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  • Specific Anti-Aging Factorsfor Naturai Clinicians

    Concepts of AgingIt is impossible to define the onset of

    "old age," which is the result of manyphysiological and sociobehavioralchanges.'"' While many seek the"fountain of youth," no one has foundit. Aging is a complex process that canbe modified only by multiprongedinterventions.'' Positive lifestyle ispivotal in the promotion of health andwell-being. While one can extol thevirtues and benefits of good lifestylefor health maintenance and longevity,the investment in "behavior changetoday for health tomorrow" is a difficult

    by Stephen Holt, MDpathway of intervention. Mental andphysical idleness result in loss of vitality.An important promoter of aging is lackof mind or body activity, resulting in the"disuse syndrome," with its hallmark ofpremature aging.'-^

    Many theories of aging have beenproposed, but no single explanationsuffices (Table 1). Despite uncertaintyabout aging theories, modern anti-aging research has identified several keydisorders orprocessesthatpromote tissueaging. These processes include immuneimpairment, sleep deprivation, obesity,adverse lifestyle, genetic programming.

    Table 1. Theories and Hypotheses of Aging with Comments about AgePromoters and Putative Age Eradicators^"

    HYPOTHESES OF AGING COMMENTS

    Free Radical Theories Free radicals cause oxidative damage.Antioxidants of many types are valuable.

    Cross-Link Theories Cross linking of sugars or aldehydes andproteins cause major alterations in bodystructure and function; concept of AGEs.

    Immunologie Theories Autoimmunity increases with age. Thethymus shrinks, and white cell function orantibody production is often compromised.

    Mutation and Error Theories Mistakes in DNA replication or RNA functionresult in aging or age related disease, e.g.,cancer.

    In-Built Programs of Tissue Aging A program exists in genetic materialtocontrol a number of cell functions.

    Stress Theories Stress is cumulative, and lifestyle-related,nutritional deficiencies enhance body stress.Adaptogenic herbs may be of benefit.

    Repair Budget Theories Environmental and lifestyle issues alter theinvestment of an organism in tissue repair.

    Miscellaneous Obesity, metabolic syndrome X, anddiabetes mellitus are disorders of prematureaging, sleep deprivation, and restorationof biorhythms are important. Need forcorrection of hormonal deficiencies orderegulation. Altered biochemical functions,e.g., poor methylation. Combat chronicinflammation. Lifestyle change pivotal.

    poor nutrition, hormonal deficiencies orderegulation, inflammation, oxidativestress to tissues, deficient methylation,and the formation of glycated proteins(Advanced Glycation End Products, orACEs).'-

    A wide range of natural substanceshad been identified that can providefavorable nutritional or chemicaleffects on several of these commondisorders or processes that acceleratetissue aging.''*'"'^ Modern researchhas identified many natural substanceswith anti-aging properties, but simpleinterventions or single supplements(or drugs) cannot address efficientlythe multifactorial aspects of tissue3gjng.ia,9-i2 j he intricate, biochemicalcascades of events involved in agingrequire a synergistic approach to theformulation of anti-aging substances,specifically dietary supplements.

    The objective of this articleis to review and focus on anti-aging interventions using dietarysupplements to induce youth-preservingimprovements in body functionsand structures. This compilation ofinformation will permit the naturalclinician to adopt a synergistic approachto the correction or retardation of tissueaging using evidence-based, dietary-supplement strategies.

    Dietary SelectionsThe optimal "anti-aging diet" should

    be reduced in simple sugars andsaturated fat, while being supplementedwith omega-3 essential fatty acids(EFA).*'^'* The diet should containmodest amounts of protein of mixedorigin (vegetable, meat, dairy, and fishorigin), high in fiber and dense in vitalnutrients, such as vitamins, minerals,and phytochemicals. Perhaps the mostimportant dietary adjustments involvethe reduction of useless, dietary calories(e.g., simple sugars, saturated fat.

    90 TOWNSEND LETTER - JULY 2008

  • or alcobol)^ and a restoration of thebalance of omega-3 EFA to omega-6EFA intake,"''' The widespread,relative deficiency of omega-3 EFA andimhalance of oniega-6:omega-3 dietaryintake ratios have been implicated inproinflammatory states, increased risksof cancer or cardiovascular disease risk,and tbe general promotion of chronicdisease.'"'^

    Omega-3 EFA supplementation isa pivotal step in anti-aging, nutrientsupplementation, but many fish oilsupplements are obsolete. The amountsof active omega-3 EFA (eicosapentanoicacid (EPA] and docosahexanoic acid[DHAD required to achieve diseaseprevention or therapeutic benefit aremuch higher than hitherto supposed,and such amounts cannot beadministered efficiently in regular fishoil liquids or capsules.'^ " The optimumway to supplement omega-3 EFA is inwell-tolerated, absorption-enhanced,pure, concentrated forms that are bestpresented in delayed-release, targeted,enteric-coated, capsule-delivery sys-tems.'^ While omega-3 EFA appear tobe of great importance in supplements,the health benefits of omega-9 EFA isapparent in Mediterranean diets that areoften enriched with olive oi l . ' '

    There are many accounts of therole of mineral enrichment in the dietof certain ethnic groups that enjoylongevity." Enhanced mineral intakehas been proposed as one explanationfor the longevity of individuals inOkinawa, Japan and people who live inmountain regions of Pakistan (Hunzas).These observations form the basis of theputative benefit of holistic concoctionsof minerals, trace mineral supplements,coral calcium, and cell salt therapies."While good mineral intake may beimportant, other dietary or lifestylefactors combine to play a role in thepromotion of an extended, healthylifespan."

    Oxidative Tissue DamageTissue aging, due to free radical

    damage, is widely accepted as atenable theory of aging.'^'^ Reactiveoxygen species are formed duringnormal body metabolism and especiallyduring exercise. Many environmentaltoxins have pro-oxidant effects ontissues. The body has efficient waysof defending against the propensity

    to cause tissue damage. Endogenousantioxidants can "mop up' free radicals.These antioxidants include Superoxidedismutase (SOD), glutathione, catatase,selenium, and vitamins A, C, and E... toname a few.'^^"

    Multifunctional, natural antioxidantsare ubiquitous in fruit, vegetables,and berries." To provide adequateantioxidant coverage, many physiciansare using vitamin supplements (e.g.,A, B complex, C, D, and E) combinedin complex mixtures of berries,greens, and vegetable powders. Theseblended powders contain a vast arrayof antioxidant phytochemicals andmicronutrients. This complex approachhas started to replace the use ofmuttivitamin supplements in the modernpractice of Integrative Medicine. Thekey to antioxidant supplementation isto attempt to cover all body tissues withan antioxidant blanket of compoundsthat access many tissues (lipophilic

    and hydrophilic antioxidants). Thisapproach should use antioxidants withdifferent REDOX potentials, in order tomaximize oxygen radical absorbancecapacity (ORAC).''

    Cell membranes are particularlyvulnerable to free radical damage.^^This circumstance demands the use oflipophilic antioxidants such as turmeric,vitamin E (tocopherols), or essentialfatty acids of the omega 3 series(indirect antioxidants). Particularlyvaluable common antioxidants includepycnogenol, luteir\ lycopene, ellagicacid, alpha lipoic acid, co-enzymeQIO, green tea or coffee polyphenols,bioflavanoids, and isoflavones.

    Co-enzyme QIO (ubiquinone)is a powerful antioxidant withwell-documented benefits in themanagement of cardiovascular disease(angina, congestive cardiac failure,hypercholesterolemia, etc.).^^ This

    Table 2: Botanical Agents That Have Adaptogenic orBiological Response Modifying Effects

    These natural substances can be combined in synergistic formulations toconstitute a baseline, natural anti-aging approach."

    ADAPTOGEN

    Ginseng (Panax, Eleutherococcus).

    Ashwagandha {)Mthania somnifera).

    Dandelion {Taraxacum offcinale).

    ACTIONS

    ...Panax (Chinese/Korean), Eleutherococcus(Siberian), Panax quinqufolius (American)have variable antioxidant, brain-supporting,cholesterol-lowering, and estrogenicactions.

    ...Ashwagandha contains alkaloidsand antioxidants that may have anti-inflammatory, cognitive-enhancing,anxiolytic, and aphrodisiac qualities.

    ...Dandelion extract has diuretic, liver-supporting, anti-cancer, antioxidant, bloodglucose-balancing, and antithromboticproperties. It may inhibit ILG and TNFalpha (anti-inflammatory).

    Ganoderma {lucidum, Reishi) Ling Zhi (Reishi) mushrooms haveanticancer, antiangiogenic, DNA-protective, anti-inflammatory effects.

    Schisandra {chinensis) Schisandra has anti-stress, anti-inflammatory, energizing, immune-stimulating, and hormone-balancingactions.

    Rhodiola {rosea) Rhodiola has anti-stress, memory-boosting, and antidepressant actions

    Bacopia (monnieri) Bacopia has anti-stress, brain-supporting.and rejuvenating properties.

    Resveratrol (skin of red grapes) Many benefits with adaptogenic effects onapoptosis.

    TOWNSEND LETTER - JULY 2008 91

  • Anti-Aging Factors

    antioxidant may play a role in themanagement or prevention of maculardegeneration, prostate or breast cancer,cognitive decline, Parkinson's disease,skin aging, muscle weakness, andchronic fatigue syndromes." Idebenoneis a modified form of CoQlO that mayhave a greater antioxidant action thanCoQIO.

    Tissue GlycationGlycation or glycosylation results

    from the undesirable combination ofaldehydes,