Tag Archives: Chronic Disease

Post #51 – How to optimize your immune system? – Part I

10 Sunday Apr 2016

Posted by in Nutrition, Optimal Exercise, Optimal Health, Optimal Nutrition, Uncategorized, Vitality, wellness

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The term immune system is talked about a lot these days in various contexts. On one end of the spectrum people talk about “building” one’s immune system to ward off or overcome diseases. On the other hand, you may have heard conversation about where the disease itself is the result of some “immune disorder”.

Many years ago, when I used to visit my primary physician to deal with my seasonal allergies (which I was able to successfully cure, as I described in another blog post), I would often ask him, what was underlying cause of my allergies and he would say, “It is something to do with immune system.  We don’t understand much about immune system yet.”

Later after doing my own research, I figured out that actually we do know a lot about the immune system and there is a lot we can do about it too. And, that knowledge gave me the impetus to take actions to cure my seasonal allergies. See my post So, did I tell you the story about my allergies?

In this post, I would like to delve into what exactly is immune system and what we can do so it is really a friend and not our foe.

What is Immune System?

Here is a quick summary of some key terms from National Institute of Allergy and Infectious Diseases (NIAID) at NIH website.

The immune system is a network of cells, tissues, and organs that work together to protect the body from infection. The overall function of the immune system is to prevent or limit infection.

Immune system is comprised of multiple organs, cells and response types that include:

Immune System

Skin: The skin is usually the first line of defense against microbes. Skin cells produce and secrete important antimicrobial proteins, and immune cells can be found in specific layers of skin.

Bone marrow: The bone marrow contains stems cells that can develop into a variety of cell types. The stem cells in the bone marrow create two types of immune cells: innate immune cells and adaptive immune cells.

Innate immune cells —neutrophils, eosinophils, basophils, mast cells, monocytes, dendritic cells, and macrophages— are important first-line responders to infection.

Adaptive immune cells—B cells and T cells—that are responsible for mounting responses to specific microbes based on previous encounters since they retain immunological memory.

Natural killer (NK) cells share features of both innate and adaptive immune cells, as they provide immediate defenses like innate cells but also may be retained as memory cells like adaptive cells.

Lymphocytes – B, T, and NK cells also are called lymphocytes.

Bloodstream: Immune cells constantly circulate throughout the bloodstream, patrolling for problems. When blood tests are used to monitor white blood cells, another term for immune cells, a snapshot of the immune system is taken. If a cell type is either scarce or overabundant in the bloodstream, this may reflect a problem.

Thymus: T cells mature in the thymus, a small organ located in the upper chest.

Lymphatic system: The lymphatic system is a network of vessels and tissues composed of lymph, an extracellular fluid, and lymphoid organs, such as lymph nodes. The lymphatic system is a conduit for travel and communication between tissues and the bloodstream. Immune cells are carried through the lymphatic system and converge in lymph nodes, which are found throughout the body.

Lymph nodes are a communication hub where immune cells sample information brought in from the body. For instance, if adaptive immune cells in the lymph node recognize pieces of a microbe brought in from a distant area, they will activate, replicate, and leave the lymph node to circulate and address the pathogen. Thus, doctors may check patients for swollen lymph nodes, which may indicate an active immune response.

Spleen: The spleen is an organ located behind the stomach. Spleen is important for processing information from the bloodstream. Immune cells are enriched in specific areas of the spleen, and upon recognizing blood-borne pathogens, they will activate and respond accordingly.

Mucosal tissue: Mucosal surfaces are prime entry points for pathogens, and specialized immune hubs are strategically located in mucosal tissues like the respiratory tract and gut.

How does immune systems defenses work?

An immune response is generally divided into innate and adaptive immunity.

Immune Types of Response

Innate immunity occurs immediately, when circulating innate cells recognize a problem by expressing genetically coded receptors. Collectively, these receptors can broadly recognize viruses, bacteria, fungi, and even non-infectious problems. However, they cannot distinguish between specific strains of bacteria or viruses. Their key feature is quick and broad.

Adaptive immunity occurs later, as it relies on the coordination and expansion of specific adaptive immune cells. If a B or T cell has a receptor that recognizes an antigen from a pathogen and also receives cues from innate cells that something is wrong, the B or T cell will activate, divide, and disperse to address the problem. B cells make antibodies, which neutralize pathogens, rendering them harmless. T cells carry out multiple functions, including killing infected cells and activating or recruiting other immune cells.

Vaccination, or immunization, is a way to train your immune system against a specific pathogen. Vaccination achieves immune memory without an actual infection, so the body is prepared when the virus or bacterium enters. Saving time is important to prevent a pathogen from establishing itself and infecting more cells in the body.

When immune system is not working as intended?

When the immune system is working well through all the parts and pieces we discussed above, it is a thing of beauty. As a pathogen enters the body, body’s defenses are activated through the appropriate part of the immune system.  The pathogen is recognized and immediately zapped.

When immune system is not working properly there could be different types of issues.

Immune Deficiencies

Temporary Immune Deficiencies: Temporary immune deficiency can be caused by a variety of sources that weaken the immune system. Common infections, including influenza and mononucleosis, can suppress the immune system.

When immune cells are the target of infection, severe immune suppression can occur. For example, HIV specifically infects T cells, and their elimination allows for secondary infections by other pathogens.

Patients receiving chemotherapy, bone marrow transplants, or immunosuppressive drugs experience weakened immune systems until immune cell levels are restored. Pregnancy also suppresses the maternal immune system, increasing susceptibility to infections by common microbes.

Allergy

Allergies are a form of hypersensitivity reaction, typically in response to harmless environmental allergens like pollen or food. Hypersensitivity reactions can be caused by antibodies, IgE or IgG, which are produced by B cells in response to an allergen. Overproduction of these antibodies activates immune cells like basophils and mast cells, which respond by releasing inflammatory chemicals like histamine. And that is why people take antihistamine to stop allergic reactions such as sneezing.

Allergic reactions can also be caused by T cells, which may either directly cause damage themselves or activate macrophages and eosinophils that damage host cells.

Autoimmune Diseases

Autoimmune diseases occur when adaptive immune cells that recognize host cells persist unchecked. Autoimmunity is either organ-specific or systemic, meaning it affects the whole body. Autoimmune diseases have a strong genetic component, and with advances in gene sequencing tools, researchers have a better understanding of what may contribute to specific diseases.

Cancer

Some forms of cancer are directly caused by the uncontrolled growth of immune cells. Leukemia is cancer caused by white blood cells. Lymphoma is cancer caused by lymphocytes, i.e., adaptive B or T cells. Myeloma is cancer caused by plasma cells, i.e.,  mature B cells. Unrestricted growth of any of these cell types causes cancer.

In addition, an emerging concept is that cancer progression may partially result from the ability of cancer cells to avoid immune detection.

So, what can we do optimize our immune system?

Things that are in our controls to enhance our immunity and make sure that the immune system does not go haywire are the ones that you have heard about gazillions of time by now and are probably tired of hearing about: Nutrition, Exercise and Lifestyle.

In the next post, we will talk of specifics of nutrition, exercise and lifestyle that can enhance immune system and also prevent it from attacking itself or the body.

In the meantime, what are your thoughts on this subject?

Would love to hear from you and learn from you.

Please click on Comment to leave your comments or question so others can benefit from your input.

 

 

Post #33 – What can you do to maintain optimal health of your brain? Or, How my sons got me playing video games?

18 Sunday Jan 2015

Posted by in Aging, Living to 120, Mental Health, Optimal Health, Vitality

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In most of my past blogs, I have talked about maintaining optimal physical health – staying physically fit, keeping all chronic diseases such as diabetes, arthritis, high blood pressure, cardiovascular issues and such at bay. Also, I have talked about developing, building and maintaining lean mass, strength, balance and flexibility.

But, what about the brain? How to keep brain in top shape as we age, while keeping Alzheimer disease and dementia far away from ourselves? What is in our control that we can do?

After all, living to 120 (or to whatever your target is), without full cognitive faculties won’t be much fun.

Researching this topic, I found that National Institute of Health (NIH), National Institute of Aging, has a very good chapter “The Changing Brain in Healthy Aging” in their publication “Alzheimer’s Disease: Unraveling the Mystery”. The following is excerpt from that chapter.

As a person gets older, changes occur in all parts of the body, including the brain:

  • Certain parts of the brain shrink, especially, the prefrontal cortex (an area at the front of the frontal lobe) and the hippocampus. Both areas are important to learning, memory, planning, and other complex mental activities.
  • ­Changes in neurons and neurotransmitters affect communication between neurons. In certain brain regions, communication between neurons can be reduced because white matter (myelin covered axons) is degraded or lost.
  • ­Changes in the brain’s blood vessels occur. Blood flow can be reduced because arteries narrow and less growth of new capillaries occurs.
  • ­In some people, structures called plaques and tangles develop outside of and inside neurons, respectively, although in much smaller amounts than in Alzheimer Disease
  • ­Damage by free radicals increases – free radicals are a kind of molecule that reacts easily with other molecules­
  • Inflammation increases  – inflammation is the complex process that occurs when the body responds to an injury, disease, or abnormal situation.

What effects does aging have on mental function in healthy older people?

Some people may notice a modest decline in their ability to learn new things and retrieve information, such as remembering names. ­They may perform worse on complex tasks of attention, learning, and memory than would a younger person.

However, if given enough time to perform the task, the scores of healthy people in their 70s and 80s are often similar to those of young adults. In fact, as they age, adults often improve in other cognitive areas, such as vocabulary and other forms of verbal knowledge.

It also appears that additional brain regions can be activated in older adults during cognitive tasks, such as taking a memory test. Researchers do not fully understand why this happens, but one idea is that the brain engages mechanisms to compensate for difficulties that certain regions may be having.

For example, the brain may recruit alternate brain networks in order to perform a task. Th­ese findings have led many scientists to believe that major declines in mental abilities are not inevitable as people age. Growing evidence of the adaptive (what scientists call “plastic”) capabilities of the older brain provide hope that people may be able to do things to sustain good brain function as they age. A variety of interacting factors, such as lifestyle, overall health, environment, and genetics also may play a role.

Another question that scientists are asking is why some people remain cognitively healthy as they get older while others develop cognitive impairment or dementia. Th­e concept of “cognitive reserve” may provide some insights.

Cognitive reserve refers to the brain’s ability to operate effectively even when some function is disrupted. It also refers to the amount of damage that the brain can sustain before changes in cognition are evident. People vary in the cognitive reserve they have, and this variability may be because of differences in genetics, education, occupation, lifestyle, leisure activities, or other life experiences.

Th­ese factors could provide a certain amount of tolerance and ability to adapt to change and damage that occurs during aging. At some point, depending on a person’s cognitive reserve and unique mix of genetics, environment, and life experiences, the balance may tip in favor of a disease process that will ultimately lead to dementia.

For another person, with a different reserve and a different mix of genetics, environment, and life experiences, the balance may result in no apparent decline in cognitive function with age.

Scientists are increasingly interested in the influence of all these factors on brain health, and studies are revealing some clues about actions people can take that may help preserve healthy brain aging. Fortunately, these actions also benefit a person’s overall health. Th­ey include:

  1. ­Controlling risk factors for chronic disease, such as heart disease and diabetes (for example, keeping blood cholesterol and blood pressure at healthy levels and maintaining a healthy weight) ­
  2. Enjoying regular exercise and physical activity ­
  3. Eating a healthy diet that includes plenty of vegetables and fruits
  4. ­Engaging in intellectually stimulating activities, and
  5. Maintaining close social ties with family, friends, and community

So, actions 1, 2 and 3 suggested by NIH NIA are the same as for keeping physical body fit and in good order. That is a good news!

But there are also additional actions 4 and 5 one can take, that are good to keep brain fit and in good order.

Piano Lessons at 60:

To increase my intellectually stimulating activities, as I was turning 60, I decided to start taking piano lessons. I have been very left brain focused on my intellectual pursuits – STEM or Science Technology, Engineering and Math education. So, I figured, it is high time I did something to develop my underused right brain. And, there is a lot of evidence in research of the benefits of learning music on the brain.

For the last six months, I have been finding piano lessons very pleasurable and at the same time very intellectually and physically demanding. One half-hour lesson a week and daily practice of half hour to an hour, is what it takes for me learn and get comfortable with a piano piece my teacher introduces in the lesson. Initially it was just one piece from the “techniques book”, for the last few weeks, there is an additional piece from a popular “songs book”. All this piano playing got be doing something good for my brain, since week after week, it seems that I am learning with my brain and in my muscles new stuff.

How my sons got me playing video games:

Until now, I have completely resisted playing video games.

For Christmas, our twin sons, Daniel and Justin, gave us a present of family membership to Lumosity. Lumosity exploits research to-date in neuroplasticity. Research has found that certain types of activities may impact the brain more than others. It’s believed that as an activity is repeated, the brain tends to fall back on the same set of existing neural pathways. To continue changing, the brain must be exposed to novel, adaptive experiences that challenge it to work in new ways.

Drawing on this idea, Lumosity is designed to give each person a set of exercises that challenge their cognitive abilities.

Lumosity “games” are based on a combination of common neuropsychological and cognitive tasks, many of which have been used in research for decades, and new tasks designed by an in-house science team. Working with experienced game designers, Lumosity neuroscientists have transformed these tasks into over 40 challenging, adaptive games.

Lumosity’s game-based training program is designed to expose your brain to gradually increasing levels of challenges, adapting game difficulty to your individual ability level. As your scores increase, you may encounter new or more difficult games. Modeled from the concept of a physical personal trainer, Lumosity pushes you to operate at the limits of your abilities and stay challenged.

They also report measures of your performance, so you can see how you are improving in speed, memory, attention, flexibility and problem solving and how you compare with others in your age bracket. A metric called LPI is a consolidated metric of these five factors. Also, you can use a test called Baseline Test to see how the scores translate to other situations you don’t play in the games.

I have been playing these games for two weeks now. It is definitely fascinating, how various skills of speed, memory, attention, flexibility and problem solving improving. With this rate of progress, who knows, I may get good enough to play some video games against Justin and Daniel!

What are your thoughts on this subject of keeping brain fit and in optimal shape?

What strategies or techniques do you use to keep you brain fit?

Please leave a comment in the blog; I would love to hear from you.

Post #29 – Eating for Optimal Health Part VIII – Add or subtract specific foods based on your personal needs

29 Saturday Nov 2014

Posted by in Aging, Living to 120, Nutrition, Optimal Health, wellness

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In blog post of 9/29/2014: So, what should you eat for optimal health?, I listed the seven basic principles I have extracted from the many diet books and resources I have studied. These principles are:

  1. What you eat, how much you eat and when you eat, all matter
  2. Eat clean
  3. Eat lots of vegetables and fruits
  4. Use only healthy fats and fat sources
  5. Incorporate sufficient proteins in your diet
  6. Best beverage to drink is pure water
  7. Add or subtract specific foods based on your personal needs

In the last posts, we discussed the first six of these principles. Today, in the last blog post of this series, let’s focus on the seventh principle: Add or subtract specific foods based on your personal needs. And, as usual without any fluff stuff, let’s get to it.

Even though we humans all are of the same species, our bodies are quite unique due to genetic and environmental differences that we grew up in. Because of this uniqueness, it is not unreasonable to have unique needs for what we eat to adapt to our bodies.

Western medicine and nutrition framework can recognize these differences only in terms of different caloric needs based on size, food allergies, intolerance and sensitivities.

However, eastern medicine and nutrition frameworks, offer other ways of matching specific foods to specific unique needs of our bodies.

Let’s explore both of these frameworks that we can use to customize what we eat.

Food Allergies, Intolerance and Sensitivities

As Mayo Clinic page on Food Allergy describes: A true food allergy causes an immune system reaction that affects numerous organs in the body. It can cause a range of symptoms. In some cases, an allergic reaction to a food can be severe or life-threatening (anaphylaxis) — even if past reactions have been mild.

If you have any food allergies, it is important to learn how to recognize a severe allergic reaction and know what to do if one occurs. You may need to carry an emergency epinephrine shot (EpiPen, Auvi-Q, others) for emergency self-treatment.

In contrast, food intolerance symptoms are generally less serious and often limited to digestive problems. But these can also be the cause of chronic issues including excess weight, obesity, leaky gut and many other related issues.

Causes of food intolerance include:

  • Absence of an enzyme needed to fully digest a food. Lactose intolerance is a common example.
  • Irritable bowel syndrome. This chronic condition can cause cramping, constipation and diarrhea.
  • Food poisoning. Toxins such as bacteria in spoiled food can cause severe digestive symptoms.
  • Sensitivity to food additives. For example, sulfites used to preserve dried fruit, canned goods and wine can trigger asthma attacks in sensitive people. Mono sodium glutamate (MSG) often used in Chinese cooking can cause digestive issues.
  • Recurring stress or psychological factors. Sometimes the mere thought of a food may make you sick. The reason is not fully understood.
  • Celiac disease. Celiac disease has some features of a true food allergy because it involves the immune system. However, symptoms are mostly gastrointestinal, and people with celiac disease are not at risk of anaphylaxis. This chronic digestive condition is triggered by eating gluten, a protein found in wheat and other grains.

With the recent research in micro biome or gut bacteria, there is mounting evidence that many of the food sensitivities and even food allergies can be cured by improving the gut bacteria.

So, it is important to understand personal food allergies, intolerances and sensitivities. And, then find workarounds or solutions to those.

Here is one quick anecdote on this topic.

Several years ago, often around menstruation time, my wife Kimberly used to have abdominal pains, sometimes quite severe and debilitating. So, we started chasing the issue. Doctors did various tests to diagnose it, but no luck. She even subjected herself to a painful colonoscopy. Radiologist pointed out inflammation at the place where her colon turns. But he could not argue why that would cause issues she had been experiencing. They even started using the “C” word for some stomach cancer, which kind of freaked her out emotionally.

During this time, I started keeping a sort of diary of her lifestyle. I noticed that every time her sister or mother visited us, for the period that followed she would have severe pains. I thought that was rather curious.

You see, ever since, I became vegetarian, she did not eat much meat. We did not cook much meat at home. And, even when we ate out, she generally preferred to share what I would eat, which would be vegetarian fair. But every time her sister or mother would visit, they will have several meals out at the restaurants and she would indulge in lots of meats, especially red meats.

Once I figured this out, I asked her to experiment with keeping meat to minimum and absolutely no red meat for a few months – which she did faithfully. And, lo and behold, her pains went away. She experimented with adding the red meat back, with the result of pains also being back. Having learned that lesson, she has now stuck to the lifestyle of mostly no red meat and pains have been gone.

Eastern medicine and nutrition frameworks

Eastern medicine and nutrition frameworks provide different methods (and some would argue, much more precise methods) of matching foods to a person’s specific needs.

I am most familiar with the Indian Ayuervedic system so I will briefly share that here.

According to Ayurveda, there are three primary body types: Vata, Pitta and Kapha.  These body types are also called Doshas.

We are born with either one of these three, or some combination of these, i.e., Vata-Pitta, Vata-Kapha, Pitta-Kapha or Vata-Pitta-Kapha types.

The primary body types are made up of a combination of five basic elements of nature: Earth, Water, Fire, Wind, and Space.

Earth + Water = Kapha

Fire + Water = Pitta

Wind + Space = Vata

By looking at the nature of the constituent elements, you can probably quickly guess the properties associated with each Dosha or body type.

Kapha person would thus be very “earthy”, heavier musculature, gains weight quickly, has moist or oily skin, likes to stays settled in a place, is slow and steady, is often cold and smooth.

Pitta person would be hot, intense, light, flexible, slightly oily, fluid, sour smelling.

Vata person will have dry skin, be on the move all the time, is often cold, rough adept to change, subtle quick and light.

The theory is that we all have an inherent body type that corresponds to our inborn nature. Eating foods and living lifestyle that take us away from our inherent Doshas cause stresses on our bodies and in turn cause issues. Progressed to advanced stages, these perturbations in the body become clinical symptoms that are discovered as ailments in the context of western medicine.

Foods on the other hand, in Ayurveda, are categorized as sweet, sour, salty, stringent, bitter and pungent. Based on the nature of food, it could either aggravate or pacify a particular body type or Dosha.

Kapha is

  • Balanced by pungent, bitter, astringent, light, dry and hot foods
  • Aggravated by sweet, sour and salty foods, heavy, oily and cold

Pitta is

  • Balanced by bitter, sweet, astringent, cold, heavy and dry foods
  • Aggravated by pungent, sour, salty, hot, light and oily foods

Vata is

  • Balanced by salt, sour, sweet, heavy, oily and hot foods
  • Aggravated by pungent, bitter, astringent, cold, dry, light foods

An Ayuervedic practitioner’s goal is to uncover any differences between inherent body type and the present body type and to recommend foods and lifestyle that will bring the body to the back the inherent body type.

As the body realigns with its inherent Doshas, different types of issues and ailments just recede and disappear.

This,  of course, is a pretty deep topic by itself.

“Perfect Health – A complete mind body guide”, a book by Deepak Chopra, M.D., is a very accessible book that explains these Ayuervedic principles and practices. Based on the Ayuervedic theory, the book offers very practical means for matching foods to one’s specific needs and/or make adjustments if you feel any “stresses” in your body.

What do you think of this approach?

Do you feel that this provides guidance on how to adjust your diet to match your personal needs?

Do you see a hole in this approach? What would you do differently?

Post #28 – Eating for Optimal Health Part VII – Best beverage to drink is pure water

16 Sunday Nov 2014

Posted by in Ideal Body Weight, Lean Mass, Life-Span, Living to 120, meditation, Nutrition, Optimal Health, Optimal Nutrition, Reversing Chronic Diseases, Vitality

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In blog post of 9/29/2014: So, what should you eat for optimal health?, I listed the seven basic principles I have extracted from the many diet books and resources I have studied. These principles are:

  1. What you eat, how much you eat and when you eat, all matter
  2. Eat clean
  3. Eat lots of vegetables and fruits
  4. Use only healthy fats and fat sources
  5. Incorporate sufficient proteins in your diet
  6. Best beverage to drink is pure water
  7. Add or subtract specific foods based on your personal needs

In the last posts, we discussed the first five of these principles. Today, let’s focus on the fifth principle: Best beverage to drink is pure water. And, as usual without any fluff stuff, let’s get to it.

I am sure by now you have heard over and over again, “Keep yourself hydrated.” Or “Drink plenty of water”. But why do we need to keep hydrated?

Water is the solvent for biochemical reactions and has unique physical properties (e.g., high specific heat) to absorb metabolic heat within the body.

Water is also essential for maintaining vascular volume and serves as the medium for transport within the body by supplying nutrients and removing waste. In addition, cell hydration has been has been suggested to be an important signal to regulate cell metabolism and gene expression.

Water is the largest component of human bodies. About 70% of our body weight is water. To maintain homeostasis, i.e., equilibrium in our biology, we need to replenish the daily water loss. Water loss comes from breathing out, sweating, urination and excretion.

You may have noticed feeling sluggish if you are dehydrated. In fact dehydration can bring on a variety of symptoms:

Mild to moderate dehydration is likely to cause:

  • Dry, sticky mouth
  • Sleepiness or tiredness — children are likely to be less active than usual
  • Thirst
  • Decreased urine output
  • No wet diapers for three hours for infants
  • Few or no tears when crying
  • Dry skin
  • Headache
  • Constipation
  • Dizziness or lightheadedness

Severe dehydration, a medical emergency, can cause:

  • Extreme thirst
  • Extreme fussiness or sleepiness in infants and children; irritability and confusion in adults
  • Very dry mouth, skin and mucous membranes
  • Little or no urination — any urine that is produced will be darker than normal
  • Sunken eyes
  • Shriveled and dry skin that lacks elasticity and doesn’t “bounce back” when pinched into a fold
  • In infants, sunken fontanels — the soft spots on the top of a baby’s head
  • Low blood pressure
  • Rapid heartbeat
  • Rapid breathing
  • No tears when crying
  • Fever
  • In the most serious cases, delirium or unconsciousness

Many diseases are linked to dehydration. These include kidney stones, gall stones, bladder, colon and other cancers, arrhythmias, blood clots, Mitral Valve Prolapse, and Osteoporosis.

How much water do we need?

So, given that we need to keep body hydrated, that is, replace the H2O we lose daily with equivalent amount of H2O, how much water do we need everyday?

Institute of Medicine of the National Academies report on Dietary Reference Intake for Water, Potassium, Sodium, Chloride and Sulfate recommends the following DAILY Recommended intakes for water for different age groups:

For Children

1–3 years         1.3 L total; 0.9 L (4 cups) as beverages

4–8 years         1.7 L total; 1.2 L (5 cups) as beverages

For Males

9–13 years       2.4 L total; 1.8 L (8 cups) as beverages

14–18 years     3.3 L total; 2.6 L (11 cups) as beverages

Over 19 years   3.7 L total; 3.0 L (13 cups) as beverages

 For Females

9–13 years       2.1 L/day of total water; 1.6 L (7 cups)

14–18 years     2.3 L/day of total water; 1.8 L (8 cups)

Over 19 years   2.7 L total; 2.2 L (9 cups) as beverages

Pregnant and Lactating women are exception and will need even more for each respective age group.

Can you drink too much water?

In very unusual circumstances, excess consumption of water and low sodium intake may lead to excess body water, resulting in hyponatremia and cellular edema. This condition comes from body getting too low in sodium rather than too much water.

What are the sources for water?

So, given that we need to keep body hydrated, that is replace the H2O we lose daily with equivalent amount of H2O, where do we get it from and where should we get it from?

Well first of all we do get a little bit of it when the body oxidizes hydrogen-containing substances during metabolism or energy production cycle. This water, called Metabolic Water is generally enough to offset the water we breathe out as vapors.

Rest of the water comes from what we consume, i.e., the stuff that crosses our lips. Of course, if you are taking nutrients intravenously (as saline solution or glucose solution in a hospital) that also counts.

All foods, especially, fruits and vegetables contain water. Beverages Coffees, tea, ice tea, milk, sodas, juices, beer all contain water. Institute of Medicine of the National Academies report on Dietary Reference Intake for Water, Potassium, Sodium, Chloride and Sulfate has the following table on daily water intake from a 2,200 calories daily diet. (Please click on the graphic below if it is not readable)

Table

NOTE: This diet meets the Adequate Intake or the Recommended Dietary Allowance for adult men and women for all nutrients for which one has been established (for fiber, it meets the ratio of 14 g/1,000 kcal) and provides energy nutrients within the acceptable macronutrient distribution ranges. Nutrient totals may not equal the sum of the parts, due to rounding. Vegetables prepared without salt.

Food composition data: U.S. Department of Agriculture, Agricultural Research Service, Nutrient Database for Standard Reference, Release 16.

DATA SOURCE: ENVIRON International

So, what is the optimal source of hydration?

When I came to the US, 37 years ago, I somehow created associations that beer is the only drink that really goes with pizza and at McDonald’s you always ate hamburger with French fries and Coke. I don’t know how those associations happened, since I did not eat pizzas or McDonald’s’ hamburgers before coming to the US. I guess it was from watching all those TV commercials or just mimicking what everyone else around me was doing.   In fact, it was four years later that watching a friend of mine, I learned that you could actually ask for water at McDonalds.

Fruits and vegetables are definitely good sources for water. Other than getting water from food, what about beverages? Are all beverages, coffees, tea, ice tea, milk, sodas, juices, beer, and wine as good a source of water?

Given the western culture, the answer could be quite confusing.

In research literature, there seems to be some controversy about whether coffee and alcohol are only transitional diuretics or permanent diuretics. Some say that caffeine and alcohol actually cause dehydration. Others disagree.

And, the citrus industry convinced us over two decades ago that “orange juice is not just for breakfast anymore”, so we should be  drinking that all day long.

Coke and Pepsi, of course, promise us sex and happiness.

“Got Milk” teaches us that all the hip people drink milk and it is a fun drink and of course, it is the only source of calcium out there.

Beer is the real beverage to quench thirst, besides it gets us sex and popularity.

Wine is definitely one for sophisticated people and of course makes us live longer.

All this just to get people to drink their stuff to get hydrated! So, what is one to do?

I tend to agree with Joe Dillon, who likes to say, “Just because it is wet, does not mean it will hydrate you.”

Bottom Line

My take on all this is to ask the basic question: when I drink a beverage for hydration, do I want the collateral stuff?

Whether it is caffeine, or alcohol, or sugars or artificial sweeteners, or artificial colors, or whatever else,  if I do want the collateral stuff, then the particular beverage at that moment is an acceptable, desirable or even a good source of hydration. If not, I rather just drink water.

And, in most of the situations, when I am looking to hydrate myself, I rather go directly to the source of hydration that my body is ultimately looking for, which, of course, is Water.

What do you think of this approach?

Do you feel that this simplifies the confusion about water and hydration?

Do you see a hole in this approach? What would you do differently?

Post #16 – What is stress really and why is it bad for longevity and health?

22 Sunday Jun 2014

Posted by in Aging, Biomarkers for Stress, Life-Span, Optimal Health, Stress

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Stress has become such a common buzz word. We all talk about it. We generally know it is bad for us. It is constantly in the news.

There are exceptions though. Some believe that stress is good, arguing that if you take away the stress you take away the motivation and drive.

But whenever I get into conversation with someone and start to dig a little deeper with questions like, “So, what do you think is stress?” “Why do you think that stress is bad?” Why do you think it is good?” Or, “How do you deal with stress?” The subject becomes very squishy, very quickly.

Even Hans Selye, the person who originally coined the term stress in 1936 in the context of health and spent life-time studying it, at one time threw up his hands and declared, “Everyone knows what stress is, but no one really knows.”

So, let us take the first question first, what is stress, any ways.

Webster’s Dictionary defines Stress as “a state of mental or worry caused by problems in your life, work, etc.”; or, “something that causes strong feelings of worry or anxiety”

According to the American Institute of Stress, another popular definition of stress is, “a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilize.”

Few useful concepts, while talking about stress are:

Acute Stress: Fight or flight. The body prepares to defend itself. It takes about 90 minutes for the metabolism to return to normal when the response is over.

Chronic Stress: The cost of daily living: bills, kids, jobs…This is the stress we tend to ignore or push down. Left uncontrolled this stress affects our health- our body and our immune system. This is the type of stress that causes wear and tear on our bodies and can impact health and longevity.

Eustress: “Good stress” in daily life that has positive connotations, e.g., marriage, promotion, child birth, winning money, new friends, graduation

Distress: “Bad stress” in daily life that has negative connotations, e.g., divorce, punishment, injury, negative feelings, financial problems, work difficulties.

So, from  the point of view of theses definitions, the stress is really a subjective concept, based on how we perceive a thing or an event. The same event or activity, say a roller coaster ride, could be a eustress (good stress) for one person and distress for another. This is why psychologists or mental health practitioners often get involved in diagnosing and helping cope with chronic stress.

Although stress is a subjective concept, the impact on our bodies is often very objective and real. We have all experienced the rising of hairs on the back of the neck, the sweats, tension in our gut, racing of heart, dilating of pupils, and pumping of blood in our face, arms and legs.

As the following figure shows, stress starting in mind, causes, a chain reaction of neurological, chemical and biological processes. (Figure is taken from a presentation,Why Stress Is A Far More Important Cause Of Coronary Disease Than Cholesterol, by Paul J. Rosch, M.D., F.A.C.P. President, The American Institute of Stress)

Effects of Stress

Physiological effects of most acute stress events subside about 90 minutes after the conclusion of the stress event. Body returns to normal homeostasis or biological equilibrium.

However, it is the repeated acute stress events or chronic stress that are real cause for concern and take toll on our bodies. The results of such chronic stress can be objectively measured from a host of biomarkers that include (from Biomarkers of Chronic Stress, by Laalithya Konduru):

  • Metabolic Biomarkers: Cholesterol, Albumin, Waist-to-Hip Ratio, Glycosylated Hemoglobin
  • Immunological Biomarkers: IL-6, TNF-α, CRP, IGF-1
  • Neuroendocrine Biomarkers: Cortisol, DHEA, Adrenaline, Noradrenaline, Dopamine, Aldosterone
  • Certain Metabolites, chemical figure prints of cellular processes
  • Modifications in Mitochondria
  • Induction in the Brain of DRR1, a tumor suppressor gene

Most of us recognize some of these biomarkers. Others are quite esoteric. In any case, from this list, it does not take a neuroscientist to figure out that chronic stress can mess with a number of things that are key to our health: insulin, cholesterol, hormones, our immune system, can cause inflammation, reduce energy level in the body and impact working of our brain.

Looks like a real important subject to me, if we want to live healthy life free of chronic diseases for an optimal life span.

What do you think? How do you fee about stress?

In a future post, I would like to explore some anti-dotes to chronic stress

Post #13 – Ever heard of Functional Medicine?

27 Tuesday May 2014

Posted by in Aging, Functional Medicine, Living to 120, Reversing Chronic Diseases, Vigor, Vitality

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In my previous blog posts, I have talked about curing my allergies, fixing migraines, and curing a whole host of other issues without pharmacological medicines. Yes, actually curing these issues and not just managing or controlling the symptoms.

For the longest amount of time, I found it difficult to talk about to these things with my physicians or even lay people. I must admit it all sounded so much like woo doo even to me as I would talk about it. A common refrain from doctors was, “We only practice evidence based medicine.” I did not know what to believe or not believe, except that from my personal experience (evidence of n=1), I could prove that these things work.

All that changed, when last year Kimberly and I attended the Health and Wellness Conference 2013 at the University of Maryland, School of Medicine at the Center of Integrative Medicine in Baltimore, Maryland. There we heard talks about yoga, Qi Gong, nutrition, meditation, detoxing, and many other so called “alternative” therapies in the setting of Evidence Based Medicine.

Key note speaker was Mark Hyman, MD. He has a private practice Ultra Wellness Center in Massachusetts. He wrote a book, The Blood Sugar Solution, which received endorsement from President Bill Clinton. He talked about the diagnosis and cure of Diabesity, a term he has coined as combination of diabetes and obesity. And, he talked about diabesity in the context of what he called Functional Medicine.

Since then I have studied up quite a bit on Functional Medicine and I do believe that many of my conversations in my blog posts fit in that framework. More I dig into this topic the more entranced I am getting with this topic. I feel that functional medicine is the key to the kingdom, when it comes to wellness, vitality and living the optimal health span and life span.

Jeffrey Bland, Ph.D. is considered “father” of this field. Mark Hyman calls him his mentor. Among Bland’s other accomplishments, he has founded Personalized Lifestyle Medicine Institute and The Institute for Functional Medicine. Recently, he has written a book, “The Disease Delusion, Conquering the Causes of Chronic Illness for a Healthier, Longer, and Happier Life.”

Institute for functional medicine describes functional medicine as follows:

“Functional medicine addresses the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. It is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century. By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, functional medicine addresses the whole person, not just an isolated set of symptoms. Functional medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, functional medicine supports the unique expression of health and vitality for each individual.”

So, the basic idea of functional medicine is to take a systems approach to disease and wellness rather than either chasing symptoms or taking germ theory approach that generally focuses on single point of correction. In his book, Jeffrey Bland talks of seven different systems for our bodies:

  1. Assimilation and Elimination
  2. Detoxification
  3. Defense
  4. Cellular Communication
  5. Cellular Transport
  6. Energy
  7. Structure

So the objective in functional medicine is to investigate symptoms to pinpoint one or more of these seven systems that are not working properly and then to change diet, exercise and lifestyle to fix the system imbalance and thereby the diseases and the symptoms.

The end result is often pretty low tech, and may seem underwhelming. That is, implement changes in diet, exercise and lifestyle to redirect expression of certain genes to cure a disease.

However, approach to getting there can be fairly high-tech in identifying the true root cause, identifying the systems that are out of balance and gene expressions that may be responsible for the underlying imbalance. And, as you see from the stories, results can be very profound and almost magical.

If you know someone, who is being treated for certain symptoms of chronic diseases by meds. e.g., high blood pressure, obesity, brain fog, constant fatigue, high cholesterol, inflammation, muscle aches, etc..  The meds being used often lead to side effects that need to be treated by other meds, which in turn are causing other side effects etc.. Such a person is the perfect candidates for functional medicine.

Have you heard of functional medicine?

Do you have any experience with functional medicine?

I have been looking for good certified functional medicine practitioners in our area that we could consult and also recommend to our friends and family. We have access to some lists, but no personal experience yet. Do you know of such a practitioner?

I would love to learn if you know someone.

Post #6 – How do we lose vitality?

06 Sunday Apr 2014

Posted by in Aging, Uncategorized, Vigor, Vitality

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So, just to be sure, my goal (and hopefully your goal) is to purposely live to 120 (or the maximum possible lifespan) with the highest attainable vitality. To achieve that, I feel, I must understand about anything that might get in the way.

In the posts so far, I have been talking about achieving the lifespan of 120 and thereby about a subject that might have sounded morbid to some of you. That is about death and dying.

Let us change our focus to the second part of the goal: Maintaining Vitality. More specifically understanding the potential hurdles to  maintaining vitality, i.e., answering the question: how do we lose vitality?

A good definition of vitality I have seen is in the Free Dictionary, as “the capacity to live, grow or develop.” A good synonym of vitality for our purpose here is vigor, including physical, mental, intellectual vigor.

You have seen it. A fried or a family member is full of vitality and then you notice that he/she starts “going downhill”. The person used to be out and about all the time, went running, then started merely walking, then walking but not as often, and then stared to just hang around the house, then on the couch more and more and then … – you get the idea. Decline happens, at times very slowly, and other times rather rapidly.

Another scenario could be that someone you know experiences a physical, mental or emotional traumatic experience and then never really recovers from it, with increasing physical pain or mental/emotional aguish rapidly goes downhill.

So, what can cause such a decline?

Well, as I started to compile a list of causes for losing vitality, I noticed that there are three broad categories: 1) acute illness, 2) chronic diseases, and 3) senescence or aging related causes. As you would suspect, there is much overlap between these categories, especially among lists for 2 and 3.

So, a list of acute illnesses may include:

  1. Tuberculosis
  2. Syphilis
  3. Typhoid
  4. Streptococcal
  5. Diphtheria
  6. Whooping Cough
  7. Smallpox
  8. Pneumonia/flu
  9. Depression
  10. Accident or Injury
  11. Heart attack
  12. Stroke
  13. Blood Clot/Thrombosis/Pulmonary Embolism
  14. Rheumatoid Arthritis
  15. Cirrhosis
  16. Kidney failure
  17. Other infectious diseases

A list of chronic diseases may include:

  1. Diabetes
  2. Coronary diseases
  3. Obesity
  4. Cancer
  5. Osteoarthritis
  6. Alzheimer’s diseases
  7. Depression
  8. Kidney diseases
  9. Liver disease
  10. High Blood Pressure

And, finally, the list of aging/senescence causes might include:

  1. Insulin resistance
  2. Hardening of the arteries
  3. Loss of muscle mass
  4. Osteoporosis or Loss of bone mass
  5. Gaining excess fat
  6. Inflammation
  7. Arthritis
  8. Stress
  9. Buildup of toxicity
  10. Loss of flexibility
  11. Loss of balance
  12. Slowing reaction times
  13. Slowing basal metabolic rate (BMR)
  14. Loss of appetite

It is interesting to ponder the implication of the overlaps between the lists.

For example, if you have known someone to have had a heart attack, it was definitely an acute illness event that probably changed their vitality curve and sent that person downhill.

Then again, may be that person was already going downhill since he/she had been losing cardio capacity due to chronic coronary disease.

And, may be the heart attack was in-part the result of hardening of the arteries due to old age.

To achieve longevity and vitality, we must overcome acute illnesses, chronic diseases and also slow the aging /senescence process.

What I am really excited about is first and foremost looking for those lifestyle activities that positively impact items on all three lists at the same time.

And, my search so far, indicates that there are such activities. The most challenging part seems to be picking through the controversies to find the optimal activities.

In any case, I think it will be an exciting journey. I look forward to sharing results of my search in the future posts.

What do you think?

Do you feel there are other hurdles that one must overcome to maintaining optimum vitality?