of us probably couldn't say why.

What exactly does vitamin C do? Like vitamin E, vitamin C helps to keep the arteries clear by inhibiting the oxidation of fat in the walls of your blood vessels. It converts cholesterol to bioacids, so they can be washed out of the body easily and not add to the problem of lipid buildup. Since vitamin C is water soluble, it enters the cells that make up the wall of the vessels themselves, binding to free radicals lurking inside the cell, precisely in the place where those free radicals are likely to cause DNA damage. Because of its healing capabilities, vitamin C helps maintain a healthy matrix in the blood vessels, repairing the vessel walls when they become damaged. When it comes to keeping the cardiovascular system healthy, vitamin C seems to help men more than women, and vitamin E helps women more than men. Regardless of your gender, you should take both vitamins (see Table 7.1).

In addition, vitamin C helps reduce high blood pressure, prevents cataracts, and promotes healing. It improves lung function, preventing ageing of the respiratory system. And it really does keep your immune system young. Linus Pauling thought vitamin C helped cure colds. We now know it decreases our risk of the one ager we all want to avoid—cancer!

Since vitamin C is water soluble, it washes out of your body when you urinate. It is important to get several doses of vitamin C a day. I recommend at least two, usually three, doses daily. I do this by combining food and supplements. In the morning, I drink a big glass of orange juice, I take a multivitamin with 200 mg of vitamin C in it, have an orange or a grapefruit at lunch, and then take a 500-mg supplement at night, just to make sure I'm getting enough. I also get vitamin C from other things I eat, just in smaller amounts, such as tomatoes or salads. The RAO for vitamin C is about 1,200 mg a day from food and supplements, taken in smaller amounts spread throughout the day. The RDA is just 60 mg, way short of the antiageing optimum. Vitamin C tends to leach out of packaged or cut vegetables. Moreover, cooking reduces vitamin C levels even more. It is important to make sure you eat plenty of fresh fruits and vegetables every day. Eat some fruit or take some of your vitamin C one to two hours before you exercise. Exercise causes the buildup of oxidants.

It doesn't matter what kind of vitamin C you take, either natural or synthetic. Your body can't tell the difference. Personally, I stay away from chew-ables because they are hard on the teeth. Although it costs a little more, I prefer taking vitamin C that contains calcium ascorbate, which helps prevent the stomachaches that straight ascorbic acid (vitamin C) can cause. If you have a sensitive stomach, take the calcium ascorbate form of vitamin C. Besides, it's another source of calcium, and, as you will see in the next section, you want to get as much calcium as you can!

Two more comments on vitamin C. A recent headline said that vitamin C caused cancer by causing breaks in DNA. What the headline didn't say was that at the 500-mg dose, vitamin C appeared to prevent, or be associated with repair of, far more DNA damage than it caused. If you take 500-mg pills, take them no more frequently than one every six hours to get the optimum balance.

Finally, I have to respond to the question, Does vitamin C prevent colds? The answer is no. But it does lessen their effect. To get this effect, when you begin to show signs of a cold, increase your dosage of vitamin C to as much as 4 grams (4,000 mg) a day, taken with plenty of water (eight glasses for 4 grams). Although this amount won't cure your cold—Linus Pauling wasn't exactly right—it will lessen the severity of the symptoms. For example, when I have a cold and take my C, I find I can keep exercising.

Now, let's consider the last big antioxidant vitamin, vitamin A. What is it about A that makes it an ageing vitamin, not an antiageing one?

Vitamin A

In 1988 Americans spent less than $8 million a year on vitamin A supplements. Now they spend $80 million on vitamin A, often sold in the form of beta carotene. They may be doing themselves more harm than good.

This is an example of too much of a good thing. In the late 1980s, a study came out showing that people who ate foods with lots of vitamin A in them tended to have lower rates of cancer. People interpreted this result to mean not that they should be eating more fruits and vegetables, but that they should be taking vitamin A supplements. The market boomed. Sales of vitamin A and beta carotene, a substance the body breaks down into vitamin A, went through the roof.

More recent studies have found that we jumped the gun. First, the correlation between vitamin A and the prevention of cancer is not as strong as was once thought. Second, too much vitamin A can actually be harmful. Although it is important to get sufficient vitamin A, you should do this by eating well, not by taking supplements. Especially avoid megadosing. Do not take more than 8,000 IU a day, which is a standard dosage in many vitamin supplements. In choosing a supplement, try to find one that has the vitamin A in the form of beta carotene because the body will not convert beta carotene into vitamin A if it has no need for it.

Vitamin A is a necessary and important nutrient, but taking large doses of it can be dangerous. Why? Because vitamin A is a nutrient that is 'level sensitive.' When levels of vitamin A are moderate, it works as an antioxidant and is important to the functioning of your body. However, when you megadose, the surplus vitamin A does the opposite. Rather than functioning as an antioxidant, high doses of vitamin A work to oxidize tissues. So taking too much vitamin A makes you age faster.

A 1993 study in Finland showed that people who took vitamin A had an increased risk of lung cancer; atherosclerosis; and, for smokers, stroke. Several other studies have confirmed these findings. Excessive amounts of vitamin A may cause liver damage. Smokers need to be especially careful about taking any kind of vitamin A, even the beta carotene form; when combined with smoke, vitamin A can be toxic.   

Although health-food stores still push vitamin A and beta carotene, remember that you probably get enough in a multivitamin and in your daily diet. For basic antioxidation, rely on vitamin C and vitamin E. Carotenoids (such as lycopene found in tomatoes) and flavonoids (found in onions, garlic, and grape products such as wine) also seem to have antioxidant power. Likewise, they help decrease ageing of the arterial and immune systems. We discuss them in Chapter 8. As good as vitamins E and C are, remember this: When it comes to vitamins, antioxidants are just the opening act. Another great duo is calcium and vitamin D.

(SOME  YEARS  BACK  MY  DAD  HAD  A  CERTAIN  HEALTH  PROBLEM [CANNOT  REMEMBER NOW  WHAT  IT  WAS];  HE  FOUND  HE  WAS  GETTING  TOO  MUCH  VITAMIN  A;  WHEN  HE  REDUCED  HIS  INTAKE  HIS  HEALTH  PROBLEM  DISAPPEARED  -  Keith Hunt)

Calcium

Bone weakening, or osteoporosis, affects more than 25 million Americans. It is the major underlying cause of hip fractures and bone breaks in the elderly— about 1.25 million bone fractures, including 300,000 hip fractures, are caused annually by osteoporosis. Although osteoporosis affects women disproportionately, especially small-boned women of northern European or Asian descent, we are all at risk. Twenty million women suffer from the disease, but so do 5 million men. As more men live longer, they, too, will be at increased risk of osteoporosis.

We often forget that our bones are living tissues that need proper care. After we have completed our growth cycles, it is easy to forget about them. Just as we can make our arterial and immune systems younger, we can make our bones younger as well. Doing so protects us for the long term, reducing our overall RealAge. How do we make our bones younger? By making them stronger. We can do that by taking 1,000 to 1,200 mg of calcium a day.

Osteoporosis is a condition involving the loss of bone density. As you age, your bones lose calcium, becoming progressively weaker. Why? Your body stores excess calcium until you reach your early thirties, at which time you reach your peak level of bone density. After that, your body stops storing extra calcium. You must then get all the calcium you need from your daily diet, or you will begin to deplete the calcium stores in your bones. Just imagine your skeleton as the structure of a house. Your bones are the beams that buttress your body. In a house, you have to worry about termites: they hollow out the beams from within until the beams become so weak they collapse. As your body depletes the calcium stored in your bones, they become weaker and weaker, until, finally, like termite-eaten beams, they are almost hollow. Then, snap. They break. And a broken bone, especially a broken hip, is one of the things that can age you the fastest. Just six months of immobility can reverse all your RealAge progress by a third or more. Each day you go without activity, you get older.

Why is breaking a hip so bad? It's not the fracture itself that ages a person but, rather, the complications that stem from such an injury. A hip fracture may be the beginning of a downward spiral, triggering a chain of ageing events. When a person is bedridden, the body weakens, becoming susceptible to pneumonia and other infections that can often be fatal. With less exercise and movement, arteries start showing signs of ageing, becoming less elastic and more prone to disease or failure. Also, the immune system becomes more vulnerable. For older people, the mortality rate from hip fractures is as high as 20 percent (12-20 percent of older women who have had hip fractures die within six months). Furthermore, 40 percent of those who survive that initial six months require long-term nursing care. More than half never regain their former quality of life.

Hip fractures are astoundingly common. Thirty to forty percent of women over calendar age sixty-five have fractured their spine or vertebrae, and twenty-five percent of such women will suffer a fractured hip. Doing what you can to prevent a fracture is one of your best protections against ageing. Remember, it's not just women, either.

Men traditionally have been much less susceptible to bone fractures than women. Just 5-10 percent of men over age sixty-five have these kinds of debilitating fractures. Since historically men have not lived as long as women, however, we know less about the strength of men's bones as they age. It appears that men also suffer bone loss as they get older, although they start out with higher bone density than women. I predict that as more men live longer, bone loss and severe fractures will become an increasing problem for them, too.

If you are working to make all the rest of you younger, you should make sure that your bones also stay young. For the best RealAge advantage, men and women should make sure to get enough calcium—that is, 1,000 to 1,200 mg a day for men and 1,200 mg for most women over thirty (pregnancy and other conditions may change the requirements slightly). Take 500 or 600 mg twice a day. (This refers to the amount of actual calcium, not calcium in combination with citrate or carbonate. If the label reads 1,000 mg of calcium citrate, read on to find the amount of calcium by itself.) Any kind of calcium supplement, even over-the-counter antacid tablets, should fit the bill, just as long as you are getting the right milligram amount. I advise against taking calcium supplements that contain bone meal, dolomite, and/or oyster shells, as these can contain lead or other heavy metals that may be toxic. Calcium carbonate is best absorbed when taken with food. Calcium citrate may be taken at any time (either by itself or with food). Both forms can cause constipation. If you notice this side effect, eat more fruits and vegetables or rely on that old standby, a prune a day. Some recommend taking about 300 mg of magnesium in conjunction with the calcium (see the section on magnesium later in this chapter).

Although calcium is plentiful in dairy foods (milk, cheese, and yogurt), most people do not eat enough dairy products to get adequate amounts of calcium from diet alone. Eat dairy foods for extra calcium, but do not rely on them as your only source of calcium unless you eat and drink a lot of dairy products (and, of course, remember to eat low-fat versions). If you consistently drink three or four glasses of milk a day (most adults do not drink anywhere near that amount), then you can modify the amount you take in supplemental form accordingly. But be very careful to make the 1,000- or 1,200-mg marker daily. And a reminder to anyone under thirty, or even thirty-five, who's reading this: You should get lots of calcium to build bone strength for the future because the calcium the body stores in bone then becomes the surplus stores for the rest of your life.

Not only does calcium help your bones, it may also help lower your blood pressure. A recent study showed that men who took 1,000 mg of calcium a day had a 12 percent reduction in blood pressure. This evidence remains controversial, as other studies have reported no such lowering of blood pressure. Although there is as yet no consensus on this finding, lower blood pressure may be just one added benefit of taking calcium, which is something you should be doing anyway. Another side note for people with high blood pressure: A common treatment for high blood pressure is the administration of calcium channel-blocking drugs. These drugs have nothing to do with calcium supplements, so don't be concerned. Go ahead and take calcium supplements.

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TO  BE  CONTINUED

REAL  AGE

Vitamin D: The Strong-Bone, Anticancer Vitamin

There are some pairings where you can't imagine one without the other: Bonnie and Clyde, Abbott and Costello, Charlie Brown and Snoopy. The same is true for calcium and its vital partner, vitamin D.

Vitamin D is essential for proper absorption of calcium. Vitamin D helps strengthen bones and prevents the joint deterioration that accompanies arthritis. Vitamin D and its metabolites appear beneficial in reducing certain kinds of breast, colon, prostate, and lung cancers. No one is exactly sure why it works as an anticarcinogen, but both animal studies and one major epidemiologic study on humans showed this to be true. One of the most important vitamins in your Age Reduction Plan might be vitamin D.

Vitamin D may also help protect the body from the onset and ageing effects of arthritis itself, but this finding is still somewhat speculative. Osteoarthritis is a disease that afflicts more than 10 percent of the population sixty-five or older. It is painful, disabling, and ageing. Recent studies from Framingham, Massachusetts, and elsewhere have shown that taking calcium, vitamin C, and particularly vitamin D can retard the progression of arthritis and perhaps even prevent it. These studies found that those who had high levels of vitamin D in their bodies had less joint deterioration and fewer of the painful bone spurs and growths that can accompany arthritis as it worsens. Arthritis patients with low levels of vitamin D and calcium were reported to be three times more likely to suffer the rapid progression of the disease than those who had high levels of these nutrients in their bodies. Arthritis caused them to age faster.

Importantly, vitamin D seems to help prevent cancers. Although no one knows exactly why, and confirming studies are yet to be done, three primary theories try to explain how vitamin D works as a deterrent to cancer. All three have some validity, as evidenced by both animal and test-tube studies, but we still lack confirmation from studies on humans.

The first theory speculates that the D3 form of the vitamin kills cells which contain DNA mutations. Somehow, vitamin D3 is directiy lethal to mutated, possibly cancerous, cells. The second theory suggests that vitamin D3 promotes the death of cancerous cells. The body has an internal mechanism by which it is able to recognize mutated cells, and vitamin D3 is an essential component used in the body's attempt to rid itself of these cells. The final theory proposes that vitamin D3 promotes protein transcription; that is, it helps make proteins from the P53 gene, a gene that is one of the body's cancer watchdogs. Vitamin D appears to be vital for the proper functioning of the P53 gene. This gene helps prevent cancer by regulating the protein production of specific oncogenes—genes that, when mutated, can cause cancers. Indeed, vitamin D not only helps in the proper functioning of the gene but also appears actually to help safeguard the P53 gene from genetic damage.

Although studies still need to be done to confirm the link between vitamin D and cancer prevention, it is very possible that vitamin D does double duty by helping to prevent ageing of not only the skeletal system but also the immune system. When I think of vitamin D, I think of 'defense.' Vitamin D helps you defend yourself.

Most American adults do not get enough vitamin D. Estimates are that 30 to 40 percent of adults are vitamin D-deficient. You get vitamin D from two and only two sources: first, the sun; and second, food and supplements. Let me explain how our bodies produce vitamin D from sunlight.

Vitamin D production is a three-stage process. In the first stage, the body takes in food that contains a kind of cholesterol that is the precursor to vitamin D. Our bodies can't use this cholesterol form of the vitamin without first converting it. Only a few foods, such as cod liver oil and certain fatty fishes (tuna; salmon; sardines; and, to a lesser extent, cod itself) naturally contain vitamin D in the form that can be used by our bodies. For conversion, the second stage, we need sun. Solar radiation is necessary to create the right chemical reaction in our bodies to turn these cholesterols into vitamin D. In the final stage of the process, the liver and kidneys convert that vitamin D into yet another form of the vitamin, vitamin D3, the active form that our bodies can use. As mentioned in the section on sun exposure (see Chapter 5), you need just ten to twenty minutes of sunlight a day to ensure that your body is producing enough vitamin D. Most of us do not get enough sun, particularly in northern climates. In Boston or Seattle, for example, it is almost impossible to produce the necessary levels of vitamin D from sunlight alone from November through February. After we reach our seventies, the precursor to vitamin D generally found in our skin diminishes three or fourfold, making it increasingly difficult for us to produce vitamin D naturally.

The second and less risky way of getting enough vitamin D is through food and supplements. Some foods, mainly fish and shellfish, contain vitamin D naturally. Such foods as milk (the major source of vitamin D in food) and most breakfast cereals contain vitamin D as an additive. These additions, which help prevent rickets (a vitamin D-deficiency disease) in children, are synthetic. When it comes to getting vitamin D, it is no better for us to drink milk than to take a pill. When you drink milk—you get the added benefits of calcium and protein. As I mentioned earlier, most adults do not drink milk in sufficient quantities to get their vitamin D from diet alone.

So how much vitamin D do you need to get the maximum antiageing protection? The RDA of 55 IU only ensures a level of vitamin D that prevents a deficiency disease, such as rickets. I recommend that you consume at least 400 IU of vitamin D a day in a vitamin supplement if you are under seventy years old, and 600 IU if you are older than seventy, unless you are absolutely sure that you are getting enough from your diet. This amount is what I consider the RAO. That means four glasses of milk a day (for 400 IU). Vitamin D overdoses are exceedingly rare among adults. To develop toxic levels of vitamin D in your blood, you would have to consume more than 2,000 IU a day for more than six months.

In addition to the supplement, I recommend getting some sunlight. Ten to twenty minutes a day outside without sunscreen should provide sufficient vitamin D protection, although the farther north you live, the less likely it is that you can produce all the D you need this way. If you are going to be in the sun for more than twenty minutes, put on sunscreen. Note that an SPF 8 sunscreen reduces your vitamin D production by 95 percent, and SPF 30 cuts it to zero. The risk of skin cancer from a little bit of sunlight is probably less than the benefits you gain from having healthy vitamin D levels, especially the older your calendar age. Finally, if you are worried about vitamin D deficiency, you can ask your doctor to test your blood levels. The test will quickly determine whether you are getting enough vitamin D.

Vitamins E and C work as a team. Calcium and vitamin D work as a team. Now let's look at a vitamin that works all on its own—folate, a member of the vitamin B family.

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TO BE CONTINUED

REAL  AGE

The Risk of Homocysteine, and the Folate Counterattack

Every time I visit my lawyer, he asks me for a health tip. The last time I went to see him, he asked me, 'So, Mike, what's the latest thing I should be doing to get younger?'

Without hesitation, I said, 'Taking 400 micrograms of folate a day as a supplement.'

'Folate? What for?' he replied.

'To reduce your homocysteine,' I said.

'My what?'

'Homocysteine. It's worse for your arteries than a sixty-four-ounce steak.'

'I thought cholesterol was the worst thing.'

'If cholesterol is petty crime, homocysteine is grand larceny.' Then I gave him some free medical advice in exchange for some paid legal advice. Lawyers!

Homocysteine is an amino acid that is a by-product of various metabolic processes that may build up in the blood. As you age, your homocysteine levels increase. No one is exactly sure what homocysteine does to the arteries, but it is well established that people with high levels of homocysteine have considerably more arterial disease and much higher rates of atherosclerosis than those who don't.

People with high levels of homocysteine in their blood are at a significantly higher risk of the early onset of arterial disease and suffer markedly greater rates of arterial ageing. Elevated homocysteine levels triple the risk of heart attacks and stroke. More than 42 percent of people with cerebrovascular disease, 30 percent of those with cardiovascular disease, and 28 percent of those with peripheral vascular disease have homocysteine levels that are too high. Getting 400 micrograms (meg) of folate a day can reduce homocysteine levels dramatically, essentially removing any excess from your bloodstream and stopping its ageing effect. It's a quick, easy, and painless way to make your arteries younger. By religiously taking 400 meg of folate a day, you can reduce your RealAge by 0.6 years in just three months. If you already have elevated levels of homocysteine, you can reduce your RealAge by three years in just three months.

As I discussed in the chapter on arterial ageing, one of the main causes of arterial ageing is atherosclerosis. For some reason—no one knows for sure— high levels of homocysteine seem to disturb the endothelium, the inner lining of the artery. Some scientists believe that homocysteine causes small openings in the cell layer, leading to deterioration of the arterial wall and the buildup of plaque. There are other hypotheses as well. Homocysteine may decrease the production of relaxing factors that let our blood vessels dilate. It may stimulate blood clots by changing the shape or form of the cells that form the endothelium. Homocysteine might also oxidize low-density lipoproteins (LDL—remember 'L' for lousy—cholesterol), promoting the buildup of plaque along the walls of the arteries.

Although we don't know all the reasons, there is a clearly established link between high homocysteine levels and arterial ageing and a clearly established link between high folate levels and arterial health. One study estimated that if everyone had proper levels of folate, the number of heart attacks in the United States could be reduced by as much as 40,000 to 150,000 cases a year, and this number may be too conservative! The risk-factor statistics predict that a more realistic estimate would be a reduction of one-third in the rate of heart attacks in the United States a year. In other words, perhaps as many as 450,000 heart attacks occur a year because we don't get enough folate.

As folate levels drop, homocysteine levels increase, and vice versa. The two compounds are part of a complex chemical reaction involving many steps, but the end result is that more of one means less of the other. The more folate you take, the lower your homocysteine levels.

Folate (in its natural form)—or folic acid (in supplements)—is part of the B-complex family of vitamins. Folic acid is often prescribed for pregnant women because it is essential for the normal development of the brain and spinal cord of the fetus. Although we tend to think of folate as being essential during infancy, we need it as adults, too. As you age, folate concentrations drop. The most common vitamin deficiency found in older people is a deficiency of folate. More that 50 percent of all Americans do not get enough folate daily. On average, American men consume 281 meg of folate a day and American women, just 271 meg. Older people ingest even less. All are far below the ideal intake of 1,100 meg of folate in food or 675 meg of folic acid in supplements a day.

Lots of foods contain folate. A glass of orange juice has 43 meg of folate, and many breakfast cereals average 100 meg a serving. Still, to get enough folate, you would have to drink about twenty-five glasses of orange juice a day! A slice of white bread has only 6 meg of folate and a green salad, just 2 meg.

Since the average intake of folate is approximately 275 meg from diet, a 400-mcg supplement is what you should take to get the 675-mcg-a-day RAO, the RealAge optimum. If you are trying to get all your folate from your diet, you will have to consume even more—as much as 1,100 meg—since the body will absorb only about half the folate found in food. For example, 700 meg of folate found in food is equivalent to about 400 meg of the folic acid found in supplements. Don't worry about an overdose of folate. Toxicity occurs only when more than 1,500 meg is ingested a day on a regular basis.

You will need to take folate consistently for the rest of your life. Studies show no known side effects of folate consumption. If your kidneys are not working properly, you should probably not only take folic acid supplements, but also eat a low-protein diet. This will help control homocysteine levels, which normally increase with a high protein diet. Vitamin B6 also lowers homocysteine levels, so you may want to consider that option. Consult your physician.

Should you have your homocysteine level cheeked? Probably not. The test is expensive and difficult to perform. It is far easier to try to get adequate folate every day. If homocysteine is high, folate will bring it down. If it is low, folate will help keep it low.

As a medical student, I was taught that high homocysteine levels were associated only with a rare disease. In those days, we 'hotshot' medical students and residents used to laugh at the 'old, out-of-date clinicians' who gave their elderly patients shots of B12 and folate as placebos, often to make them feel better. Perhaps those 'old fogies' knew something we young hotshots didn't. Getting enough folate makes your RealAge at least 1.2 years younger.

By the way, make sure you get adequate B12 (25 meg) and B6 (4 mg) each day, as well. The highest quantities of B6 are found in almost all beef, parsley, many fish (cod, halibut, herring, salmon, sardines, and tuna), bananas, avocados, some fortified cereals, whole grains, eggs, chestnuts, peanuts and sunflower seeds, beans (garbanzo beans, lima beans, green beans, pin beans, and lentils), soybeans, spinach, potatoes, and green peppers. Most of us get this much B6 and B12 from our diets or multivitamin, but vegetarians may need to take supplements of these two vitamins (see Chapter 8).

TO  BE  CONTINUED

Real Age

Minerals

Besides calcium, a number of other minerals are found in either large or trace amounts in our bodies, all of which are necessary for basic metabolic function. Magnesium, potassium, sodium, chloride, sulfur, and phosphorus are, like calcium, needed in relatively large quantities. Most people's diets provide sufficient quantities of all these minerals, and, in the case of sodium, we may get far more than we require. People with salt-sensitive high blood pressure, arterial disease, and excess weight gain often need to reduce their sodium intake. Trace minerals that we need include chromium, copper, cobalt, iodine, iron, fluoride, manganese, molybdenum, selenium, and zinc. Our bodies demand these minerals in much smaller amounts, and we generally get them from our diet. Silicon, vanadium, nickel, lithium, cadmium, and boron are other trace minerals we seem to need, but scientists know much less about them. If you are eating a well-balanced diet, you can make sure you're getting enough of all these minerals by taking a multivitamin at least once a week. Do not take extra mineral supplements.

Why? Minerals are insoluble elements that come from the earth's crust. Many of them are heavy metals, which can be toxic in excess amounts. With minerals, you want to make sure to get enough without overloading. Extra minerals can build up in the body. Iron is a perfect example.

Iron

Unless you have been diagnosed with an iron deficiency—a condition seen almost exclusively in premenopausal women, growing children, and occasionally vegetarians—it is more likely that you have to worry more about getting too much iron than not enough. Men and postmenopausal women are at the lowest risk of iron deficiency, and most of us—no matter who we are—get plenty of iron from meats, fortified breakfast cereals, breads, and pastas. In fact, the United States has been criticized for adding too much iron to such foods as breakfast cereals. The critics aren't all wrong; the consequences of taking too much iron can be grave. Iron overload can be life threatening and may make your RealAge older.

Perhaps this news sounds surprising. After all, most of us were raised with cartoon images of Popeye gulping down spinach to revitalize his strength. We all thought we needed iron. Don't get me wrong—spinach is good. It's needless iron in supplements that ages us. Avoid iron unless it is prescribed for you by a physician.

When Jason—a body builder, just twenty-four years old—came to see me, he should have been at the peak of health. Instead he was near death. He suffered from congestive heart failure, unusual for someone so young. A few more months of decline, and he would have needed a heart transplant. Whereas he once had been able to bench-press three hundred fifty pounds, by the time I saw him he could barely get out of a chair. His condition seemed a mystery: A young man to an old one in just three years. Luckily for him, other patients' histories had convinced me of the need to ask everyone about the use of vitamins and supplements, and I learned that Jason was taking 10 grams of iron a day. He thought that it would help him build muscle, but he was wrong. It was killing him. Fortunately, the treatment to remove the excess iron that had built up in his body worked. He recovered completely, his heart intact.

Although iron overload as extreme as Jason's is relatively rare, his story proves a point. Iron stays in the body for a long time and, when present in large amounts, can be toxic. The body rids itself of iron primarily through bleeding, which is why menstruating women are sometimes anemic or deficient in iron. Early symptoms of iron overload include abdominal pain, fatigue, and loss of sex drive. Later symptoms include enlargement of the liver, diabetes, arthritis, and shrinking of the testicles. In severe cases, such as Jason's, iron overload can cause an abnormal heartbeat and even heart failure.

Hemochromatosis—chronic iron overload—is a fairly common affliction, and as many as one of every two hundred fifty people has a genetic predisposition to developing the condition, making hemochromatosis one of the most frequently occurring genetic disorders. Even people who don't carry the gene can develop the disorder, which damages such key organs as the liver and heart and causes needless ageing.

Even slightly excessive levels of iron in the body can be damageing. Too much iron may interfere with our levels of zinc. Studies have linked elevated iron levels with increased rates of cardiovascular disease and cancers. Although in both cases the evidence is somewhat preliminary and more studies are needed to prove the links, taking extra iron is not worth the risk. In RealAge terms, it can increase your ageing.

There are two possible ways that even low levels of iron toxicity can age us. First, iron appears to contribute to arterial ageing. No one knows exactly how, but the theory is that because iron is an oxidant, it increases the oxidation of LDL cholesterol. When LDL cholesterol is oxidized, it becomes especially dangerous, causing atherosclerosis. Some scientists have speculated that one of the reasons menstruating women have lower rates of cardiovascular disease is that they have lower levels of iron in their blood. One Finnish study showed that the rate of heart attacks doubled when the concentration of iron in the blood exceeded 220 mg/dl (milligrams per deciliter of blood). This risk was four times higher for patients who had both high iron levels and an LDL cholesterol reading of 190 or higher. Other studies have been unable to confirm this link, and the claims about the connection have been strongly contested. But, why risk it?

Elevated iron levels have also been linked to cancers. The data remain preliminary, and we still don't completely understand the relationship, but two major theories suggest why this may be the case. First, iron is an oxidant. In contrast to antioxidants, such as vitamins C and E, that remove free radicals from the body, iron enhances the production of free radicals, which, in turn, is linked to an increased incidence of cancer. Second, cancer cells appear to demand more iron than other cells. When cancers do develop, the increased iron in the body may fuel them to grow at a faster rate. Although neither theory has been proven, studies in the United States and Finland have shown an increased risk of cancers for people with elevated levels of iron.

If you are not iron deficient, make sure that your multivitamin does not contain iron. Eat normally. Take iron only if anemia is a chronic problem and you are specifically directed to do so by a doctor. If you are a vegetarian, be sure to have your red blood cell count checked annually just to ensure that you are not developing an iron deficiency. If you are a vegetarian and are eating a balanced diet, you are probably getting enough iron from other sources. If you are a woman and still menstruating, have your iron levels checked before you decide to take iron. Most menstruating women do not require iron supplements.

Chromium

Chromium, a mineral involved in glucose metabolism, is important for the synthesis of cholesterol, fats, and protein. Health-food gurus advocate chromium—usually in the form of chromium picolinate—for everything from weight loss to cholesterol reduction to the alleviation of depression to treatment for hypoglycemia and diabetes. Chromium has also been said to prevent osteoporosis, to build muscle, and to promote longevity. In light of these claims, should you take chromium as a supplement? Chromium is certainly a necessary mineral, but we generally get enough from our diets to provide for our needs. Chromium is found in many whole grains, meats, and dairy products—even in beer! Clearly, having proper levels of chromium in your body is necessary to metabolize blood sugar, and most of the benefits associated with chromium are tied to the process of proper glucose metabolism. Doctors sometimes advise that people with Type II diabetes take chromium to boost the effect of insulin. Regardless, if you have diabetes, you should not take chromium or any drug without first consulting your doctor.

Most of the longevity claims made for this mineral stem from animal studies and seem to be tied to the already well-known fact that a low body mass index increases life span. Several studies in the 1980s glorified chromium as a wonder nutrient, but the results have largely been disproved. It is still unclear whether taking chromium as a supplement promotes safe weight loss, and some studies have indicated that chromium may even cause weight gain. Indeed, one study linked the intake of chromium picolinate with weight gain among already overweight women. As for other claims, studies have shown little evidence that chromium adds muscle mass. Since we know little about chromium toxicity, we don't have much sense of how much a person can take without causing a negative effect. Too much chromium can cause heart palpitations, high blood pressure, and even psychosis. Animal studies have shown that chromium can cause chromosomal damage and so may pose a risk of cancer as well. I recommend eating a balanced diet and taking a multivitamin as a backup. That should provide all the chromium you need.

Selenium

Recently, there has been a big stir over selenium, which has been heralded for its antioxidant properties. Selenium is one of the trace minerals that our bodies need. We get selenium largely from such plant foods as garlic, which absorb the mineral from the soil they grow in. The soil in different regions of the country varies considerably in selenium content.

A recent study in the Journal of the American Medical Association reported a 50 percent reduction in cancer deaths among diagnosed patients who took 100 meg of selenium twice a day. Yet other research has suggested that selenium may have an immune effect as well, boosting resistance to certain viruses. These findings are still preliminary and have been much criticized by some cancer researchers. Unfortunately, all we have are tantalizing tidbits. The National Cancer Institute is funding at least five studies on the potential benefits of selenium, and we should know considerably more about the role of selenium within the next four years. Of the five primary medical advisers on the ReaLAge team, one thought the data convincing enough that he began taking selenium. The other four chose to wait for more information.

Although we may find that selenium has important antiageing properties, it is a trace mineral that is not easily excreted by the body and can build up to toxic levels, causing needless ageing. The current recommended daily allowances for selenium are 70 meg a day for men and 55 meg a day for women. I recommend that you get this mineral from your diet, rather than from a supplement. That way, you probably won't overdo it. Most Americans who eat a balanced diet should not worry about a deficiency, since selenium is plentiful in many foods: garlic, whole grains, cereals, meats, and some seafood. Since garlic in particular has been thought to provide numerous health benefits, I recommend getting selenium by loading your meals with lots of garlic.

Potassium

Strokes are the major cause of cognitive ageing, or ageing of the brain. Thankfully, strokes can largely be prevented. One easy thing you can do to minimize the risk of stroke and the ageing it can cause is to increase your intake of potassium. If you already eat a normal diet rich in fruits and vegetables, supplementing that diet with three bananas (or their potassium equivalent) a day can make your RealAge as much as 0.6 years younger in just three years.

What makes potassium so important? Potassium is what is known as an electrolyte, an electrically charged particle, an element the body needs for proper cellular functioning. Every time a nerve impulse is conducted or a muscle is contracted, potassium—because it carries an electrical charge— makes that reflex possible. Potassium, in conjunction with other minerals, regulates blood pressure and allows the heart and kidneys to function properly. Four major studies have shown that increased potassium intake is linked to a decrease in the incidence of strokes and may prevent other kinds of arterial ageing, too. How does potassium prevent ageing?

We still don't know, but studies on rats have shown that potassium acts as a counterbalance to sodium intake. Whereas rats fed a high-sodium diet normally had shortened life spans, that effect was mitigated when they were fed a high-potassium diet. In human clinical trials, the Rancho Bernardo study found that people who ate comparatively little potassium had 2.6 to 4.8 times the risk of stroke as those who ate considerably more potassium. Of the 287 people who had high potassium intake, no one had a stroke during the study. Among the 572 people with lower potassium intake, 24 had strokes. Possible explanations? Three studies found that increased dietary potassium intake decreased blood pressure, thus decreasing the rate of arterial ageing, which can cause both heart attacks and strokes. That could not have been the whole story because the decrease in blood pressure does not account for the entire RealAge benefit. Other biological mechanisms that may account for the RealAge effect include stabilization of arterial plaques, decreased oxidation of lipids, and stabilization of nerve cells when they get inadequate oxygen.

There is no RDA standard for potassium, but nutritionists recommend that you consume about 3,000 mg a day. If you eat a balanced diet, you will probably get a little more than half that amount in normal consumption. Bananas and avocados are, ounce for ounce, the richest sources of potassium. One banana contains about 467 mg of potassium, and both Florida and California avocados contain over 1,000 mg of potassium per fruit. Although avocados are highly caloric because they are high in fat, they are rich in monounsaturated fats—the kind of fats that are good for you (see Chapter 8). Potatoes, citrus fruits, tomatoes, spinach, celery, cantaloupes, and honeydew melons are also excellent sources of potassium, having 400 to 500 mg a serving. Even though they are relatively high in calories, dried apricots and peaches provide over 1,500 mg of potassium per cup, which is all the extra potassium you need in a day. Dairy products, lean meats, and such fish as tuna, mackerel, and halibut contain over 500 mg per serving. Sardines are extremely rich in potassium, with over 1,000 mg per serving. Skim milk and low-fat yogurt are excellent sources of potassium (400 mg per serving). To get the RealAge benefit of potassium, try to eat three bananas (or about 1,400 mg of potassium) a day and get the rest from a well-balanced diet, with plenty of fruits and vegetables rich in potassium. By doing so, your total intake would be about 3,000 mg a day.

Under no circumstances should you take potassium supplements unless advised to do so by your doctor, as overdosing can be a problem. Although most of us do not consume the optimal amount of potassium, actual potassium deficiencies are truly rare, except in people with very specific medical conditions. Since certain medications may deplete potassium supplies, supplements may be advised, but they should be taken only under strict medical supervision. Remember, too, that increasing potassium intake can actually cause ageing in people who have kidney disease or are taking certain medications, so talk to your doctor before increasing your potassium intake. For most of us, however, increasing potassium intake through diet is a quick, easy way to make our RealAge 0.6 years younger and to decrease our risk of stroke and the associated cognitive ageing it can cause.

Sodium

Although sodium is a vital mineral for proper functioning of your body, you don't need to worry about getting enough of it. Most Americans consume far more sodium than they need. The minimum amount of sodium you need for good health is 116 mg a day, and the average American consumes more than 4,000 mg.

When we hear the word sodium, we tend to think of table salt (sodium chloride), but the fact is, sodium comes in many other forms. Approximately 75 percent of the sodium you consume comes not from the salt shaker but as an additive to processed food. Table salt is actually only 40 percent sodium.

High consumption of sodium is associated with higher blood pressure in some, and perhaps all, people. Numerous studies have found this to be true.

The most famous study of this kind was the InterSalt study, which evaluated sodium consumption in over 10,000 people in fifty-two study centers. Sodium intake correlated with an increase in blood pressure, and, correspondingly, high blood pressure correlated with an accelerated rate of arterial ageing. For years, doctors have been prescribing low-salt diets to those whose blood pressure showed a particular sensitivity to sodium. Indeed, the first correlation between sodium intake and high blood pressure was made by Ambard and Beaujard in 1904. As a result, early in the century, low-sodium diets were frequently prescribed as a way to successfully lower blood pressure. The development of blood pressure medications encouraged many doctors to move away from this approach, except in rare instances in which it could be shown that an individual was 'sodium sensitive.'

Newer data suggest that perhaps all of us age faster when salt consumption is excessive. The idea of sodium sensitivity is problematic. A chief drawback of the sodium-sensitivity theory is that no one knows who is sodium sensitive until after high blood pressure develops, and by then significant ageing has already begun. Many people's sensitivity to sodium changes with age, as their metabolism undergoes other changes as well. The best choice is to cut back on sodium intake. Sodium chloride (salt) restriction, exercise, and weight control form the triad of behavioral changes that can best help you reduce the likelihood of developing high blood pressure and subsequent arterial ageing.

Although the average American consumes about 4,000 mg of sodium a day, most reputable medical organizations, including the U.S. Surgeon General's Office, the National Institutes of Health, the National Academy of Science's Research Council, and countless experts in the field, suggest that sodium intake should not exceed 2,400 mg (about a teaspoon of salt) a day. I go further and suggest that for the maximum Age Reduction benefit, try to keep sodium consumption at less than 1,600 mg a day. A fifty-five-year-old man who has consistently consumed only 1,600 mg of sodium a day is as much as 2.8 years younger than his counterpart who has paid no attention to sodium intake.

How can you reduce sodium intake? The easiest way is to decrease your consumption of processed and prepackaged foods, since a lot of sodium is used to preserve these products. Most fast foods are also high in sodium—just one more reason not to frequent Burger Heaven. Alternatively, fresh fruits and vegetables and fresh meats and poultry contain little sodium. If these foods form the basis of your diet, you will significantly reduce your sodium consumption without really trying. When you do buy prepackaged or canned foods, read the labels. Foods that you would never describe as 'salty' can have an astounding amount of sodium. Cheese, preserved meats, many condiments, and some shellfish are very high in sodium, so beware. Often similar products have surprisingly different sodium levels; many companies now offer 'no-sodium' and 'low-sodium' variants of their products. Even though you should cut back on table salt, remember, it is the hidden salts in processed foods that account for most of your sodium consumption.

Although sodium deficiencies are virtually unheard of, strenuous exercise on a hot day can lower salt concentrations in the body, a condition that can trigger other complications that age the body. When exercising, drink plenty of water to keep yourself properly hydrated.

Magnesium

Magnesium is a mineral that is essential for energy metabolism. Muscle contractions, nerve impulses, and even the most basic processes of cellular energy storage require magnesium. Unfortunately, magnesium deficiency is increasingly common. Experts estimate that 40 percent of Americans are getting less than 70 percent of the RDA for magnesium. Life in the modern world seems to be especially hard on our magnesium intake: Stress, sugar, alcohol, and the phosphates commonly found in soft drinks and processed foods all deplete our stores of magnesium. Even exercise, one of the most important factors in preventing ageing, can cause magnesium deficiency because we lose magnesium when we sweat. Moreover, magnesium deficiency often provides no symptoms. The first sign that something is wrong can be a heart attack caused by an abnormal heart rhythm.

A ten-year study of four hundred persons who were at a high risk of coronary disease found that those who ate a magnesium-rich diet had fewer than half as many complications from cardiovascular-related problems as did those who ate only about one-third of the recommended amount of magnesium. Overall mortality rates for people who ate a magnesium-rich diet were lower as well. Although this ten-year study was the first in-depth study of magnesium, if its findings are true, it would mean that eating a magnesium-rich diet would lower your RealAge by as much as 0.9 years.

For now, I cannot say with certainty that eating a magnesium-rich diet will lower your RealAge, although both anecdotal and preliminary evidence suggest that it would. It has been known for some time that heart attacks are less common in areas where the water supplies are rich in magnesium. Magnesium is also known to lower blood pressure; dilate the arteries, and, when given after a heart attack, restore normal heart rhythms. Magnesium is especially important in the regulation of calcium. Since we do know that taking calcium helps reduce RealAge, it is also vital to get enough magnesium to allow for the proper absorption of calcium.

The suggested intake of magnesium is about one-third the intake of calcium, which means that women should get at least 400 mg of magnesium a day, and that men should get at least 333 mg a day. Current studies show that the average intake for Americans is less than 300 mg. People who need to be extra careful to get the right amounts of magnesium include pregnant and lac-tating women, those with kidney disease, diabetics, those on low-calorie diets, and those taking digitalis preparations and diuretics. All these people should consult their physicians before beginning any new regimen.

Magnesium is found largely in whole-grain breads and cereals. Breads made with refined flours unfortunately have little magnesium because most of the mineral is lost during the refining process. Most fortified and whole-grain cereals contain 100 to 200 mg per bowl. Soybeans and lima beans contain 100 mg per serving, and most nuts contain 100 to 300 mg per serving. Such fruits and vegetables as avocados, bananas, beets, raisins, and dates are also good sources of magnesium. When you choose your daily vitamin supplement, check to see that it contains magnesium. If you worry that you are not getting enough magnesium, consider supplementing your diet with 250 to 300 mg daily. As with all Age Reduction behaviors or plans you adopt, check with your doctor first, since those who have kidney problems can accumulate too much magnesium and have serious side effects.

Zinc

Recent claims have linked zinc to antioxidant activity and immune system response. Unless you are a vegetarian or are on a restricted diet, you probably get enough zinc from food. Zinc is most commonly found in animal products but is also found in nuts, legumes, and fortified cereals. Zinc is vital to the synthesis of DNA and RNA (ribonucleic acid) and is therefore important for cell division.

Zinc deficiencies are rare. As with most trace minerals, I do not recommend that you take extra supplements. Although zinc deficiencies may cause various problems, boosting zinc beyond basic levels appears to do no good and may even cause harm. For example, too much zinc may interfere with the workings of another trace mineral you need, copper. As with most minerals, high intake may prove toxic, and too much zinc can damage the immune system. Take no more than 30 mg daily. The RDA is just 15 mg for men and 12 mg for women. More than that can be harmful. For example, taking just 50 to 75 mg a day can actually reduce your HDL (healthy) cholesterol, something you want to avoid.

Recently, zinc has received a lot of attention for its role in fighting colds. One study found that zinc lozenges may help ease cold symptoms; another showed they did not. We still need more information.

Herbs and Miscellaneous Supplements

I have talked about vitamins and minerals, but what about all those other bottles you see lining the shelves of any health-food store? Again, as little as we know about minerals, we know even less about most herbal remedies and food supplements. Drawn from various folk treatments, as well as from traditional Eastern medicine, herbs no doubt can provide some benefits. More scientific studies are being done on such remedies each year. Most of the herbs are probably harmless, but some cause needless ageing. Never, for example, take anything with comfrey in it. This herb is known to cause liver damage. Also, sassafras, chaparral, germander, and pokeroot have been associated with severe and even lethal effects.

If you think you might want to take an herbal remedy or food supplement, find out about it first. Do not simply ask the clerk at the health-food store or rely on a book there. Do research at the local library or on the Internet. With the right search, you can find out about popular claims and the status of that herb in the scientific literature. If you don't have time to do a search yourself or don't have access to the resources, ask your doctor to find more information for you. Sometimes you may decide that you want to try an herb even though its claimed effects remain unproven. As long it is proven harmless, go ahead. It might prevent you from ageing, but you want to make sure that it does not cause ageing.

Here's my review of some of the more popular herbal remedies and food supplements. The list is almost endless and ever changing.

Coenzyme Q10

Coenzyme Q10 has gained popularity recently for alleged benefits in preventing cardiovascular ageing. Found naturally in our organs, it helps stimulate energy pathways at a cellular level, notably in the muscle tissue of the heart. Studies have claimed that coenzyme Q10 is an antioxidant that can prevent arterial ageing. It has gained some popularity for therapy of critically ill patients awaiting heart transplants, and the findings of some clinical studies have supported these claims. Our bodies naturally produce Q10 when they are not lacking in vitamin C or any of the B-complex vitamins. There is little information on the effects of the supplemental form of the coenzyme, and there are no guidelines regarding dosage. Currently, the American Heart Association lists it as an experimental drug. Although coenzyme Q10 appears safe and beneficial in some studies, no studies have been done on its possible side effects. I cannot recommend taking coenzyme Q10 as a supplement, as no scientific data suggest that it has greater antiageing benefits than risks. In any case, the group of patients for whom there is a purported benefit—those with severe and life-threatening heart failure—should take a supplement or medication only under the strict supervision of their physicians.

Echinacea

Come cold and flu season, I always see individuals who are taking echinacea, an herbal powder derived from the leaves and stems of the coneflower. A popular folk remedy, echinacea is purported to boost the body's natural immunity. Unfortunately, the very few studies that have been done on this herb, both in Germany and the United States, have produced mixed results. Some found an immune response, others found no effect. At this stage, we really don't have any proof whether it works. In general, echinacea appears harmless. People with allergies to plants in the sunflower family should steer clear of it, and those with autoimmune diseases will want to talk to their doctors before taking this herb. Do not take echinacea for long periods; even fans of the herb recommend taking it for only a few weeks at a time, when cold or flu symptoms set in.

Ginkgo Biloba

Ginkgo biloba, an herb that comes from the Chinese ginkgo tree, is purported to have antioxidant properties. It is best known for its supposed enhancement of mental clarity. It is also believed to lower blood pressure and have other antiageing properties. Are these claims true? No one knows. Ginkgo biloba does contain flavonoids and other compounds that are known to scavenge free radicals. Several European studies have indicated possible benefits for Alzheimer's disease, but these studies were not performed using proper clinical-trial design, and so amount to hearsay.

Only one scientifically credible clinical trial on ginkgo biloba has been conducted in the United States. It indicated that the herb may help improve cognitive functioning in people who have Alzheimer's disease or other forms of dementia. Published in the Journal of the American Medical Association, the study found cognitive improvement in 37 percent of those given the extract, as opposed to 23 percent of those given a placebo. The data offered by the study were preliminary, merely a first-round screening of the supplement. The study relied largely on subjective social indicators—such as whether caregivers of patients suffering from dementia noticed any change in behavior when the patients took the herb—rather than on concrete physiological or psychological tests. More research needs to be done on ginkgo biloba before we know if it really has any effect.

Ginkgo biloba appears to be another of many possible antioxidants found in fruits and vegetables. It is unclear whether it has any unique properties that are not found in other antioxidants. Even if its alleged positive effects were proven, it is not as effective in diminishing the symptoms of Alzheimer's disease as are certain known medications currently prescribed. On the other hand, there are no known side effects associated with gingko biloba.

Ginseng

Ginseng is a root that has long been used in Eastern medicine to boost energy. Recently, medical reports have claimed that it can boost immune response and increase white blood cell count. As with most herbs, there have been very few rigorous studies, so most information we have comes from personal testimonials and word of mouth. One study linked ginseng to a reduced incidence of the common cold and flu, but another showed that the immune systems of mice who were fed ginseng were damaged. Ginseng made the mice suffer more illness and get older faster than they would have normally. There are claims that the American variety of ginseng, not the Asian variety, has more active properties. In general, the evidence for a beneficial effect of ginseng is low. Ginseng is known to increase blood pressure and may negatively affect sugar metabolism. Some reports related to these side effects indicate that ginseng should not be used except for discrete periods of two weeks or so. Since there are no proven benefits and there are known side effects, I cannot recommend the use of ginseng.

Thymus Extract

Because of its alleged antiageing benefits, there has recently been a stir about thymus extract. Should you take it? No. Why not? The thymus is a gland that is active during childhood and adolescence. It helps control and modulate the immune system. By age twenty, the thymus begins to dry up, and by age fifty, it has virtually disappeared. The theory behind taking thymus extract as a supplement is that the extract will help stimulate immune functioning and protect you from cancers, arthritis, and other ailments that age you. Since the thymus is active during our youth, it is assumed (wrongfully) to be something that will keep us young. No studies and no data indicate that thymus extract helps in any way. Furthermore, taking the extract has a potential hazard. Thymus extract that is introduced into the body is different from that produced by your own body. Since supplemental thymus extract is a foreign protein, it may trigger an immune reaction, which, in turn, may cause your body to develop antibodies against itself.

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Real Age

OVERALL  EATING

Eating, next to breathing, is perhaps the most intimate way you interact with the world around you. Yet this contact, unlike breathing, is something you consciously control. The decisions you make about when, where, and what you eat make a difference not only in your weight and health but in how fast you age.

Surveys show that the vast majority of Americans know that they should eat more carefully, watching fat and calorie intake, but the overall American diet is getting worse. More Americans are being classified as overweight than ever before. A poor diet—one that is full of saturated fats and trans fats (I explain these terms in detail later) and laden with calories—accelerates ageing. In contrast, a diet rich in nutrients, full of fiber, and low in calories can slow the pace at which you age. The difference between being on a good diet and a bad one can be as much as twenty-four RealAge years. A bad diet can make you as much as twelve years older than the average American, and good dietary choices can make you twelve years younger. If you like to eat—and who doesn't?—learn how to eat right. It will buy you added years of good meals.

When I went to medical school in the late 1960s and early 1970s, I received just two lectures on nutrition. First, we learned about diseases associated with vitamin and mineral deficiencies, diseases that are rare except under starvation conditions. Second, we learned—big surprise!—that eating too many calories caused people to gain weight and that eating too few caused them to lose weight. Discussion over. Fortunately, the two-lesson-view of nutrition is a thing of the past. Increasingly, studies show that the food you choose can greatly affect your rate of ageing and substantially alter your odds of being stricken with arterial disease, cancer, diabetes, and other disorders.

Why did it take us so long to see the diet-health-youth connection? And what made our attitudes change? I attribute the change to what I call the 'industrialized society' paradox. From the 1940s through the 1960s, modern medicine really came to the fore. The discovery of antibiotics and the development of safe vaccines helped us exert control over the infectious diseases that had ravaged earlier generations, and advancements in surgery and internal medicine lowered the rate of other afflictions. Life expectancy increased dramatically. People in the medical community felt a real exuberance, fostering a 'we-can-conquer-any-disease' mentality. As the ravages of some diseases decreased, other medical problems became endemic. Cardiovascular disease and cancer emerged as the new killers, becoming the number one and two causes of death in most affluent and industrialized societies. These diseases did not fit the old model of disease. Suddenly, such issues as diet and nutrition that had been ignored began to provide some intriguing clues.

When researchers began investigating cardiovascular disease, they discovered something interesting. People who lived in rural Greece and Italy, and even Albania—in communities less 'developed' and less affluent than our own—had significantly lower levels of arterial disease. Certain Asian populations also had slower rates of arterial ageing. If we Americans and northern Europeans were so 'advanced,' why were we so afflicted?

Genetics seemed a clear answer. But studies soon showed that genetic background, though having some impact on the onset of arterial ageing and cancer, certainly could not explain the widespread incidence of these diseases. When individuals moved from their rural villages and emigrated to the United States, they developed the same diseases as those around them. The onset of diseases correlated with lifestyle. One of the most important factors seemed to be diet. Researchers learned that eating a diet rich in fruits and vegetables— one that was full of fiber, nutrients, and fish but that had a minimum of meat, calories, and fats (especially saturated fats and trans fats)—caused a major postponement in the onset of arterial ageing. In this healthy diet, the primary fat consumed is olive oil, a monounsaturated fat that lowers the LDL-to-HDL ratio (discussed later) while decreasing the amount of harmful LDL cholesterol in the bloodstream. Dairy products that are heavy in saturated fats, such as cheese, are consumed in small amounts. These food choices were found in the diets of the Mediterranean region and throughout Asia, and they seemed to correlate with long and healthy lives.

Within the past two decades, medicine and American society have changed. These nutrition studies have been well publicized, and most of us now know that cutting back on fats and boosting vegetable and whole-grain consumption will help us stay healthy longer.

(THERE  IS  NOTHING  WRONG  WITH  GOOD  ORGANIC  COW  OR  GOAT  MILK;  SO  WITH  ORGANIC  BUTTER;  SO  WITH  ORGANIC  CHEESE;  SO  WITH  ORGANIC  YOGURT  -  ALL  IN  MODERATION  OF  COURSE.  BUT  HAVING  THEM  AS  PART  OF  YOUR  REGULAR  DIET  WILL  NOT  AGE  YOU,  WHEN  THE  REST  OF  YOUR  DIET  IS  ALSO  IN  BALANCE  -  FRUITS,  VEGETABLES,  PROTEIN  -  Keith Hunt)

But knowing we should eat healthier and actually doing so are two different things. What guidelines should you follow?

Nutrition Basics

Eat Your Way to Youth?

Many people have a little goblin in their heads that says, 'If it's good for you, it will taste bad.' This is simply not true. You can eat your way to youth and do so deliciously. All it takes is a commitment, which starts with exorcising all those unhealthy ideas about diets.

Eating should be fun. If your diet is like a prison sentence, you will only end up breaking out. Eat sensibly and reasonably. If once in a while you eat something that's not 100 percent healthy, it's not the end of the world. What's important are general habits, not obsessive compliance. How can you eat for youth without sacrificing good taste?

With eating and weight loss, no quick fixes exist. There are only long-term methods. The best eaters—and the ones most likely to have young RealAges because of their food choices—are those who love to eat and who see healthy, tasty eating as a challenge. Become a food connoisseur, searching out the best and freshest ingredients while expanding your food horizons. Along the way, you might be surprised to find that the best-tasting food is often the healthiest food. Now let's consider twenty things you need to know to eat right, so you can shed pounds and years deliciously.

1. Eat a Nutrient Rich, Calorie Poor Diet

Did you know that it takes at least twenty minutes to work off the calories you can eat in about thirty seconds? I'm not talking french fries, but healthy foods like bananas or apples. Whenever you eat, make every calorie count toward getting younger. Make sure the food you eat is full of the vitamins, minerals, nutrients, and fiber you need to stay young. Too many Americans waste their meals on empty calories. We end up devouring foods that contain lots of sugar, fats, empty (few nutrients) carbohydrates, and calories without getting the nutrition we need.

As you get older, your dietary requirements change. As you hit middle age, muscle mass declines, as much as 5 percent per decade, contributing to a slowing of metabolism of as much as 30 percent. This change in your body composition increases the ratio of fat to muscle and decreases bone density. As your calendar age increases, you need to be even more careful to eat less fat and fewer calories. At the same time, you need to be even more vigilant about getting the right nutrients. Medications and certain diseases can affect the rate at which you absorb nutrients and your appetite. Some studies find that as many as 60 percent of older individuals have some kind of dietary deficiency.

(SINCE  THE  AGE  OF  40  MY  METABOLISM  CHANGED  -  COULD  NOT  CONSUME  AS  MUCH  FOOD,  THE  GOOD  HEALTHY  FOOD  I  WAS  LIVING  ON,  WITHOUT  GAINING  WEIGHT - A  CUT  BACK  WAS  NEEDED.  AT  ABOUT  AGE  60  IT  WAS  EVEN  MORE  SO.  HENCE  BECAUSE  MY  FOOD  INTAKE  IS  MUCH  LESS  THAN  BEFORE,  I  TAKE  VITAMIN  AND  MINERAL  SUPPLEMENTS.  AND  I  MAKE  SURE  I  GET  LOTS  OF  EXERCISE  -  Keith Hunt)

2. Eat Less Fat, Eat the Right Fats, and Time Them Right

There is clear evidence that eating a diet that is low in fats, particularly saturated fats and trans fats, can help prevent arterial ageing while reducing the risk of plaque buildup, heart attacks, and strokes. Although the evidence is controversial and definitive studies are lacking, such a diet also appears to slow the immune system ageing that is linked to cancer. Estimates run the gamut, with experts claiming that 10-70 percent of all cancers stem from eating a diet high in saturated fats and trans fats and low in fruits and vegetables. A report in the Journal of the American Cancer Institute said that women who ate more than 10 grams of saturated fats a day had a 20 percent greater risk of ovarian cancer. Consuming red meat more than once a week has also been linked to increased ageing from colon cancer, presumably because of the saturated fats contained in red meat.

(NO,  NOTHING  WRONG  WITH  CLEAN  MEATS [GOD'S LAW OF CLEAN AND UN-CLEAN],  IF  ORGANIC.  EVEN  3  OR  4  TIMES   A  WEEK  -  Keith Hunt]

By limiting your consumption of saturated fats and trans fats, you limit your risk of ageing. Stay away from fried foods and don't eat fried fast foods. Be careful about eating too much salad dressing: most contain lots of saturated fats. Try to eat red meat no more than once a week. When eating beef or pork, [ no pork  - its un-clean in God's law - Keith Hunt] choose low-fat cuts. For beef, choose 'round' or loin cuts....Avoid all processed meats, such as frankfurters, salami, and other luncheon meats. Stay away from anything containing palm or coconut oil, as these are saturated fats. Dairy products low in fats include fat-free milk, fat-free yogurt, and cottage cheese.

(THIS  BOOK  WAS  WRITTEN  IN  2000.  TODAY'S  FACTS  SHOW  NOTHING  WRONG  WITH  SATURATED  FATS.  COCONUT  OIL  IS  NOW  PROVED  VERY  HEALTHY  FOR  YOU.  THE  IDEA  OF  "FAT FREE"  MILK,  YOGURT,  CHEESE,  IS  WAY  WRONG  AND  OUT  OF  DATE.  OUR  GRANDPARENTS  AND  GREAT-GRANDPARENTS  ATE  NATURAL  ORGANIC  MILK,  YOGURT,  CHEESE.  ALL  VERY  HEALTHY  FOR  YOU  IN  MODERATION  OF  COURSE  -  Keith Hunt) 

There are several kinds of fats, and knowing which ones to avoid, which ones to eat, and when to eat them can make a big difference in how they affect your rate of ageing. In fact, this topic is so important, I have devoted an entire section of the chapter to it (pp.191-195).

(AND  IF  HE  HARPS  ON  ABOUT  SATURATED  FATS  BEING  BAD,  HE  WAS  VERY  WRONG;  NOW  PROVED  IT  IS  TRANS-FATS  THAT  ARE  YOUR  ENEMY.  NATURAL  FATS  IN  ORGANIC  MILK  AND  ITS  PRODUCTS  ARE  JUST  FINE.  COCONUT  OIL  IS  ONE  OF  THE  VERY  BEST  OILS  YOU  CAN  USE  -  Keith Hunt)

3. Keep a Steady Weight

Clearly not all of us are or can be pencil thin. The point is to be the right weight for you. Your aim should be to keep your weight as close to your weight at age eighteen for women or twenty-one for men. Having a low body mass index—or weight-to-height ratio—is one of the things that will help keep you young. Studies of animals have shown that restricting calorie intake can increase longevity. For example, mice that were fed a low-calorie, low-fat diet lived considerably longer than mice fed a more high-calorie, high-fat diet. Low-fat eating, in combination with exercise, is the easiest and quickest way to lose weight and to keep your weight where it should be. The most important point is this: Moderation and balance are the key principles when it comes to eating for youth. Avoid yo-yo weight loss and gain—this is worse for you than simply being overweight. We don't know why, but the data repeatedly confirm this finding. For more information on weight and ageing, see the section on Slimming Down later in this chapter.

4. Diversify Your Diet

Everyone thinks he or she eats a balanced diet, but it's not so. Forty percent of Americans don't eat fruit daily, even though it is recommended that a person eat four servings every day. And 30 percent of Americans don't consume any dairy products regularly. On average, Americans get less than half the 25 to 30 grams of fiber they need a day.

Why is diversity in your diet so important? Choosing a diverse diet can lower your RealAge. If you eat items from all five food groups daily, you can be as much as five years younger than if you eat from only two food groups. (The five groups are breads and cereals, fruits, vegetables, dairy products, and meats and other proteins). It is also important not just to choose one thing from each food group but to eat diversely within each food group. For example, some vegetables contain lots of one nutrient and virtually none of another. Try to eat four servings of fruit, five servings of vegetables, and six servings of breads, cereals, or grains a day. These amounts will give you the vitamins and fiber you need without excess calories. Eat two or three servings of low-fat dairy foods and no more than two servings of protein—nuts, beans, meats, fish, or poultry—daily.

(Wrong  on  "low  fat"  dairy  once  more.  Within  your  normal  metabolism,  mainly  when  young,  yes  you  can  and  should  eat  as  suggested.  I  certainly  did  up  to  age  40,  and  never  gained  an  ounce.  But  you  may  have  to  adjust  even  at  any  age  for  some,  if  weight  gaining  is  a  problem  -  Keith Hunt)  

5. Eat Your Vegetables

One of the tricks to eating a diet that is low in fat, low in calories, and full of nutrients is to eat lots of vegetables. Since they contain lots of fiber, vegetables help you fill up fast. With only twenty to forty calories a serving, they help you feel full and keep your weight down. They also have loads of vitamins, carotenoids, and flavonoids, many of which have antioxidant properties that will help keep you young. Try to eat five or six servings a day.

Just because you hated vegetables as a kid doesn't mean you won't like them now. Try steaming them with a little lemon juice or lightly sauteing them. Cook green vegetables just until they turn bright green. If they go all the way to gray, you've cooked them way too long. Try to eat some kind of dark green leafy vegetable and one serving of a cruciferous vegetable (broccoli, cauliflower, or cabbage) each day. Remember, too: Yellow, orange, and red vegetables contain essential vitamins and lots of carotenoids, which are natural antioxidants.

Make vegetables your new snack foods. I buy bags of precut baby carrots and other vegetables and keep them in the refrigerator. When I'm looking around for something to munch on, I start there. Cucumbers, celery, peppers, radishes ....all make great snacks. Eaten raw, they keep all the nutrients and fiber that cooking can deplete.

(If  you  can  eat  them  raw  fine,  good.  I  personally  could  only  eat  carrots  and  peas  raw  -  Keith Hunt)

6. Don't Forget the Fruit

The lengthening of the average life span in America has paralleled the availability of fresh fruits. This is a correlation, not a proven cause-and-effect relationship, but the data suggest that increased fruit consumption may contribute to longevity. Fruits are rich in vitamins and dietary fiber and are loaded with carotenoids and other nutrients.

Carotenoids are vitamin-like substances found in many fruits and vegetables. Over six hundred different types of carotenoids are found in foods, the best known being beta carotene, a substance the body turns into vitamin A (see Chapter 7). For a long time, scientists did not know whether most carotenoids had any nutritional benefit, but it is increasingly clear that many of them have antioxidant—and, hence, antiageing—properties. You can spot carotenoids by the red, orange, and yellow color they impart to foods, such as tomatoes, carrots, and apricots—basically any fruit or vegetable with these hues. Also, carotenoids are plentiful in dark, leafy, green vegetables—spinach, broccoli, kale. Lycopene, a carotenoid found mainly in tomatoes, helps prevent prostate cancer (see Chapter 5). Carotenoids are one of the reasons eating a diet rich in fruits and vegetables can help keep you young. Flavonoids are also present in fruits.

Like carotenoids, flavonoids are an antioxidant found in plants and help protect the body against damage from free radicals. One reason red wine has an antiageing effect is because it is rich in flavonoids. The richest sources of flavonoids are onions, green tea, cranberries, broccoli, celery, apples, and grapes. So flavonoids are another reason a diet rich in fruits and vegetables will help you stay young.

Because most fruits have only thirty-five to sixty calories a serving, they are low-cal alternatives to cookies or candy. Dried fruits contain considerably more calories per mouthful, so be careful. If you are tired of common fruits, such as apples, oranges, and bananas, then diversify. Buy exotic or seasonal fruits. I find it easier to have such bite-size fruits to munch on as grapes, cherries, or small plums. I keep a big fruit bowl in my office. That way, I can grab a piece when I feel hungry, and everyone else in my department can grab a piece, too.

When eating fruit, remember to wash it well but keep the peel on. If you peel an apple or pear, you are throwing away all the fiber. Juices don't have the same fiber content as whole fruit. Although drinking fruit juice provides one or two servings a day, don't make these your only servings of fruit. Try to eat two or three pieces of whole fruit a day and make one of them a citrus fruit. It will give you the added vitamin C that you need to prevent immune system ageing (see Chapter 5).

(NOW  it  is  proved  that  BLUEBERRIES  are  one  of  the  very  best  fruits  you  can  eat,  if  not  THE  best.  As  mentioned  this  book  of  2000  is  out  of  date  on  some  things;  a  reason  it  is  no  longer  in  print  -  Keith  Hunt)

7. Fruits + Vegetables = Fiber

A key reason that diets high in fruits, vegetables, and grains are good for you is that these foods contain lots of fiber. People who eat diets high in fiber have significantly lower rates of ageing. Eating 25 grams or more of fiber a day can lower a person's RealAge by as much as three years, compared with eating only 12 grams of fiber a day, the national average.

Fiber is found solely in plant foods and is largely indigestible, passing through the digestive tract intact. Since it cannot be digested, fiber contains no calories, but it makes you feel full sooner and helps you control overeating. Fiber seems necessary to keep the digestive tract running smoothly. High-fiber diets speed up digestive processes, adding bulk to stool and helping the body rid itself of waste products more quickly. Thus the exposure time, in the bowel, of potentially carcinogenic substances found in food is significantly reduced. This shorter exposure time appears to help reduce ageing from intestinal disorders and from heart disease. High-fiber diets also correlate with a reduction in colon cancer and probably other cancers as well. For example, one study found a connection between low-fat, high-fiber diets and reduced blood oestrogen levels in women, possibly helping to explain why women on such diets have a lower incidence of breast cancer. In a study of forty-three thousand participants conducted at Northwestern University, a 10-gram increase in the daily intake of cereal fiber decreased the risk of heart attack by 29 percent (making a fifty-five-year-old's RealAge 1.9 years younger). People who eat less fiber also tend to have worse overall diets and to be more sedentary.

Fiber helps regulate metabolism and digestion, stabilizing blood glucose levels and affecting the rate of absorption of nutrients. Fiber clearly helps reduce the risk of diverticulitis and inflammatory bowel disease, both of which cause inflammation of the gastrointestinal tract. A high-fiber diet also helps reduce the incidence of hemorrhoids, a condition that can be provoked by excess pressure on the bowel walls caused by the forced bowel movements that often accompany a low-fiber diet.

Don't go on a high-fiber diet all at once. Increase your fiber intake gradually. Make sure to drink lots of water, as fiber tends to absorb water. Eat breads and cereals that have whole grains in them. Even healthy-sounding breads made of 'wheat flour' have had their fiber removed by the refinement process. Check the labels on processed foods, which are now required to indicate the overall fiber content.

(DRINKING  LOTS  OF  WATER  IS  ALSO  NOW  OUT  OF  DATE;  YOU  KNOW  THIS  "6 TO 8 GLASSES OF WATER DAILY" TALK  -  OUT  OF  DATE  NOW.  IT  IS  LIQUID  THAT  YOUR  BODY  NEEDS,  AND  THAT  CAN  COME  IN  MANY  FORMS.  ALSO  YOUR  BODY  TELLS  YOU  WHEN  LIQUID  IS  NEEDED;  HENCE  IN  THE  HOT  SUN  MORE  WATER  IS  NEEDED,  AND  WATER  IS  IN  THAT  SITUATION  THE  VERY  BEST  THIRST  QUENCHER  -  Keith Hunt)

8. Watch Excess Protein Consumption

There is much debate about how much protein we should eat. Recently, some nutritionists have advocated high-protein diets. Unless you consume lots of dairy products as a counterbalance, meat proteins can leach calcium from your bones. A high-protein diet places undue strain on your kidneys, which excrete metabolized proteins. Your body uses only the amount of protein it can consume, and much of the excess must be excreted (some excess is turned into sugars and fat). Studies have shown that excess protein consumption does not promote health, weight loss, or the building of muscles.

Although the average American diet consists of 100 grams of protein a day, the recommended daily allowance (RDA) is only half that amount. I recommend restricting protein intake to 20 percent of your daily total calories. Protein content is highest in meats, poultry, fish, dairy products, soybeans, and nuts, all of which have a protein content of 15—40 percent of their total caloric content. Beans, cereals, lentils, and peas have a protein content under 15 percent. Limit your intake of fish, meat, and poultry to five to seven ounces a day (an ounce is 31.1 grams). Since these foods contain only about 40 percent protein, eating this amount will give you plenty of protein without overloading.

If you are getting your protein entirely from vegetable sources, it is important that you choose from a wide array of foods to ensure you get all the essential amino acids. For example, breads and grain cereals lack certain amino acids, and lentils and nuts may have those amino acids but lack others. If you are a strict vegetarian, you should talk to your doctor or a nutritionist about balancing your protein intake. Generally, protein deficiencies are rare in this country.

(A balanced  protein  would be to have a little  for  lunch  and  supper  dinner.  Protein  is  in  whole  milk,  so  something  like  whole  milk  and  whole  grain  cereal in  the  morning,  with  maybe  some  blueberries  and  banana  added,  would  be  a  great  breakfast  meal.  I  have  100  percent  whole  oats,  whole  milk,  banana and/or blueberries  for  breakfast.  I  was  drinking  way  too  much  natural  fruit  juices  all  day.  My  doctor  said  I  was  too  high  in  sugar [yes  fruit  contains  natural  sugar]  and  told  me  to  cut  back  to  only  one  glass  of  natural  organic  fruit  juice  per  say - it  solved  the  problem  -  Keith Hunt)

9. Remember, Carbohydrates Were Meant to Be Complex

In a well-balanced diet, 50-60 percent of daily caloric intake should come from carbohydrates—preferably complex carbohydrates. Two basic types of carbohydrates exist: simple and complex. Simple carbohydrates are the sugars—both refined sugars and those found in honey and many fruits. Complex carbohydrates—the kind found in cereals, breads, pasta, vegetables, beans, legumes, and some fruits—are starches that the body breaks down into simple sugars. This leads to two obvious questions: If complex carbohydrates break down into simple sugars, why are they any different from the simple carbohydrates found in sugars? Don't they provide the same amount of energy?

Yes and no. They do provide the same amount of calories per sugar molecule and the same amount of energy. Most complex carbohydrates are found in foods that are rich in vitamins and nutrients and high in fiber. The body treats complex carbohydrates differently. They break down more slowly, consuming more metabolic energy in digestion and keeping glucose levels more stable. Since they are not concentrated in form as refined sugars usually are, we eat less complex carbohydrates per ounce of food.

Forget those old diet myths that breads and pasta are fattening. Carbohydrates contain far fewer calories per gram than fats: 4 per gram as opposed to 9 per gram. Eating a diet high in complex carbohydrates—fruits, vegetables, and grains—will help you shed excess pounds and gain extra years of youth.

(INDEED  SO.  THE  LATEST  IDEA  WITH  BOOKS  LIKE  "WHEAT  BELLY"  ARE  WAY  WRONG  FOR  THE NATURAL  METABOLISM  BODY.  EVERYTHING  NORMAL,  THERE  IS  NOTHING  BUT  GOOD  STUFF  IN  ORGANIC  WHEAT,  EVEN  MORE  SO  IN  ORGANIC  BARLEY.  YOU  HAVE  TO  HAVE  AN  IMBALANCE  IN  YOUR  BODY  TO  STOP  EATING  HEALTHY  WHOLE  GRAINS.  GOD  GAVE  TO  ANCIENT  ISRAEL  TWO  FIRST  HARVESTS  -  BARLEY  WAS  FIRST [THE BEST  NUTRITION;  WHEAT  WAS  SECOND,  THE  SECOND  BEST].  I  HAVE  A  LITTLE  BOOK  ON  THE  SCIENCE  OF  BARLEY  -  IT  IS  AMAZING  HOW  NUTRITIOUS   BARLEY  IS.  IT'S  HARD  TO  FIND  100  PERCENT  BARLEY  LOAVES,  SO  MAKE  YOUR  OWN  -  Keith Hunt)

Vegetarianism: Pro or Con?

Only about 5 percent of Americans classify themselves as full-time vegetarians, but increasingly the health conscious are choosing vegetarianusqee diets. Many people have eliminated red meat from their diets, and more are choosing to eliminate poultry and fish as well. This choice may be a good thing. Study after study has shown that a diet low in animal protein and rich in fruits and vegetables does the most to keep a person young. Decreasing the consumption of red meat to once a week or less reduces ageing of both the cardiovascular and immune systems. However, vegetarians need to be careful. They run the risk of not getting the appropriate variety of foods, thereby missing out on proteins and nutrients that are more plentiful in animal products. Anyone who adopts such food choices will need to supplement his or her diet with vitamin B12, which is obtained almost exclusively from animal products. If you do not eat any animal products, make sure to take a vitamin containing adequate amounts of folate, B6, and B12 daily. If you decide to go on a vegetarian diet, I suggest meeting with a nutritionist to go over a sensible food choice plan.

(IF  MEATS  ARE  ORGANIC  AND  CLEAN  UNDER  GOD'S  LAW,  THERE  IS  NOTHING  TO  FEAR  IN  EATING  THREE  OR  FOUR  MEATS  A  WEEK.  ANCIENT  ISRAEL  PRIESTS  WHEN  ON  DUTY  IN  THE  TEMPLE  ATE  MEAT  EVERY  DAY - IT  WAS  PURE  ORGANIC.  I  DO  NOT  HAVE  A  SOURSE  FOR  ORGANIC  MEATS,  SO  I  EAT  LITTLE,  HENCE  VITAMIN  B12  AND  B6  I  TAKE  DAILY  -  Keith Hunt)

10. Cut Out Excess Sugars

Although the consumption of sugar is not tied to ageing itself, it is linked to weight gain. Simple sugars tend to be more concentrated in foods, meaning that you consume more calories per mouthful. Cutting back on overall sugar intake is a quick and easy way to make extra calories disappear from your diet. Some people think that eating too much sugar is associated with the development of diabetes; this is not true. However, foods containing lots of refined sugar are high in calories, and most of these calories are nutritionally empty. Don't

[If you eat a little fat prior to eating carbohydrates, your stomach doesn't empty its contents into the intestine as quickly. This slowing of stomach emptying has two RealAge Age Reduction effects. First, you feel full faster and stay full longer, so you eat less; and second, since sugars are largely absorbed in the intestine, the amount of sugar in the blood rises slower and peaks at a lower level]

delude yourself: honey and natural sugars are not a healthy substitute for white sugar. In the end, the body breaks them down into the same molecule, and they contain the same number of calories. Finally, though it is not true in all cases, many people find that a diet low in sugar can help provide a more stable blood glucose level. Eating sugar in large doses tends to cause peaks in a person's metabolic level. Eating a little fat first will slow the emptying of the stomach into the intestine, which keeps your stomach fuller and stabilizes your blood sugar levels, so you feel full and eat less. Furthermore, since sugars are largely absorbed in the intestine, delaying the sugar getting to the intestine slows and decreases the rise in the sugar level in the blood (see Figure 8.1). Lots of people find that eating less sugar gives them more energy without after-the-big-meal sleepiness.

(WRONG  ON  HONEY  -  GOOD  ORGANIC  HONEY  IS  GOOD  FOR  YOU  -  CONTAINS  ALL  KINDS  OF  THINGS  HEALTHY  FOR  YOUR  BODY  -  THE  BIBLE  TELLS  YOU  SO  IN  THE  BOOK  OF  PROVERBS.  USE  PURE  ORGANIC  HONEY  AS  YOUR  SWEETENER,  BUT  AGAIN  LIKE  EVERYTHING,  IN  MODERATION - AND HONEY  CONTAINS ALL THE "B" VITAMINS-- Keith Hunt)

11. Eat Fish

Salmon; white fish, such as cod; and other fish contain lots of omega-3 fatty acids, a type of fat that actually reduces triglyceride levels in the blood and appears to lower blood pressure. Eating fish at least once a week may cut the risk of heart attack in half, making the RealAge of a fifty-five-year-old man more than 2.7 years younger. Although no one knows precisely how omega-3 fatty acids work to prevent heart attacks, some experts believe that these substances prevent the buildup of plaque along arterial walls. Others suggest that omega-3s help stabilize a person's heartbeat, cutting down on the irregular heart rhythms associated with heart attacks. Omega-3s also appear to make platelets less sticky, decreasing the risk of clotting. Recent data showed a 52 percent decrease in sudden death when fish was consumed at least once a week. Omega-3s may also reduce blood pressure. Although you can buy fish-oil supplements at the health-food store, it's best to eat fish itself.

Finally, be careful about eating raw seafood, which is more likely to carry disease-causing germs than cooked seafood.

12. Make Substitutions

Eating habits learned over a lifetime can be hard to break. Learn how to substitute healthy ingredients into recipes that have always been unhealthy. When a recipe calls for butter, ask yourself, 'Does the recipe really need all that saturated fat? Could I use something else? Could I substitute orange juice and ginger? What about a teaspoon of olive oil?' Garlic, ginger, vinegar, and spicy ingredients can often make up for the lack of saturated fat in a dish. My mother used to make mashed potatoes with lots of milk and butter, but I roast a head of garlic and mix the cloves in with the potatoes while mashing them. Roasting gives the garlic a mellow flavor, and the individual cloves take on the consistency of butter. Fruit butters, such as apple butter, contain no fats and are a good substitute for real butter. Use them as a spread for bread or mix them in with other foods.

(AGAIN  THIS  IDEA  ABOUT  "BUTTER"  IS  OFF THE  MARK  TODAY.  GOOD  ORGANIC  BUTTER  IN  MODERATION  IS  GOOD  FOR  YOU  -  Keith Hunt)

If you're roasting a chicken or other meat, put it on a rack so all the fat drips down. Cook tomato sauce and balsamic vinegar and add some spices and herbs to make a tasty sauce for everything from chicken breasts to eggplant to pasta. Baste your meats with fruit juice, not drippings from the pan. Make sauces out of vegetable purees or wine instead of cream. Soups can be just as creamy when you substitute potato-chicken broth puree for the cups of whipping cream. Every time you use a recipe that calls for saturated fats or trans fats, ask yourself, 'How can I cook this so I maximize the nutrients and minimize the fats?'

(AGAIN  THERE  IS  NOTHING  EVIL  ABOUT  SATURATED  FATS  FROM  BUTTER  OR  CREAM.  IT  IS  THE  MODERATE  EATING,  AND  ACCORDING  TO  YOUR  METABOLISM,  THAT  IS  THE  KEY  -  Keith Hunt)

13. Be Aware of Hidden Fats and Calories

Most saturated fats, trans fats, and sugars enter the diet in the form of 'hidden' ingredients in many processed foods, and the package labels may provide the clues you need. For example, many commercial brands of cereal and most processed breads contain a great deal of added fats and sugars. In addition, canned soups and vegetables and even granola are often high in both sugars and saturated fats or trans fats. By becoming a label reader, you won't consume needless calories that you didn't know were there.

Remember, 'fat-free' doesn't mean 'not fattening.' Many 'fat-free' products are good for you and will form part of an Age Reduction diet, but that is not always the case. Fat-free cookies and fat-free ice cream may be 'fat-free,' but they are usually full of calories yet low on nutritional value.

(YES  MANY  THINGS  TO  TAKE  INTO  ACCOUNT,  IN  ACCORDANCE  WITH  YOUR  PARTICULAR  BODY  METABOLISM  -  Keith Hunt)

14. Cut Back on Cholesterol and Salt

Cut dietary cholesterol intake to less than 300 mg a day (see the cholesterol section later in this chapter). Limit sodium intake to 2,400 mg a day, preferably 1,600 mg or about a teaspoon of salt (see Chapter 7).

15. Eat Regularly Throughout the Day

Many people believe they will lose weight if they starve themselves all day, waiting until dinner to eat, at which time they gorge. This habit adversely affects overall body metabolism. More important, most people cheat, sneaking a cookie here or a candy bar there sometime in the mid-afternoon. Make sure to eat regular meals. Many experts recommend 'grazing'—eating a number of small meals throughout the day, rather than just two or three large ones. That way, your body metabolizes food on a regular basis, not going through long periods without fuel, followed by intense periods of excess. See if eating this way helps you eat more nutritious food and lose weight.

16. Don't Forget the Water

Because your body is approximately 80 percent water, you need lots of fluid (at least eight glasses a day) to keep it running right. Water is best, although juices, soups, and skim milk can also rehydrate you. Make sure you drink extra water to keep yourself properly hydrated, especially if you are exercising or the weather is hot. What's the best kind of water? We don't know. But most experts agree that as long as your town treats its water, tap water is just fine.

(NO  MOST  TAP  WATER  IS  NOT  FINE.  GET  A  FILTER,  OR  BUY  STREAM  WATER.  YET  STREAM  WATER  MAY  BE  CONTAMINATED  TODAY.  FILTERED  WATER  IS  SOLD  JUST  ABOUT  EVERYWHERE  TODAY.  IT  IS  A  MYTH,  NOW  PROVEN  INCORRECT,  THAT  YOU  SHOULD  BE  DRINKING  8  GLASSES  OF  WATER  A  DAY.  YOUR  BODY  NEEDS  FLUID,  AND  THERE  ARE  MANY  HEALTHY  FLUID  DRINKS  IN  STORES  TODAY  -  Keith Hunt)

17. Think 'Healthy' at the Grocery Store

Think about the control you have over your diet when you go shopping for food. If you don't buy food that's bad for you, you won't eat food that's bad for you. Before you put any item in your cart, ask yourself, first, 'Why am I eating this?* And, second, 'Will it help keep me young?' If the answer to the first question is 'Because it's quick,' and the answer to the second question is 'No,' get it out of your cart. Fast!

Become a label reader. Look out for saturated fats and trans fats and see what you can do to buy foods with the most nutrients. Even similar products may have different ingredients. For example, I remember trying to buy a can of refried beans for a Mexican dish. One brand contained partially hydro-genated oil, while another had canola oil, and the third had no oil at all. Although they all looked the same, their calorie and fat content were very different. The first was unhealthy, the second was moderately healthy, and the third was very healthy. If I hadn't bothered to look, I wouldn't have known.

18. Age Proof Your Kitchen

Get rid of staples that will surreptitiously make you age faster than you want. Then make substitutions. Throw out all those cooking implements—ice cream makers and deep-fat fryers—that will entice you to eat foods that age you. Clear out your recipe files, banishing recipes that call for a lot of cream or butter. While you're at it, throw out any take-out menus for places that serve unhealthy food. Keep the menu from the Vietnamese restaurant and toss the one from the fried chicken joint. That way, you won't be tempted.

(CREAM  AND  BUTTER  -  ORGANIC  IF  POSSIBLE  -  IS  GOOD  FOR  YOU,  IF  YOU  HAVE  IT  IN  MODERATION  -  Keith Hunt)

19. Don't Let Situations You Can't Control Stop You from Making Smart Food Choices

At home, it is relatively easy to develop a diet plan and stick with it. When you're out on the town it's a different story. Many people find it hard to keep eating right when they go out for meals or have to travel. Learn how to make the situations in which you have less control more manageable for you. For example, when you go out to eat, look for low-fat options on the menu. If you don't see anything, try to modify an existing dish by asking the waiter to have it baked or broiled without fat. Ask to have sauces served on the side, or request that your omelet be made with just egg whites. Most restaurants prove extremely accommodating. (I remember eating in a restaurant with nutrition expert Dr. Jerry Stamler and being amazed at how he changed the menu, asking the chef to modify dishes to suit his dietary requirements.) The answer is usually YES, and the food delicious.

(AGAIN  THIS  IDEA  OF  OMLETS  JUST  FROM  EGG  WHITES  IS  WAY  OUT  OF  DATE.  GOOD  ORGANIC  EGGS,  ALL  THE  EGG,  IS  GOOD  FOR  YOU  -  Keith Hunt)

Also, if you're invited to a party and think that everything's going to be calorie laden and heavy, eat before you arrive and then eat less when you get there. Just smile and say, 'It's fabulous but just so filling.' If you travel frequendy on airplanes, pack your own snacks. Or call ahead to see if you can order a special meal. Most airlines offer vegetarian food or heart-healthy selections, and these meals are generally tastier, more nutritious, and lower in saturated fats and trans fats than their usual entrees. Wherever you are, don't hesitate to take a low-fat snack pack with you when you're on the run—at work or at play. It will help you keep the years away.

(OR  WITH  YOUR  MEAL  ON  A  LONG  AIRLINE  FLIGHT  HAVE  A  GLASS  OF  RED  WINE  WITH  IT  -  Keith Hunt)

20. Finally—and Most Important— Make Healthy Eating Fun

You are making changes for a lifetime—changes for a younger lifetime. This shouldn't be hard work. Healthy eating should be part of enjoying all those years of added youth. Buy a low-fat cookbook. Try out a new recipe three nights a week or every Sunday. If you live with someone who shares cooking, make it a game. See who can make the best-tasting low-fat dishes. Be inventive. If you haven't a clue what to do with that funny new vegetable (like kohlrabi), figure something out. Dare to be bold and adventurous. If you always eat a certain style of food, break the mold. Try new options: Thai food, Italian, or vegetarian. Make low-saturated-fat eating an adventure, not a chore.

(AGAIN  THIS  LOW  FAT  IDEA  IS  OUT  OF  DATE,  UNLESS  YOUR  BODY  METABOLISM  IS  SUCH  THAT  YOU  NEED  TO  BE  ON  A  LOW  FAT  DIET  -  Keith Hunt)

These are general guidelines for Age Reduction eating. It may take a while to adjust to the changes. Stick with it for a couple of months and see how you do. If you have questions regarding serving sizes or the nutrient content of foods, I suggest you buy a nutritional information book. Many good books list the calories and nutrients in a whole range of foods. (I love the tables in Roy L. Walford's The 120-Year Diet, Pocket Books, 1988.) The better informed you are about what you eat, the better food choices you will make, and the younger you will stay.

(GET  THE  CHARLES  ATLAS  HEALTH  AND  STRENGTH  COURSE,  STILL  AVAILABLE.  TYPE  IN  CHARLES  ATLAS  IN  YOUR  WEB BROWSER  AND  UP  IT  WILL  COME.  IF  YOU  HAVE  NO  PROBLEM  WITH  BODY  METABOLISM,  CHARLES  ATLAS  STILL  HAS  THE  BEST  OVERALL  TEACHING  ON  FOODS.  AS  HE  OFTEN  SAID,  "YOU  ARE  WHAT  YOU  EAT."

Now let's consider three food concerns we all have and about which you will want more information: fat consumption, cholesterol intake, and weight maintenance.

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REAL AGE

Cholesterol: The Facts Behind the Hype

Remember when almost every health story featured cholesterol as its subject, and everyone you knew was rushing out to have his or her cholesterol levels checked? Even as recently as a few years ago, we thought that having a low cholesterol level ensured long-term arterial health. We now know the story is more complex. Sure, it's generally good to have a low total cholesterol level, but many other factors are more important to ageing than cholesterol. In fact, most people who have cardiovascular disease have cholesterol levels below the 'high' marker of 240 mg/dl (milligrams per deciliter). Although high levels of total cholesterol and/or LDL (lousy) cholesterol can contribute to arterial ageing, other factors contribute even more: high blood pressure; cigar, cigarette, or passive smoking; not exercising; high levels of homocysteine; diabetes; and a diet that is heavy in fats and and poor in nutrients. Nevertheless, you should keep in mind that high cholesterol levels can affect your rate of ageing.

What Does 'High Cholesterol' Mean?

Cholesterol is a type of lipid (a fat soluble molecule) found in three places: in our cells, in our food ('dietary' cholesterol), and in our blood. As much as we fear cholesterol, it is a vital component of our bodies. Cholesterol is required for the body to manufacture hormones, build cell walls, and produce bile acids, which are essential for the breakdown and digestion of fats. In some areas of the body, cholesterol levels are high. For example, skin cells contain a lot of cholesterol, making them highly water resistant. This water resistance protects the body from dehydration by reducing the evaporation of water. The brain also has high concentrations of cholesterol.

When we measure cholesterol, we measure the amount of cholesterol circulating in the blood. Problems develop not from having cholesterol in the blood, but from having too much cholesterol and too much of the wrong type of cholesterol in our blood, where it can cause damage to our arteries. In general, having a high total cholesterol level is bad: Excess cholesterol can promote arterial ageing. However, even among such high-risk populations as middle-aged men, only 9-12 percent of those with total cholesterol readings of over 240 mg/dl will actually have symptomatic cardiovascular disease as a direct result of cholesterol. For each 1 percent increase in the overall cholesterol reading in middle-aged men (for example, for 202 versus 200 mg/dl), the risk of developing cardiovascular disease increases by 2 percent. High cholesterol levels affect different population groups disproportionately. For example, high cholesterol seems to have a significant ageing effect on young and middle-aged men, but a much less significant effect on older men and women of all ages. The female sex hormone oestrogen generally decreases the presence of cholesterol in the blood, whereas androgens—the male sex hormones—increase blood cholesterol. Premenopausal women rarely have to worry about their cholesterol levels.

The Ratio of LDL to HDL

Far more important than a person's total cholesterol reading is the ratio of his or her LDL to HDL. There are three basic types of cholesterol in your body: low-density lipoproteins (LDL), high-density lipoproteins (HDL), and very-low-derisity lipoproteins (VLDL). Because the VLDL level is rarely measured directly, in general, cholesterol tests measure total cholesterol, LDL, and HDL cholesterol. (LDL is calculated by subtracting HDL from total cholesterol.) LDL cholesterol causes ageing of the arteries; HDL cholesterol prevents it. (Recall that I remember the 'L' of LDL as 'lousy' and the 'H' of HDL as 'healthy.')

In general, a total cholesterol reading of 240 mg/dl is too high and can cause arterial ageing. In the most rigorous study on cholesterol, the Framingham Study, individuals with a cholesterol reading lower than 200 mg/dl had a 10 percent risk of coronary artery disease over a twenty-year period. Those with a total cholesterol reading above 240 mg/dl had about twice as much chance (20 percent) of developing the disease.

Most people who have high cholesterol also have high levels of LDL cholesterol, which causes arterial ageing. LDL molecules deliver cholesterol to the cells in the body. When cholesterol rises, excess LDL molecules in the bloodstream can attach to small ruptures or lesions in the arterial wall, the endothelium, and trigger a process that can lead to the development of arterial plaques and cardiovascular ageing.

It is interesting to note that some people with very high cholesterol levels have arteries that are in better condition than those of other individuals who have low cholesterol levels. These lucky people have high levels of HDL cholesterol and low levels of LDL cholesterol. Since HDL molecules remove excess cholesterol from the arteries, the more HDL you have, the less excess LDL cholesterol you have and the less arterial ageing you will undergo. Unfortunately, these people are the exception, not the rule.

When you get your cholesterol levels tested, make sure to ask not just for your total cholesterol level but for your total/HDL ratio. The lower the ratio, the better. The average ratio for middle-aged Americans is 5. It is calculated by dividing the number for total cholesterol by the number for HDL. For example, if you have a total blood cholesterol of 200 and your HDL is 40, the ratio is 5 (200/40). On the other hand, if your total blood cholesterol is 200 but your HDL is 57, your ratio is 3.5. A fifty-five-year-old man with a ratio of 3.5 would have only about half the risk of arterial ageing as the average man in his age group; his RealAge would be eight years younger. In contrast, if that man had a ratio of 9 (for example, 270 total/30 HDL), he would have more than five times the risk of arterial ageing as the average man in his age group; his RealAge would be twelve years older than average. Similarly, having either high LDL or a high LDL/HDL ratio can cause arterial ageing.

As mentioned, having a total cholesterol of over 240 mg/dl suggests a high risk of ageing. Likewise, a level of LDL cholesterol above 160 mg/dl or an HDL reading below 35 mg/dl correlates with an increased rate of arterial ageing. If your total cholesterol is more than 240, if your LDL cholesterol is higher than 160, or if your HDL cholesterol is lower than 35, you should talk seriously with your doctor about improving your cholesterol levels to retard arterial ageing. Having either high LDL levels or low HDL levels can make your RealAge anywhere from three to six years older. Having both high total LDL and a high LDL-to-HDL ratio can make your RealAge anywhere from six to eighteen years older, depending on the ratio. Even if your cholesterol status is more moderate—LDL levels above 100 but below 160 or HDL levels less than 55 but above 36—you should also consider taking steps to reduce your LDL cholesterol and increase your HDL levels.

Despite all the buzz about cholesterol-free foods, cholesterol is one factor that is largely determined by genetics. Genetics determine whether you have a tendency toward high LDL levels, and genetics largely determine your LDL-to-HDL ratio. That means that genetic factors gready determine how seriously you will be affected by arterial ageing caused by elevated LDL cholesterol levels if you don't adopt Age Reduction activities that are specifically targeted toward preventing arterial ageing. For example, if you are a man with a high LDL cholesterol level or a high LDL-to-HDL ratio and a number of your close male relatives died early from heart disease, you are at a high risk of the premature onset of cardiovascular disease (see Table 8.2).

As I mentioned, an HDL level above 60 mg/dl appears to provide tremendous protection against arterial ageing. Although some medications will help increase HDL levels, drugs are not the most effective way of improving your cholesterol ratio. In fact, no techniques have been proven to work for everyone. Exercise is one of the best ways to improve your HDL reading. Women tend to have higher HDL levels than men, and women are able to improve their HDL levels with exercise to a greater extent than men. A recent North Carolina study found that aerobic exercise increased HDL by 20 percent in female patients but by only 5 percent in male patients. Also, a glass of alcohol a night (half a glass for women) may increase your HDL level. For many people, losing excess weight improves their HDL readouts. Although the interaction between weight gain and cholesterol levels is still not well understood, the correlation between the two is strong.

In contrast, if you have low LDL cholesterol, your genetics are protecting you from arterial ageing. Finally, there are a lucky few who have high total

[Soybeans as Youth Beans - Recent studies have linked soy protein to a reduction in levels of LDL cholesterol. People who regularly consume soy products—soy milk, tofu, and soy beans (and that doesn't mean soy sauce!)—have LDL cholesterol levels that are, on average, 13 percent lower than those who don't. Try substituting soy-based products for animal protein in your diet. The consumption of soy products may have a particularly big impact on those with very high cholesterol levels. It is not clearly understood why or how soy protein helps reduce cholesterol levels, although some experts theorize that the soy works as an antioxidant on cholesterol. Others think that soy may interfere with the formation of plaque. To make a substantial difference in cholesterol, you would need 31 to 47 grams of soy protein a day. Soy also contains a natural oestrogen that has been shown to reduce the risk of both breast and prostate cancers and to provide extra protection for ageing of the bones] The  very  important  fact  is  you  have  to  make  sure  the  soy  product  is  organic  and  not  GM -  genetically  modified  in  any  way  -  Keith Hunt

cholesterol and high HDL cholesterol. These people have a genetic trump. All that HDL cholesterol helps protect them from arterial ageing. They can have a RealAge as much as twenty-six years younger than their cohorts.

How to Reduce Cholesterol Levels

Since there has been so much focus in the media on eating a 'low-cholesterol' diet, it is surprising to learn that eating a low-cholesterol diet is not an especially effective way to reduce LDL cholesterol. Cholesterol consumed in food will cause a rise in cholesterol levels for some people and will have no effect on other people. Only 15 percent (one in seven individuals) who try a low-cholesterol diet get a significant antiageing effect from doing so. Again, genetics play a role: Genetic factors largely determine your sensitivity to dietary cholesterol, and people can range from extreme sensitivity to complete insensitivity. A person who has a genetic insensitivity may consume as much as 1,000 mg of cholesterol daily without negative consequences. In general, though, it is recommended that you consume less than 300 mg of cholesterol a day. People who show a particular sensitivity to dietary cholesterol should eat even less than that to retard or reverse arterial ageing. How do you know your responsiveness to dietary restriction of cholesterol? Only by measuring blood levels before and after restricting dietary cholesterol. A dramatic decline suggests that you are sensitive. A more modest decrease of 10-15 percent suggests that you are not.

For most of us, consumption of fat influences our levels of cholesterol in the blood far more than consumption of cholesterol itself. Unless you are especially sensitive to dietary cholesterol, your body produces almost all the cholesterol that exists in the bloodstream. The liver manufactures cholesterol from the saturated and trans fats you consume. This is yet another reason why it is important to eat a diet low in saturated and trans fats.

The best way to reduce high LDL cholesterol is to choose foods that are low in cholesterol, saturated fat, and trans fat. If you have high LDL cholesterol, you may want to consider taking medicine to reduce those levels. Talk to your doctor about getting a more extensive lipid evaluation and about the pros and cons of medication for improving either your overall cholesterol level or your LDL-to-HDL ratio......

Triglyceride Levels

Triglycerides are lipids (fats) that circulate in the bloodstream. Triglyceride measurements are usually taken after an overnight fast and when cholesterol levels are analyzed. The average fasting triglyceride level is 120-125 mg/dl. Levels above 200 mg/dl are associated with significant arterial ageing, especially with plaque buildup along the arterial wall. Since triglyceride levels fluctuate a fair amount, people with high levels (above 190 mg/dl) will want to have their blood analyzed several times to get an accurate estimate. If your fasting triglyceride level is above 200 mg/dl, reduce total fat intake. Cutting saturated and trans fats to less than 7 percent of your total caloric intake, eating fish rich in omega-3 fish oils at least three times a week or more, and increasing your physical activity are all actions to choose before considering possible drug therapies 

Low Cholesterol Levels

With all this talk about high LDL cholesterol, do we have to worry about the other side of the spectrum? Can your cholesterol level dip too low?Apparently, yes, although we know far less about ultra-low cholesterol than high cholesterol, as very few people without an acute disease or chronic malnutrition have cholesterol levels low enough to be of concern. In a few but not all studies, people with low total cholesterol levels appeared to have a higher incidence of cancers and, curious to note, suicides. Although very few studies have been done on this subject, and we still cannot say with any certainty how low 'too low' is, it appears there is some risk. A possible explanation for the relationship to cancer may be that cholesterols are necessary components of vitamin D3, a proven cancer fighter. As for the suicides, no one really knows. Cholesterols are important in the functioning of brain cells and the production of hormones, so an ultra-low level of cholesterol may affect these two functions.

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TO  BE  CONTINUED

REAL AGE

Slimming Down

How Shedding Pounds Amounts to Shedding Years

Perhaps no health issue is more emotionally charged than weight gain. We need only to look at the plethora of diet books and the news stories about eating disorders to sense the concern. Ironically, in spite of the abundance of information on diet, nutrition, and the health problems associated with being overweight, the American population has been getting progressively heavier.

Being overweight can provoke many conditions that age your body. It causes high blood pressure, inhibits exercise, and promotes chronic diseases like diabetes. Excess weight is associated with accelerated arterial ageing and the onset of cardiovascular disease; ageing of the bones and joints; diseases of ageing, such as gallbladder disease and gout; increased levels of depression; and increased incidence of cancers, especially breast, uterine, and prostate cancers. Being overweight can make your RealAge as much as ten years older.

Fad diets are not the solution. Losing weight—and keeping it off—is no easy trick. The only way to do it is to change behaviors at the most fundamental level: Weight loss and maintenance of the ideal weight are always tied to healthy eating and exercise behaviors that are practiced for a lifetime. Repeatedly losing weight and gaining it back stresses your body and actually accelerates ageing.

The customary way of calculating your ideal weight is to determine your body mass index (BMI), or your weight-to-height ratio. The BMI reading is one of the best tools for assessing whether a person weighs too much because it accounts for variances in body size, giving a standard for evaluating people at a range of heights. (Although BMI is not the best measure of body fat, for most people, it provides a good general estimate and can easily be calculated at home.)

The average BMI for Americans is 26.3 kg/m2 (kilograms per meter' squared). In terms of Age Reduction, the ideal BMI is 23 or less. As long as your weight is not abnormally low because of some health complication, such as a chronic disease, if you have a BMI of 23 or less, you can expect your RealAge to be as much as eight years younger than if your BMI were at the national average of 26.3.

If your BMI is over 25, you will probably want to consider a moderate weight-loss program that includes boosting exercise and cutting caloric intake. If your BMI is over 27, excess weight is causing unnecessary ageing, and, again, you should consider a safe and gradual weight-loss plan involving exercise and cutting calories. People with BMIs over 30 should consult a physician or weight-loss professional before beginning any diet, to establish a safe and practical weight-loss plan.

Despite the well-publicized health problems from obesity, more than 40 percent of all men over age fifty are significantly overweight. That is, they are 20 percent or more above their desirable weight and have a BMI over 27.8. Fifty-two percent of women in their fifties and 41 percent of women age sixty and over are significantly overweight: they are 20 percent or more above their desirable weight and have a BMI over 27.3. In 1960, fewer than one-quarter of all Americans were significantly overweight; now more than one-third are. From 1980 to 1990, the weight (adjusted for height) of the average American increased by eight pounds.

What is the major factor causing this increase in weight? Some scientists argue that obesity stems largely from our food choices. We choose to eat a calorically dense diet, one that is high in saturated fats and trans fats, rich in sugar, and low in both fiber and nutrients. Others argue that we are genetically predisposed to obesity. Yet others believe that in our sedentary society, obesity is due to the abundance, variety, availability, and palatability of the food we can eat. That is, we overeat. I say it's double trouble; even when genetic factors are taken into account, we eat too much, and we eat the wrong things. In addition, we don't get enough exercise, especially strength-building exercise.

The best way to lose weight and to get younger by doing so is to eat less food and get more exercise. Approximately three hundred thousand people die a year because of weight-related illnesses. Indeed, our society's tendency to correlate thinness with beauty has done incredible harm. Instead of learning healthy eating practices, we crash diet to lose pounds and, in the process, do incredible damage to our bodies. Or else we give up, thinking that because we will never be supermodel thin, we may as well not bother losing weight at all.

How to Spot a Fad Diet

Every year there are new diet plans and lots of hype accompanying them. One year it is the grapefruit diet, the next year the cabbage soup diet. Some of these plans contain reasonable and healthful information. Others encourage bad diet habits or contain information that is just plain wrong—information that can either do nothing for you or, in some cases, cause real harm. The Food and Nutrition Science Alliance gives good advice on how to spot a bad diet fad:

1. If it sounds too good to be true, it probably is.

2 .Don't believe in the quick fix. When it comes to food, there are no overnight miracles.

3. Dire warnings—or raves-—-about one ingredient or regimen are not the answer. The all-tofu diet isn't going to keep your weight down.

4. Don't be tricked by simplistic conclusions drawn from complex studies. View what you read with a critical eye. Look for informed commentary in the health-minded press.

5. Recommendations based on single studies should not be believed. Wait for confirmation.

6. Dramatic claims that are disputed by other experts in the field are a clear warning sign. Try to evaluate who is correct.

In most of the discussions about weight, what is forgotten is the relationship between weight maintenance and good health. The point is not to be the skinniest person around, but to be the right weight for your height and build. So far, there are no good and lasting quick fixes. If you are just a bit overweight, you can probably increase your exercise levels or reduce your caloric intake and lose the weight.

Recent studies, such as one just completed at the University of Chicago, have found that the best way to lose weight is to increase exercise. In the University of Chicago's research on overweight women, not only did exercise burn calories, it also boosted the overall metabolic rate. When you exercise regularly, the body burns more calories per minute even when you are not exercising. Strength exercises are especially important because they build muscle, which burns more calories per minute than other kinds of body tissue (see Chapter 9).

New evidence shows that weight gain between the ages of eighteen (for women) or twenty-one (for men) and forty is particularly dangerous. Weight gain during these years can make your RealAge six months to one year older for every 10 percent gain in the BMI. Furthermore every 10 percent increase in relative weight is associated with a 6.5 mm rise in systolic blood pressure, and high blood pressure is one of the major factors affecting ageing.

Why are some people more prone to being overweight than others? Two factors that contribute are genetics and behaviors. 

Certainly, one key factor is heredity. Some of us are born thin, and some of us aren't. Our genes determine all kinds of influences on height, body weight, and metabolic rate, and these influences vary widely from person to person. The study of genetic factors affecting weight gain is a burgeoning field, and scientists have already discovered some genes and gene products that are tied to weight gain. For example, in 1994 and 1995, one of the first hormones tied to fat regulation—leptin—was characterized in the now-famous studies of 'fat mice': Mice with genetically caused obesity were given injections of leptin and lost weight! Despite the initial belief that a magical new weight-loss drug had been found, the discovery of leptin proved how complicated the genetics of food metabolism and weight gain are. Subsequent investigations showed that leptin is just one hormone of many involved in a complicated metabolic pathway. Some people with genetically caused weight problems have leptin-related disorders, but-others don't. Weight regulation is a complex genetic trait: Many different genes and proteins interact to determine body size. We are still years from understanding the interactions. Fortunately, heredity isn't everything.

What should you do to shed extra pounds? First, review this chapter, which contains tips on eating an Age Reduction diet. Then read the next chapter, in which you will learn how to develop an Age Reduction physical activity plan.

Second, don't torture yourself. The dieter's mentality of sacrifice and denial leads to failure. Don't punish yourself for occasional slipups. Instead, try to establish good eating behaviors that will last a lifetime. It makes no sense to go oh a diet for six weeks. Instead, you need to establish routines that will help you keep the weight off for the long term. Don't do anything dramatic or extreme. Use common sense and talk to your doctor. Remember, your food choices are for life: You can keep young by choosing to eat well.

Third, don't go it alone. It's too easy to lose your willpower. Find someone who has a common goal and try to lose weight together. Encourage your spouse or partner, friends, and colleagues to support you or join you. Although a diet sounds like the least entertaining thing imaginable, there are ways of making weight loss fun. For eleven years, I had a running bet with a group of friends. We agreed to lose two to three pounds a month—an achievable goal. Once a month we met for a weigh-in. Anyone who weighed in higher than his or her goal had to pay each of the others a hundred dollars for every pound he or she was over the target weight. Having the penalty be that high gave all of us an extra incentive to meet our goal. In eleven years and 132 weigh-ins, only one of us ever missed our target weight.

Fourth, if you're on a diet, reward yourself. When you lose the pounds you want, treat yourself to a new outfit, a night on the town, exercise clothes, a massage, or whatever makes you feel good—anything except an ice cream sundae! If you know a dieter, help celebrate when his or her weight-loss goal is reached.

Finally, you may want to have professional support. Joining a responsible weight-loss clinic or participating in a program such as Weight Watchers can help you lose extra pounds. These diet clinics and programs can teach you simple tricks for eating healthier, choosing foods that are good for you, and consuming fewer calories. They provide handy tips like what to order in a restaurant when no low-fat options are obvious and how to avoid empty-calorie foods. Also, the social environment really appears to pay off. It encourages a 'we're-all-in-this-together' kind of attitude as you leam how to motivate each other and make healthy food choices together. These groups help you celebrate those pounds-off victories.

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REAL AGE continued

Fit for Youth

AGE REDUCTION EXERCISE MADE EASY

So you think you don't have time to exercise? You don't have time not to. Time spent exercising actually gives you more time. It not only increases longevity, making your RealAge years younger, but it also gives you more energy so that (like other Age Reduction choices) you actually feel years younger, too. By adopting a three-pronged approach for boosting your physical activity, you can reduce your RealAge by 8.1 years. A moderate and balanced exercise routine is an integral piece of your overall Age Reduction Plan, and it's easier than you think to integrate into your everyday life.

• Boost physical activity. You don't have to run marathons to benefit from  exercise. Just taking a twenty-minute walk every day can reduce your risk of a heart attack or stroke by 15-30 percent in just twenty weeks. And it makes your RealAge one year younger. Make physical activity-—-walking to work, taking an evening stroll, or pedaling the exercise bike while watching the evening news-—part of your daily life, slowly building up to a goal of expending 3,500 kcal (kilocalories) a week. It will make your RealAge 3.2 years younger.

Difficulty rating: Moderately difficult

• Build stamina. Through vigorous exercise-—-whether it's aerobics classes, swimming, jogging, tennis, or anything else that makes you break into a sweat and causes your heart to beat faster—you can reduce your RealAge. Exercise strengthens your heart, arteries, and lungs and delays-—and may even reverse—arterial and immune system ageing. Exercises that cause you to sweat have a double benefit: They not only count toward the sixty minutes of stamina exercise required per week for optimum Age Reduction, but also burn extra calories toward your 3,500-kcal-per-week goal. Stamina exercises can make your RealAge as much as 6.4 years younger.

Difficulty rating: Moderately difficult

Build strength and flexibility. Keeping your body strong and flexible helps fend off the wear and tear that make us older. Doing strength and flexibility exercises three times a week keeps your muscles supple and strong. Stretching, weight lifting, and yoga all promote a younger body. You don't need to invest that much time to benefit: Lifting weights for ten minutes just three times a week makes you 1.7 years younger.

Difficulty rating: Moderately difficult

When it comes to fitness, remember the number three. There are three basic types of physical activity that make you younger-—general physical activity, starmina-building activities, and strength and flexibilityexercises-—-and each affects your ageing process differently. To get the maximum Age Reduction effect from your fitness plan, you need all three.

First, there is just general physical activity-—walking, gardening, bringing in the groceries—anything that uses your muscles, no matter what it is. Just boosting your overall activity level—not even breaking a sweat—can earn you 40 percent of the Age Reducing effect normally attributed to exercise. Raising your overall caloric expenditure to 3,500 kcal a week makes your RealAge 3.2 years younger. A kcal is the same amount of energy as a calorie, except that, for some reason, the custom is to use the term calories when we're talking about food and kcal for the same amount of energy when we're talking about exercise. Therefore, a donut is said to contain about 400 calories, and swimming is said to bum 400 to 600 kcal an hour.

Second, there are activities that raise your heart rate—the so-called stamina activities. This is what most of us think of when we think 'exercise'—jogging, biking, swimming, aerobics, a 'workout.' This kind of exercise contributes another 40 percent to the Age Reduction that can be tied to physical fitness.

Third, there are strength and flexibility exercises. Building and strengthening muscles and keeping them in top form through weight lifting, stretching exercises, or other activities contribute just 20 percent to the overall Age Reduction effect of exercise. But don't be fooled; it's a critical 20 percent. These activities provide a kind of insurance policy for the body, helping you to avoid injury and skeletal weakening and allowing you to continue your overall exercise routine without the disruptions caused by pulled muscles or broken bones. Strengthening exercises are especially important for women. To protect bone mass and density, women need to lift weights even more than men. Lifting weights for just thirty minutes a week makes your RealAge 1.7 years younger.

The best fitness plan is one that builds on all three components. One without the other two will provide some, but not the maximum, Age Reduction effect.

Exercise and Longevity: The Basic Facts

How many times have you told yourself, 'I will start exercising'? How many times have you finished that sentence with 'tomorrow'? Although more than 90 percent of Americans agree that exercise is an important part of healthy living, only 15 percent get as much exercise as they should. More than 76 percent fail to do even one vigorous activity a week. Over two hundred fifty thousand deaths a year, 12 percent of the national total, are attributable to the lack of regular physical activity. Despite the sports fashion boom of the 1980s, Americans seem to be exercising less and less. As a nation, our fitness level is declining. Fewer people are fit in the 1990s than they were in the 1980s, and fewer people in the 1980s were fit than in the 1970s. Although Americans spent more than $40 billion on fitness equipment in 1995, much of that equipment is gathering dust in the basement.

Even modest physical activity can make your RealAge younger—substantially younger. A study published in the Journal of the American Medical Association found that one of the key reasons Americans don't exercise is the common misconception that a person needs to do taxing and rigorous workouts to reap benefits. That's simply not true. Almost all of us would benefit greatly by just boosting our overall physical activity. In fact, a recent policy statement from the Centers for Disease Control and the American College of Sports Medicine suggested that getting just half an hour a day of moderately intense activity, such as walking, gardening, or housecleaning—-that is, burning just 200 kcal a day (or 1,400 kcal a week) beyond the 'resting metabolic rate'—can provide many of the health benefits attributed to exercise. Even getting just 750 kcal a week of physical activity—that means about two ten-minute walks a day—-makes your RealAge 0.9 to 1.7 years younger than if you did nothing. If you get an hour's worth of physical activity a day—and that includes such things as walking up the stairs or taking a couple often-minute strolls—you can reduce your RealAge two to five years. That doesn't mean hard-sweat exercise, just anything that uses your muscles. In fact, I often don't even use the term exercise, preferring the term physical activity. Physical activity—just boosting your overall activity level—is a key component of Age Reduction.

Who should exercise? Everyone. Who can exercise? Everyone who is not seriously incapacitated. Just two decades ago, many doctors and scientists believed that heredity determined your ability to do exercise and to benefit from it. More recent studies have indicated that choices and habits—-that is, your own desire and resolve to stay in shape—determine, by more than 70 percent, your ability to achieve and maintain physical fitness. The first step is changing your frame of mind.

Even if you have a health problem—especially if you have a health problem—you should integrate exercise into your life. Exercise makes the RealAge of those who are at a higher risk of cardiovascular disease and other chronic illnesses disproportionately younger. You get the biggest benefit if you begin exercising before you have a major health problem or, as I like to think of it, an ageing event.

People who start exercising or doing even moderate physical activity in midlife have a decreased rate of ageing. In fact, you are never too old to begin. Fitness researchers have even found that encourageing the frailest nursing home residents—people already in their nineties and even as old as one hundred—-to lift weights actually makes an astounding difference in the quality of their lives, enabling some to move out of their wheelchairs and back on their feet. In fact, I've been told that the nursing home where these studies were done had to close a wing after the studies were finished because so many of their residents got well enough to go back home. No matter what your age or physical condition, exercise almost always makes you younger. What is most important about fitness is that you continue to exercise. Studies have found that within five years of giving up their sports and exercise, college athletes were no more fit—and no younger-—-than those who had never exercised. Exercise keeps you young only as long as you keep doing it.

Exercise and Disease: Lowering Risk, Getting Younger

Exercise is a whole-body phenomenon. It doesn't just make your muscles stronger, it slows down the ageing of your entire body. Exercise affects everything: your cardiovascular system, your immune system, your musculoskeletal system, and your emotional well-being. It affects you all the way down to your cells. Let's consider the scientific research on exercise as it pertains to various health conditions.

Coronary and arterial ageing. People who exercise regularly have significantly less cardiovascular ageing and are at a far lower risk of heart attacks and strokes, regardless of their genetic background. Exercise lowers blood pressure, raises the levels of protective HDL cholesterol, stimulates weight loss, and helps prevent blood clots. The Harvard Alumni Study found that the incidence of heart attack was inversely proportional to the amount of exercise performed: Men who exercised less than 2,000 kcal a week had a 64 percent higher risk of heart attack than those who exercised more than that. Studies have also shown that a three-month period of intensive activity, like that experienced by military recruits, can result in an increase in HDL ('healthy') cholesterol of as much as 33 percent and a decrease in LDL ('lousy') cholesterol of 9 percent. Even moderate amounts of physical activity are shown to lower total cholesterol rates and to lower LDL/HDL ratios, although the results are not as dramatic. Exercise is a-way to control cholesterol without medication and to make your RealAge younger.

Immune system ageing. Physical activity affects you even at the cellular level. It reduces the rate at which your cells age, meaning that you are less likely to develop cancers and that microscopic cancers that do exist are less likely to spread. Exercise also improves the overall functioning of the immune system, increasing the production of 'watchdog' cells that seek and destroy invading disease cells and cancer cells. Those who are physically fit have fewer colds and other illnesses.

Colon cancer. The rate of colon cancer is significantly higher in highly industrialized, affluent societies. Why? Researchers blame our fatty diets and sedentary lifestyles. Several studies have shown that individuals who are physically active have much lower rates of colon cancers; a study in Sweden found that those with low levels of activity were three times more likely to get colon cancer.

Breast cancer. Preliminary studies show that women who exercise regularly have an incidence of breast cancer that is almost one-third lower than that of women who do not exercise regularly. One Norwegian study found that among women who exercised, the risk was reduced by 37 percent. Unfortunately, many questions still exist about the relationship between breast cancer and exercise. Some scientists hypothesize that women who exercise more have lower fat stores and, hence, less long-term exposure to impurities stored in fat cells. Others hypothesize that endurance training helps increase the number of immune system cells that are known to kill off potential cancer cells.

Prostate cancer. Prostate cancer is linked to elevated testosterone levels, and regular vigorous exercise reduces such levels. Men who exercise consistently have much lower rates of prostate cancer. The Harvard Alumni Study found a significantly reduced risk of prostate cancer among men who exercised more than 4,000 kcal a week and an increased risk for men who expended less than 1,000 kcal a week. The risk was nearly 50 percent lower for men over age seventy and more than 80 percent lower for men under age seventy. Although other studies have confirmed the link, there is still debate over the exact relationship between exercise and prostate cancer.

Arthritis. Practically everyone over age sixty-five begins to show some sort of arthritic symptoms. A study recently published in the Journal of the American Medical Association found that people who had osteoarthritis can and should exercise. Moderate to vigorous exercise, in conjunction with strengthening exercise, eliminated many of their symptoms and made their joints younger.

Weight management. By burning calories and increasing your metabolic rate, exercise helps you lose weight and replace fat with muscle. The more muscle you have, the more calories you burn, even when you're not exercising. Strengthening exercises are particularly important because they build muscle.

Diabetes. Exercise helps increase the body's sensitivity to insulin. This increased sensitivity to insulin, in turn, lowers blood sugar levels and decreases insulin production. Active people, even if they have a genetic predisposition to the disease, are much less likely to develop adult-onset (Type H) diabetes. Furthermore, if symptoms do occur, exercise helps diminish their ageing effect.

Osteoporosis and loss of bone density. Any resistance activity—walking up a hill or lifting groceries—-strengthens muscles and, just as important, increases bone density, making bones stronger and less likely to fracture. Indeed, resistance activity actually increases the calcium content of bones. Although strengthening-—or weight-bearing—exercises are the best for improving bone strength, new evidence shows that exercises such as riding a stationary bicycle and water aerobics may also increase bone density. Take note, however: Some new studies warn that people who exercise vigorously need to get proper amounts of calcium—1,000 to 1,200 mg a day-—to ensure that enough calcium is available for the bones to build density. During intense training, large amounts of calcium are lost through perspiration.

Falls and broken bones. Each year, approximately 30 percent of people over age sixty-five fall down, and 15 percent of those who fall suffer serious injuries. More than 6 percent of all medical care dollars spent on people over age sixty-five involve fall-related injuries. Hip fractures and other bone breaks age a person significantly. It's not just the bone breaks that age, but the long periods of immobility that often follow. Studies of the elderly population have found that those who exercised, particularly those who did balance-building exercises, such as tai chi chuan, were much less likely to fall or to sustain fall-related injuries.

Sleep-related disorders. Studies done at both Stanford and Emory Universities found that adults who exercised fell asleep more quickly and slept better than their sedentary counterparts.

Depression and anxiety. Exercise has significant emotional benefits: It helps ease depression, anxiety, and other psychological disorders. Depression is a widespread, though often undiagnosed, problem among older people. Doctors have known for years that exercise, particularly when done in a social environment, helps relieve clinical depression. Exercise also reduces anxiety disorders and improves mental health in other ways. Even for those who have not been diagnosed as having a psychological illness, exercise is a known mood lifter, helping them feel happier and more upbeat.

Stress management. Regular exercise decreases the stress response, meaning that you are more relaxed, feel better, and are better prepared to cope with life's stressful events. We all have stresses, but by staying fit, we are better equipped to avoid their ageing effects.

Long-term memory. Exercise helps improve long-term memory and brain function. It helps prevent the arterial ageing that contributes to the early onset of Alzheimer's disease.

Tobacco use. Increasing exercise levels helps people quit smoking. Regular exercise diminishes nicotine cravings.

As this list shows, exercise clearly helps us stay young. But how are we to motivate ourselves to take on a real exercise regimen?

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TO  BE  CONTINUED

REAL AGE

The Exercise Basics

Cynthia W. was forty-three when she became my patient. At 5 feet 5 inches, she was eighty pounds heavier than she had been at age eighteen. Her body mass index was 38, well over the cutoff point for being considered overweight. The managing editor of a business magazine, she had a high-stress job. She spent every day sleuthing stories, answering phone calls, and making sure that the news got out on time. When deadlines neared, she worked around the clock, living on take-out food. By the time she became my patient, she had had a heart scare that brought her in for an electrocardiogram. She realized it was time to start taking care of herself.

When I tried gently to bring up the matter of her weight, she said, 'Dr. Roizen, don't beat around the bush. I know I need to lose weight. And,' she smiled, 'you're the one who's going to help me do it' After fighting with issues of body image and beauty for a long time, her recent heart scare made Cynthia realize that weight loss wasn't about looking good—it was about being healthy.

She told me, 'All of sudden, I woke up one day, and I was five times the size I always thought I was. I just never made the time to take care of myself. But I don't want to haul all this weight around anymore. Tell me what I can do?

'Eat less and,' I paused, 'exercise.'

'Damn. I thought you'd say that'

'Sorry, but what else can I say? Let's develop a plan you can stick to.'

Cynthia started her first 'workout' that day. She walked from her house to the end of the block and back. That was it: short, sweet and slow. The next day, she did it again. By the end of the next week, she was walking all the way around the block. Within three weeks, she was walking eight city blocks—the equivalent of a mile—each day. Then she began timing herself, increasing her pace a little bit each time. Within three months, she was walking half an hour each day. On weekends she would walk for a full hour. "Mike," she said to me one day, "I never thought I'd say this, but I actually find myself craving my daily walk. Me, the living paperweight actually wanting to exercise! I'll be at the office, the phones will be ringing off the hook, and all I can think is, Gee, I really want to take a walk.''

She had discovered that exercise doesn't have to be painful or exhausting. It can be something to look forward to, a reward. Soon Cynthia set a goal to walk in a five-kilometer walk-run race, just over three miles. And she did it, even jogging part of the way.

Within two years, she has lost more than forty-five pounds. Her blood pressure has dropped, and she feels a whole lot better. "I have more energy, and I actually like the way my body looks and feels," she laughed. Cynthia still hasn't reached her goal of getting back to the weight she was at eighteen, but she's getting closer every day.

Cynthia's doing it the easy way, remembering that health should play an important part of every day. She's working up gradually, aiming to meet her own goal of eight years younger. Cynthia started with the goal of just boosting her overall level of physical activity, aiming to get half an hour a day of moderate activity. Then she moved on to building up stamina, strengthening her heart, lungs, and arteries and to increasing her overall endurance. She has gone from getting less than 500 kcal of activity a week to reaching the ideal goal of 3,500 kcal a week. She still isn't doing lots of vigorous exercise, but she did buy an exercise bike and, on it, she reaches her goal of 65 percent of her maximum heart rate for twenty minutes or so at least three times a week. She is aiming to bring it up to 80 percent of the maximum. She still needs to do some strengthening and flexibility exercises, especially as she builds more stamina, to prevent injuries.

If you want to start exercising, how should you start? 

Like Cynthia, you should start slowly. A behavior change that can last a lifetime takes effort. Don't try to fit a year's worth of workouts into the first week. You'll just get discouraged.

The most common reason for not exercising is "I don't have the time." Yet, exercising doesn't use up time; it makes more of it if you invest a little time each day, you will become younger in the here and now. In just ninety days, the effects will be measurable. You will feel better and more energetic, and your body will be healthier and more efficient. When people say they don't have time to exercise, I remember a clearly out-of-shape comedian who said, "All the time I gain from exercising, I spend exercising." Funny but, thankfully, not true. Just twenty minutes a day of physical activity will make your body younger and more efficient for all the other minutes of the day. In fact, most of my patients who have adopted the three-pronged RealAge physical activity plan tell me that they save more than an hour a day when they exercise. They are more energetic and more efficient in all the other things they do. No wonder. They are 8.1 years younger.

Physical Activity: The Antiager

The first goal of any fitness plan is to figure out how to boost your overall level of activity. Most of us lead sedentary lives. We sit at desks all day at work, watch TV when we get home, and drive too much. Future archeologists will label us "The-Sit-Around-and-Get-Round-Society." The decision to get in shape is a big decision, but it's the small steps that really matter. Like deciding to walk to the neighborhood grocery instead of driving. Pedaling an exercise bike while watching the football game. Lifting weights instead of chips during the commercials. Actually walking the dog, instead of just tossing or shoving him out into the backyard. Every movement you make improves your physical fitness level. Housework, gardening, and mowing the lawn—not to mention fun things, like dancing and sex—are all activities that burn extra calories. The point is to get your muscles moving. The more active you are, the younger you are.

At rest, your body burns 1,400 to 1,900 kcal a day. This is your 'resting metabolic rate.' This is the energy your body spends just keeping you alive— the energy it uses to keep your heart beating, to keep your blood flowing, to digest your food, and to breathe. Your resting metabolic rate is approximately 1 kcal per kilogram of body weight per hour. (To get your weight in kilograms, divide your weight in pounds by 2.2.) If you weigh 132 pounds, or 60 kilograms, you will burn 60. kcal an hour. Then multiply this hourly number by 24 hours to get your expenditure per day. A person weighing 60 kilograms would burn 1,440 kcal a day even doing nothing. Likewise, a person weighing 90 kilograms, just about 200 pounds, would burn 90 kcal an hour and 2,160 kcal a day. Ideally, you should expend 3,500 kcal of energy a week in exercise above and beyond your resting metabolic rate. Getting that much physical activity gives you the maximum health benefit with none of the drawbacks of overexercising. Just as examples, brisk walking bums 300 kcal an hour, and jogging bums 400 to 500 kcal an hour.

Think about your daily routine

How and where can you integrate more activity into your routine? At work, take the stairs instead of the elevator (each flight burns 5 kcal). Take a walk at lunchtime, or ride your bike to work instead of driving. In the middle of the afternoon, take a ten-minute break and, instead of having another coffee, walk around the block. It will give you an energy burst without the caffeine. You can even plan a meeting around a walk. I call it the 'walk-and-talk.' Walking a city block bums up 9 kcal. Walk short distances instead of driving. Instead of spending ten minutes looking for the perfect parking spot, park a bit farther and use those ten minutes to walk to your destination. Buy a stationary bicycle, treadmill, or rowing machine and put it in front of your TV. That way, you can catch the evening news, expand your mind, and burn 300 to 600 kcal in an hour.

Getting just thirty minutes of physical activity a day, done in eight-to-ten-minute bursts, not only leads to measurable changes in physical fitness levels but has positive emotional effects. It makes you feel younger and more vigorous. Exercise provides a 'dose-response' relationship. The more exercise you get, the better you feel. The benefit of exercise reaches its maximum at about  3,500 kcal a week. Above that, the benefit is more or less the same until you reach 6,400 kcal a week, at which point you may be overexercising and causing ageing.

Some good news: Every little bit of physical activity matters. Studies have found that people who begin exercise programs doing several small segments in a day are more likely to stay with the program than those who try to do an extensive workout all at once. If you are now relatively sedentary, burning just 750 kcal a week beyond your daily average can make you one year younger.

Although everyone needs exercise, exercise is even more important for those already at elevated risk of cardiovascular disease and other kinds of chronic disease. A famous study done by fitness researcher Steven Blair at the Cooper Center in Dallas showed that people who were physically fit, and even those who achieved physical fitness later in life, had significantly lower death rates no matter what the cause of death and regardless of any other risk factors, such as a family history of cardiovascular disease or previous heart attacks. The Harvard Alumni Study found that people who smoked, had high blood pressure, and didn't exercise had more than seven times the chance of having a heart attack. Having two of these three factors meant that a person's risk was only twice as high as the norm. If you are a smoker, have high blood pressure, or any other major risk factor that ages your arteries, exercise is especially important to retard or reverse ageing.

Family support is an important part of being able to maintain an exercise routine. Talk to your spouse or partner about the need to get in shape and about how important it is for both of you. Each of you should set exercise goals. "When one of you reaches a goal, have the other one cook a special saturated-fat-free celebratory meal or give some other reward. It may be corny, but encouraging someone to stay in shape is the best way to say 'I love you.' It means you want to have that person around for a long time. Use exercise as a way to find time in your busy schedules to get together. You can fill each other in about the day's events just as easily when you're on exercise bikes at the gym as you can in front of the TV at home.

Another problem many of us face when beginning an exercise plan is that we're literally fair-weather friends. Many people begin an exercise regimen in the spring, work out in the summer, reach their fitness peak in the fall, and then give up altogether as winter approaches,. Then they start from scratch all over again the next spring. Instead, plan for the cold weather. Join a gym or a club with an indoor pool. Even shopping malls provide indoor walking routes. More than 3 million Americans over calendar age sixty-five now mall-walk.

Starting to Exercise

Here's how I recommend that my patients start Age Reduction exercising:

Start slowly. Don't overdo it. Just go for five or ten minutes at the beginning. Even a walk around the block is a place to begin.

Do a bit more each week. Try to build your workout by a couple of minutes each week. Aim to increase your workout by 10 percent a week.

Warm up first, then stretch, and stretch again afterward. Save your muscles from pulls and tears and notice how good your body feels when your muscles are warm and stretched.

Visualize. Imagine yourself doing your sport. Make a picture in your mind of hitting the perfect shot or running in perfect form. Imagine how your body would move.

Treat yourself right. If it hurts, slow down. If it feels good, do more than you planned.

Cross-train. Try to plan your workout schedule around a number of different activities, such as walking, biking, and, swimming. Rotate your activities on different days.

Reward yourself. Set goals and when you achieve them, treat yourself. Buy a new pair of shoes or get a massage. Celebrate your Age Reduction!

Drink water. Don't let yourself get dehydrated.

Find an accomplice. Exercise with a friend. You'll encourage each other and push yourselves to meet your goals. Get the whole family involved.

Take a lesson. Even if you don't normally work out with a trainer or a pro, treat yourself to an hour with an expert who can show you how to maximize your workout and avoid needless injuries. It's a great way to get started.

Vary your workout pace. Do more on some days and less on others.

Consider whether you need a pre-exercise medical exam. Most adults do not need to talk to a doctor before beginning an exercise plan of moderate intensity. If you have a chronic disease or some other kind of health problem, you should talk to your doctor. Also, if you are a man over forty or a woman over fifty and are planning to start an intensive fitness program, you might also want to ask your physician to help you design a workout routine. If you don't have a regular doctor, ask your clinic or health maintenance organization (HMO) if anyone on its staff specializes in fitness.

If you really like being outdoors but get stopped cold by winter, learn how to dress for the weather. Wearing the proper gear can mean the difference between suffering through your workout and enjoying it. You can keep running right through the winter if you wear a hat and gloves. The advances in exercise wear in the past ten years have produced new fabrics, such as fleece and Lycra, that make exercise clothing both warm and lightweight. To make the most of the cold weather, learn a winter sport. There are few sports that provide the complete body workout of cross-country skiing. Ice skating, downhill skiing, and snowshoeing are all sports that can turn those gray winter months into something you actually look forward to.

Some people find that they miss their exercise routine when they travel or go on vacation. Plan for exercise. For example, I do a lot of traveling for work, and I always try to stay at hotels that offer fitness facilities. I find it's a great way to unwind after a long day of meetings or to start the morning off right. If I can't find a hotel with a gym, I pack a jump rope (some of my friends pack exercise bands). Twenty minutes of jumping rope—done in the right shoes and on a low-impact surface—is a great workout that you can do anywhere with a little bit of room. The ceilings in most hotel rooms are high enough. I often wonder what the person in the room below me thinks, but I know that I am not letting being way from home get in the way of keeping myself young.

(THE  CHARLES  ATLAS  COURSE [STILL OBTAINABLE]  HAS  ALL  KINDS  OF  EXERCISES  YOU  CAN  DO  ANYWHERE,  NOTHING  BUT  YOURSELF  NEEDED  -  Keith Hunt)

Boosting your physical activity levels should be a starting point. It provides the first 40 percent of the Age Reduction benefit attributable to fitness (see Table 9.2). To get the next 40 percent, you have to move to the second phase: stamina exercise.

Building Stamina: Getting Fit for the Long Run

The second element of any exercise routine should be aerobic (stamina-building) exercises. These are exercises that raise your heart rate and make you sweat. Activities like jogging, swimming, biking, and even brisk walking provide a fundamental piece of your Age Reduction exercise plan. Realistically, if you plan to get 3,500 kcal of activity a week, you will need to do something that really gets you moving. 

You will want to start slowly and work your way up. Stamina building is a RealAge 'two-for-one' special: Stamina exercises give you double RealAge credit  benefits for boosting your overall physical activity—burning kcalories— plus additional Age Reduction benefits for building stamina and aerobic capacity. In the Harvard Alumni Study of ten thousand subjects, those who expended 3,500 kcal a week had half the rate of ageing for the period studied as the least active people. In RealAge terms, individuals who were fit— those who reached overall activity levels of 3,500 kcal a week and included stamina-building exercises in their weekly routines—were 6.4 years younger than those who were completely unfit.

Aerobic exercise increases the body's uptake of oxygen and boosts your overall metabolic rate, meaning that the more you exercise, the more calories you burn, even when you're sitting still. Elevating your heart rate to 60-90 percent of its maximum for twenty minutes or more three times a week will give you a stronger heart, arterial system, and lungs and will help your body attain a higher resting metabolic rate. You also will reach your 3,500-kcal-a-week goal in half the time.

In contrast to your overall fitness level, the goal of stamina exercises is not the expenditure of kilocalories, but an increase in 'metabolic equivalent units,' or METs—-that is, a change in your metabolic rate, or the amount of oxygen that your muscles consume during exercise. One MET represents your metabolic rate at rest; 10 or 11 METs is the goal you should strive for when doing a vigorous workout. You will want to boost your metabolic rate to ten times its normal rate. Whereas kilocalories measure the total amount of energy burned, METs measure the intensity, or rate, at which you burn that energy. That is, the higher your metabolic rate (the higher your METs), the more kilocalories you burn in a shorter period. The goal of the second prong of your exercise plan-—-the stamina-building prong—should be to reach 10 METs for sixty minutes a week if you are a woman and 11 METs for sixty minutes a week if you are a man.

Now that you know what you're aiming for, how can you measure METs? Unfortunately, you can't, or at least not easily. METs can be measured accurately only at a sports medicine clinic or some other place equipped to monitor METs. There are three good substitute guidelines for measuring your metabolic rate: estimating the kilocalories burned per hour, estimating 'sweat time,' and determining your heart rate. Use these guidelines for measuring the intensity of your workouts. Look at 'calories-per-hour rates' to get a rough guideline for your MET level. If you walk briskly (300 kcal per hour), you will reach a metabolic rate of six to seven METs. If you do something that burns more than 600 kcal an hour, then you are somewhere close to 10 METs. You should try to exercise at this rate for at least twenty minutes three times a week. Another good way to estimate METs is by sweat time—try to sweat for twenty minutes or more three times a week. The amount of time you actually spend sweating is a relatively reliable indication you have reached 70 percent of your maximum heart rate and metabolic rate. The third way to estimate METs is by measuring your heart rate—the number of times your heart beats per minute. During bouts of vigorous exercise, your heart rate should get within 65-80 percent of the maximum.

How many beats per minute is that? First you need to calculate your maximum heart rate (the number of times your heart beats per minute when pushed to the limit). Calculate this by subtracting your calendar age from the number 220. If you are forty, your maximum heart rate should be about 180 beats per minute. If you are sixty, your ideal should be about 160 beats per minute. As I've gotten more fit, I challenge myself by subtracting my RealAge from 220. When you first start on your exercise program, the goal is to raise your heart rate to at least 65 percent of the maximum for twenty consecutive minutes at least three times a week. As you get in better shape, you should try to reach 80 percent of that number. For example, if you are forty, you should try to raise your heart rate to 117 beats a minute for twenty consecutive minutes each time you do a stamina-building exercise. As you progress, try to increase that number to 144 beats a minute. If you are sixty and just beginning to exercise, you should raise your heart rate to 104 beats a minute and subsequently aim for 128 beats a minute.

These are general guidelines that describe ideal heart rates for the average person in a particular age range. Remember, however, that there are individual variations in heart rate.

How do you measure your heart rate? When you are well into your workout, stop your exercise for a few seconds. Place the finger of one hand on your opposite wrist and search for the pulse point. It lies on the spot of your wrist just below the base of your thumb. Feel around for it. Make sure to use a finger, not your thumb, to feel for the pulse, as the thumb itself has a pulse point that can distort your reading. Then count the number of heartbeats in fifteen seconds, subtract one, and multiply by four to get your heart rate for a minute. Remember, a heartbeat has two parts to it—an 'in' and an 'out.' You should feel both. If you find it difficult to get this down, or if you want a more exact measure of your heart rate, buy a heart-rate monitor. These monitors are easily found at sporting goods stores but can be expensive. You can even get watches that have a heart-rate monitor in them.

As you start your new exercise program, begin slowly and build. Do as Cynthia did: Start with slow walks and gradually increase your workout each week by 10 percent. Soon you will start to sweat. When you begin a sport, it is more important to build stamina than intensity. Run farther but at a slower pace. Bike farther, rather than go all out for a short distance. Quantity matters most. Space your workouts during the week. Exercise every other day or switch between sports.

Forget the statement 'No pain, no gain.' Exercise shouldn't be painful. True pain is your body's way of telling you to back off. If you hurt, slow down or try a different regimen. The most common kind of pain you feel when you first start exercising is a slow, burning ache in the muscles and being out of breath. This feeling is normal because you are reaching your anaerobic threshold and are at the limit of your endurance. The pain is caused by the buildup of lactic acid in your muscles, which occurs when your muscles are not getting enough oxygen. This is not an indication of an injury but of reaching your fitness limit. The more you work out, the higher your anaerobic threshold will go, and soon you will be able to work out for longer periods and at a more vigorous rate.

If you feel sore after a workout, especially the next day, don't worry. Unless something really hurts, it will probably go away within a day or two—eventually producing lean muscle where there used to be flab. That's why you should space your workouts and rotate between activities-—-so that different muscle groups are worked on different days, getting a day off in between.

As you do more of your workout, set new goals and try to meet them. Try to increase the length and intensity of your workouts. Start small but be consistent, and you will do wonders. Stamina-building exercise can give you 6.4 years of youth.

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TO  BE  CONTINUED

SOUNDS  SOMEWHAT  COMPLICATED.  WELL  IF  YOU  ARE  IN  THE  UN-FIT  SITUATION,  YES  START  OUT  SLOW  FOR  SURE.  IF  IN  THE  FIT  CATEGORY,  THEN  DIFFERENT  VARIETIES  WITHIN  YOUR  FITNESS  PROGRAM  IS  A  MAJOR  KEY  TO  BEING  ABLE  TO  STICK  WITH  YOUR  OVERALL  PROGRAM.  HAVE  A  VARIETY  OF  THINGS  YOU  DO  TO  KEEP  YOU  FIT.  

ONE  IMPORTANT  RECENTLY  NEW  DISCOVERY  IS  THAT  "HARD  AND  FAST"  TRAINING  WITH  RESTS  IN-BETWEEN  FOR 1/2  AN  HOUR  DOES  WONDERS  FOR  YOUR  BODY.

MY  EXAMPLE  IS  WHEN  I'M  SWIMMING…..I  DO  A  FAST  AS  POSSIBLE  LAP  SWIM,  REST,  RELAX,  30-60  SECONDS,  THEN  ANOTHER  FAST AS  POSSIBLE  LAP,  AND  SO  ON.  THIS  NOT  ONLY  GETS  YOUR  MUSCLES  WORKING  HARDER  BUT  ALSO  YOUR  HEART,  LUNGS  AND  ETC.

YES  PARK  AT  THE  FAR  END  OF  THE  SUPER-MALL  PARKING,  WHEN  GOING  SHOPPING  AND  BRISKLY  WALK  TO  THE  SUPER-MALL  OR  GROCERY  STORE.

IF  YOU  GET  THE  CHARLES  ATLAS  HEALTH  AND  STRENGTH  COURSE,  YOU'LL  BE  GIVEN  ALL  KINDS  OF  STRENGTH  AND  STRETCHING  EXERCISES,  THAT  DO  WONDERS  FOR  YOUR  BODY,  NO  GADGETS  REQUIRE.

I  ALSO  HAVE  DUMB-BELL  WEIGHTS,  ONES  THAT  ADJUST  REAL  EASY  FROM  5  POUNDS  TO  50  POUNDS.

I  HAVE  A   BIKE.  AND  I  AM  A  HORSEMAN  WITH  MY  OWN  HORSE.

SO  THERE  IS  MY  VARIETY  OF  EXERCISING  ROUTINES  IN  ANY  GIVEN  WEEK.

AND  I  WORK  PART  TIME  AS  CARETAKER  FOR  A  COMMUNITY  CENTER…..MANY  THINGS  REQUIRE  EXTENDING  ENERGY  AND  MUSCLES.

I  DO  ALL  OF  THIS  AT  A  BIRTH  CERTIFICATE  AGE  OF  71  -  72  SEPTEMBER  11TH  2014.  PEOPLE  THINK  AND  GUESS  MY  AGE  AT  ABOUT  50.

I UPLOAD THIS AS OF DECEMBER 2025 TO THIS BLOG. I AM NOW 83 BUT MY BIOLOGICAL AGE ABOUT 60.

I STILL DO ALL OF  THE ABOVE, AND YES I STILL HAVE A HORSE.

Keith Hunt 

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