May 2 2013 Thu BDE.pdf - Brooklyn Daily Eagle

Views on Aging, from A Longtime, Expert Observer
Age is an issue of mind over matter. If you
don’t mind, it doesn’t matter. – Mark Twain
By Ciril J. Godec, MD
Chief, Department of Urology
Professor of Urology,
Downstate Medical Center
At Long Island College Hospital
Getting older is inevitable, growing
up less so. Ask my wife; she will
tell you immediately that growing up
and maturity do not apply to me. What
is aging? Of the many definitions, I’ll
mention just two. “The process of
growing old and mature.” Or, a more
biological definition, “aging is the endogenous
and hereditary process of accumulative
changes of molecular and
cellular structures disrupting metabolism
with the passage of time, resulting
in deterioration and death. Aging
occurs on both levels, of the whole organism
as well as of individual cells”.
Aging is, by far, the leading cause
of death. Of the approximately 150,000
people who die each day, roughly
100,000 die of aging. In developed countries,
up to 90% of deaths are due to aging.
In 2012, the average lifespan for the
U.S. was 78.49 years and for the world
was 67.59. Still, for longevity, the U.S.
ranks only fiftieth among the countries
in the world. The first is Monaco with
89.68 years, and at the bottom is Chad
with 49.
At the present time, the maximum
lifespan for humans is approximately
120 years. The oldest documented
human being was Jeanne Calment, a
Frenchwoman who died in 1997 at the
age of 122 years and 164 days. Centenarians
are currently the fastest growing
segment of the American population.
While they number 70,000
in 2012, the American Census Bu-
reau predicts that in 2050 we’ll have
600,000 in the US. Among centenarians,
women are at a distinct advantage:
85% of centenarians are women.
But if men can make it past 100,
they are in general in better health.
Not everybody will get Alzheimer in
very old age; only one third of centenarians
have it, one third have some
hearing and vision impairment (they
might appear Alzheimerish, but they
are not) and one third are completely
normal and functional.
Is aging really a universal principle
in nature? Maybe not. We know that
most animals don’t die of aging. They
are eaten or killed by other animals or
humans. There are some animal species,
like jellyfish, that never die. Some
whales and turtles can survive over
200 years. Many trees can survive over
thousands of years.
In 2011, heart disease and cancer
were the two leading causes of death
in the U.S.: 590,000 for heart and
570,000 for cancer. Alzheimer was in
sixth place, with 83,000 deaths. All
three diseases are age-related; the older
we get, the more of these three diseases
we get. Heart and Alzheimer disease
increase steadily with age, but
cancer is different. Up to age 90, the
incidence of cancer is growing, but
after 90, it starts to dip. If we look at
death certificates of centenarians, we
discover that most centenarians die of
either heart failure or Alzheimer’s disease
and very seldom of cancer.
What is the reason? In general, our
immune system protects us against
cancer and many other diseases, but
with age, the immune system becomes
weaker. Some studies suggest that the
immune system in the very old is different.
In advanced age, instead of
8 • INBrooklyn – Section of Brooklyn Daily Eagle/ Brooklyn Eagle/Brooklyn Heights Press • May 2, 2013
progressively deteriorating, it reorganizes,
and in many centenarians,
it is actually augmenting. Centenarians
seem to be immunologic
outliers. We do not know
the precise mechanism of
this phenomenon. Do some
epigenetic switches get activated
to protect the very
old? Do very old people become
more resistant to mutations?
Most diseases are more
connect to lifestyle than to
our genes: 80% is lifestyle,
only 20% is genes. We cannot
change our genes, but they can
be switched on or off with our
lifestyle. We are no longer powerless
when facing chronic diseases
of older age. From some animal
studies, we have learned that
activating or silencing just
a few genes can significantly
extend lifespan
or protect us against
certain diseases. Recent
studies of the
human epigenome
support the direct
impact of lifestyle
on our health. Once
the National Epigenome
Project is
finished, we might
be able to significantly
extend the
human lifespan.
The way we live
matters the most.
A healthy lifestyle
can be achieved
by following a
few basic principles:nonsmoking,
good nutrition, daily exercise,
seven to eight hours of sleep, being socially
connected with friends, family
and community. Spirituality matters:
there is a biological value in prayer, no
matter what your religion. If you are a
non-believer, try meditation; it has the
same biological value as prayer. Also,
remaining active, at work or in retirement,
helps to decelerate the aging
process. Indeed, achieving old age is
like a pedaling the bicycle: if you stop
pedaling, you’ll fall. Do not forget: life
is a verb, not a noun.
What should we eat and how physically
active should we be? Nutrition
first: eat lots of vegetables, fruits and
fish (except talapia, which has too
many omega 6 fatty acids). You don’t
need to be vegetarian; you still can
eat meat but in moderation. Reduce
your salt and fat intake (potato chips,
nachos, fritos). Stay away from processed
food, such as bologna. Drink
lots of fluids, especially water, tea
(green or black), coffee, and red wine
in moderation. Do not take vitamin
supplements, especially the three vitamins
A, C and E. The only vitamin
where we have solid data that supplement
helps is vitamin D. The best vitamin
intake is in well-balanced nutrition.
Eat fruits, but don’t drink fruit
juices – oranges yes, orange juice no.
Fruit juices have about 50% more sugar
than fruits.
Avoid sugary soda drinks. All cancers
are addicted to sugar. In a recent
experiment, researchers compared
cancer cell growth in culture alone
versus culture with added sugar. Cancer
cells grew much faster in the culture
to which sugar had been added.
So, try to limit the amount of sweets
in your life.
Eat slowly. It takes twenty minutes
for the stomach to send a message
to the brain that it is full. If we eat
fast, we can consume lots of food in
those first twenty minutes before we
Ciril J. Godec, MD.
feel that we have eaten enough. Many
fast eaters, mostly men, overeat. Slow
down. Do not eat on the run.
Physical activity, like nutrition,
has numerous health benefits. It
burns calories, prevents obesity, and
reduces coronary disease, stroke,
metabolic syndrome, type 2 diabetes,
and depression. It also significantly
contributes to the prevention
of the four major cancers: colon,
prostate, breast and lung. It also reduces
arthritis and falls. On a physiological
level, it boosts LDH (the
“good cholesterol”), lowers triglicerides,
increases testosterone, and
slows down the shortening of telomeres
at the end of the chromosomes,
which are responsible for our
longevity. If exercise were a pill, everybody
should be on it.
We all would like to live a longer
lifespan, not as mentally and physically
disabled, but fully functional to
the end of our days. We should not
die after months or even years of prolonged
disabilities. In the near future,
we might be able to compress morbidity
to only a few weeks before we die.
Adding years to our lives is important,
but even more important is adding
life to our years. Extending longevity
makes sense only if we can increase
our healthy lifespan. It is no longer
true that the older we get, the sicker
we get. What is more true is that the
older we get, the healthier we have
been.
Until we get epigenetic control
for silencing or activating genes, getting
older will remain hard work. Old
age is no picnic, it is not for sissies.
The number of changes, transitions
and losses may be huge. The longer
we live, the more we lose. We have to
build resilience and be resourceful in
finding healthy ways of coping with
challenges when times get tough. We
should strive to die young but as late
as possible.