The search for the Fountain of Youth is ages old, yet as we move
into the next millennium, researchers and customers alike are increasingly
interested in gaining some control over the inevitable aging process.
As people get older, physiological changes are unavoidable. They might notice
changes in their vision, memory, or sexual function. They might see a subtle
loss of strength, their sleeping patterns may change, and digesting food may
become more difficult. Visible signs of aging include wrinkles; dry skin with
pigment deposits, and loss of elasticity and flexibility; hair loss; and posture
deterioration. Aging can also be associated with serious diseases such as
arthritis, atherosclerotic heart disease, cancer, diabetes, strokes and even
asthma. Other conditions associated with aging are degenerative eye disease and
senile dementia. [ 1 ]
It's not all bad, though. Gradual changes are inevitable, but the rate of
change is variable. Plus, the development of what are considered the
"diseases of aging" may not be as unavoidable as many people think.
In fact, with current knowledge, older customers can design a supplement
program to protect them from the age-related decline that typically occurs
among people who do not take care of themselves. The following supplements can
be added gradually to their plan as they grow older. Start them with a basic
comprehensive multivitamin and mineral with enough B complex; basic amounts of
vitamin C and E; beta-carotene; trace minerals including chromium, copper,
manganese, selenium and zinc; and, if possible, adequate magnesium and calcium,
which may need to be taken separately because of their bulk.
Start by suggesting that people older than 40 take 400–800 IU of vitamin E per
day, up to 4,000 mg/day vitamin C, 50–100 mg/day Co-Q10, and if they have
trouble sleeping, 1–3 mg melatonin at bedtime. It is also a good time to
incorporate mixed bioflavonoids (1–2 g daily), specifically quercetin for the
heart, liver and stomach [ 2-4 ] and proanthocyanidins for the brain,
kidneys, eyes and blood vessels. [ 5-8 ]
Dietary supplements protect the body from accelerated aging processes in a
variety of ways. They enhance metabolic functions that protect against several
age–related health problems. They also help detoxify harmful substances
produced in the normal course of metabolism. Most of the supplements discussed
here have some antioxidant activity, or they recycle antioxidants after they
have spent themselves quenching free radicals. (For more on the role of free
radicals in aging, see p. 562) Some of the supplements are important cofactors
for the activity of antioxidant enzymes. They are arranged in order of
importance and availability.
Vitamin E is an antioxidant that enhances immune function and protects against
cancer, heart disease, diabetic retinopathy and kidney disease. In 1990,
researchers at the Tufts University USDA Human Nutrition Research Laboratory on
Aging showed that 800 IU of vitamin E per day enhanced immune function in the
elderly. [ 9 ] In addition to enhanced cell-mediated immunity, they
found vitamin E reduced formation of lipid peroxides, which can damage cell
membranes and arterial lining cells and eventually lead to heart disease and
diminished cellular function. Vitamin E also restored the levels of
interleukins 2 and 6 to those seen in younger people, thereby restoring normal
immune function. More recent studies show immune benefit with vitamin E doses
as low as 200 IU per day.
Many studies show vitamin E protects against different cancers. A
population-based study conducted between 1984 and 1985 showed reduced oral and
esophageal cancer in those who regularly supplemented with vitamin E. [ 10
] In addition, vitamin E helps prevent the most common cause of death,
arteriosclerotic heart disease. A 1989 report said serum levels of vitamin E
are a better predictor of heart disease risk than cholesterol. [ 11 ]
People with the highest blood levels of vitamin E had the lowest risk of heart
disease.
More recently, researchers using megadoses of vitamin E have shown reversal of
diabetic retinopathy and kidney disease. [ 12 ] This was a small
eight-month trial with 36 patients. After four months, circulation to the
retinal vessels improved in patients who took 1,800 IU vitamin E per day, and
the improvement was maintained during the withdrawal period. Retinopathy and
nephropathy are but two examples of the accelerated aging process in diabetics
that can be slowed down by vitamin E supplements.
Vitamin C, another protective antioxidant, reduces the risk of age-related
diseases, including oxidative damage. One sign of this damage is abnormal
function of cells lining the arteries, called endothelium. These cells produce
nitric oxide, also known as endothelial-derived relaxing factor. In one study,
researchers gave patients with coronary artery disease 2,000 mg of vitamin C
two hours before testing how well their arteries relaxed. Compared with a
placebo group, there was a significant improvement in arterial dilation. [ 13
]
Vitamin C has numerous mechanisms of action that suggest it can help slow the
aging process. It also helps prevent cancer and heart disease. Vitamin C
enhances wound healing, improves collagen production and stimulates immunity. [
14 ] In a prospective study in Switzerland, vitamin C, independent of
other beneficial antioxidants, was associated with reduced heart disease risk.
[ 15 ] The authors of that study suggest the benefits of antioxidants
are likely to be greater when they are all available in adequate amounts
because they work together to protect against free radicals.
Carotenoids help retard the aging process as well as treat age-related
diseases. As of 1995, a total of 21 carotenoids had been identified in human
blood. [ 16 ] All of them function as antioxidants. Beta-carotene,
probably the best known carotenoid, may enhance immune function when 25,00050,000
mg is taken daily. [ 17 ] It is associated with lower risks of cancer
and heart disease. Lycopene, abundant in tomatoes but also available as a
supplement, is the most prevalent carotenoid in the serum. People with the
highest lycopene levels have the lowest rate of age-related macular
degeneration (ARMD). [ 18 ] Lycopene helps to prevent prostate cancer
and in doses of 15 mg per day may help to slow its progression. [ 19 ]
Two other carotenoids, lutein and zeaxanthin, are also related to the
prevention of ARMD. [ 20 ]
Mineral cofactors enable antioxidant enzymes, which are produced in the body
and include superoxide dismutase (SOD), catalase, and various peroxidases such
as glutathione peroxidase. In the mitochondria, SOD depends on manganese, and
in the rest of the cell SOD depends on zinc and copper. Catalase is dependent
on iron as a cofactor, but excess iron can actually lead to increased free
radical generation. Glutathione peroxidase depends on adequate selenium as well
as adequate glutathione, a sulfur-containing amino acid derived from glutamine.
A typical selenium dose is 200 mcg per day.
Zinc levels decline with age in both animals and humans. As the thymus gland
ages, it shrinks and loses its vigor in a process called involution resulting
in decreased cellular immunity. Zinc supplements prevent thymus involution and
enhance the activity of the thymic hormone thymulin. [ 21 ] In elderly
diabetic patients, zinc supplements can restore some deficits of T-cell
function and thus enhance immunity. [ 22 ] Zinc deficiencies lead to
conditions commonly associated with the aging process––immune deficiencies,
impaired wound healing and lowered resistance to infection. [ 23 ] An
adequate dose is 30 mg per day with 23 mg copper.
Coenzyme Q10 (Co-Q10) also helps protect against oxidation and age-related
diseases. It is essential for energy production in the mitochondria, especially
in the heart. It can reduce damage to the heart muscle in ischemic heart
disease. Researchers in one study found that 20 mg/kg of Co-Q10 injected into
muscle and 10 mg/kg injected into the abdominal cavity increased aerobic energy
production and protected enzymes from free radical damage. [ 24 ] In an
animal study, cell membrane damage was prevented with 10 mg/kg/day oral Co-Q10
when challenged with adriamycin, a chemotherapeutic agent that induces cell
membrane damage. [ 25 ]
In addition, Co-Q10 can prevent acetaminophen-induced liver damage through
peroxidation, adding evidence to its role in free-radical protection. [ 26 ]Typical
preventive doses of Co-Q10 would be 50100 mg daily, but if someone has signs
of age-related disease--particularly cancer, heart disease or immune
disorders--the dose may be increased to 100400 mg daily.
Herbs and flavonoids can help prevent and treat age-related conditions, though
it is impossible to thoroughly cover all of them in this review. For example,
silymarin, found in the berries of milk thistle (Silybum marianum)
protects the liver and helps control blood sugar; [ 27 ] St. John's wort
(Hypericum perforatum) treats depression, a common problem in the
elderly; [ 28 ] while hawthorn berry (Crataegus spp.), [ 29
] garlic (Allium spp.) [ 30 ] and proanthocyanidins from grape
seeds [ 7 ] protect the heart and the eyes. Saw palmetto (Serenoa
repens) and pygeum (Prurrus africana) help prostate disorders common
in men older than 50. [ 31,32 ] Ginkgo (Ginkgo biloba) preserves
memory, [ 33 ] reduces vertigo, and improves small blood vessel
circulation that helps with the functional signs of atherosclerosis. [ 34
] Memory loss is one of the most distressing signs of aging. I recommend 60 mg
of standardized ginkgo extract two or three times a day.
Melatonin and DHEA supplements may slow the aging process, as shown in animal
studies and strongly suggested by their mechanisms of action. Melatonin,
produced by the pineal gland, is a powerful antioxidant hormone that protects
the brain, particularly by scavenging the damaging hydroxyl free radical. [ 35
] Melatonin production declines with age, and it is associated with age-related
disorders. Melatonin appears valuable against Alzheimer's disease. [ 36
] It is thought to protect brain cells from the oxidative damage that may lead
to brain deterioration. Antioxidants that might protect the brain need to cross
the barrier between blood and the brain, and melatonin readily does so, where
it protects nerve receptors from oxidative damage. [ 37 ] Melatonin
enhances many parameters of immune function. [ 38 ]Typical doses of
melatonin range from 16 mg, always taken at bedtime.
Dehydroepiandrosterone (DHEA) is another hormone that declines with age.
According to several review articles, supplements appear to help many
conditions that are usually age related, including Alzheimer's disease,
diabetes, immune function decline and osteoporosis. Low levels of DHEA are also
associated with increased cardiac disease. I recommend 5100 mg daily, but
people taking more than 5 mg/day should have their blood levels monitored.
Customers with specific health problems can customize their plan: higher doses
of chromium for diabetics, garlic and Co-Q10 for heart disease, lutein and
lycopene for eye disease, and saw palmetto for prostate enlargement.
Many supplements can help prevent or treat the diseases of aging. It is always
best to combine them with a healthful diet and other supportive practices. With
the proper choices, your customers should have no trouble keeping away from
serious health problems. We know enough to empower everyone to control these
age-related conditions and be vibrant, productive and fully functional into
their golden years.
Michael Janson, M.D., is past president of both the American Preventive
Medical Association and the American College for Advancement in Medicine. He is
the author of Dr. Janson's New Vitamin Revolution (Avery, 1999) and All
About Saw Palmetto and Prostate Health (Avery, 1999).
Sidebars:
The Free Radical Theory of Aging
References:
1. Florence TM. The role of free radicals in disease. Aust N Z J Ophthalmol
1995 Feb;23(1):3-7.
2. Pace-Asciak CR, et al. The red wine phenolics trans-resveratrol and
quercetin block human platelet aggregation and eicosanoid synthesis:
implications for protection against coronary heart disease. Clin Chim Acta 1995
Mar 31;235(2):207-19.
3. Humiczewska M, et al. The effect of the pollen extracts quercitin and
cernitin on the liver, lungs and stomach of rats intoxicated with ammonium
fluoride. Folia Biol (Krakow) 1994;42(3-4):157-66.
4. Alarcon de la Lastra C, et al. Antiulcer and gastroprotective effects of
quercetin: a gross and histologic study. Pharmacology 1994;48:56-62
5. Cahn J, Borzeix MG. Administration of procyanidolic oligomers in rats.
Observed effects on changes in the cerebral biochemistry, secondary to multiple
infarction. Sem Hop 1983 Jul 7;59(27-28):2035-8.
6. Melcion C, et al. Protective effect of procyanidolic oligomers on the
heterologous phase of glomerulonephritis induced by anti-glomerular basement
membrane antibodies. C R Seances Acad Sci III 1982 Dec 6;295(12):721-6.
7. Corbe C, et al. Light vision and chorioretinal circulation. Study of the
effect of procyanidolic oligomers (Endotelon). J Fr Ophtalmol
1988;11(5):453-60.
8. Michiels C, et al. A comparative study of the protective effect of various
phlebotonic agents on hypoxic endothelial cells. Phlebologie 1991
Apr-Jun;44(2):509-16.
9. Meydani SN, et al. Vitamin E supplementation enhances cell-mediated immunity
in healthy elderly subjects. Am J Clin Nutr 1990;52:557.
10. Gridley G, et al. Vitamin supplement use and reduced risk of oral and
esophageal cancer. Am J Epidemiol 1992; 135:1083.
11. Gey KF. Inverse correlation of vitamin E and ischemic heart disease. Int J
Vitam Nutr Res Suppl 1989;30:224-31.
12. King GL, et al. Diabetes Care 1999;22:1245-51.
Author: by Michael Janson, M.D.
