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.
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 E IS FOUND IN WHOLE WHEATS, SO ORGANIC WHOLE BREADS IS A GOOD COURSE - Keith Hunt
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.
TO BE CONTINUED
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
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