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Post #68 – Resources I used to rehabilitate my knee: Part I – Diagnose and Fix Structural Issue

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A little over two years ago, I hurt my knee. I was doing some vigorous aerobic workout style dancing. I might have twisted my right knee and it started to hurt really badly. I thought it would be fine in a couple of weeks by giving it the usual TLC. But it took over two years to heal it. And it turned out to be quite an opportunity to learn.

Whenever I talk to my contemporaries, the topic of knee pain comes up frequently. So, I thought I would share here my journey of healing my knee pain and more importantly the resources I found useful. Trust others will find this information useful.

In this Part 1 of this series of blog posts, I share different resources for diagnose and fix the structural issues with my knee.

History and Background

You see I have been dealing with knee pain off and on for a long time. About 30 years ago, I took up the goal of running a marathon. I started the training. Ran my first 5K and then my right knee started hurting when I would run. Could not figure out how to run pain free. So, that was the end of my marathon running goal.

Since that episode, over the last thirty years, I have been working on bringing my knee functionally to 100%, judging by the capacity and capability of my left knee. It is still not there 100%, but it is the closest it has come to that goal in thirty years.

Resource #1 – Orthopedic Doctors

My first stop was to get my knee checked out by an orthopedic doctor. I even picked a practice specializing in Sports Medicine. They did a quick X-ray, showed me the picture and pointed out that I had a mild case of osteoarthritis in my knee.

So, what do I do then? I was told not to run. And, if I was to run, maybe use a knee brace. I bought a brace. Tried running with it. Did not really work.

Over the years, the pain went away but it did not really allow me to run. However, I became comfortable with a variety of activities, jumping rope, skiing, rollerblading and so on.

And this time around, which is about two years ago, another trip to the orthopedic knee specialist. A quick X-ray, was showed the picture and told that now I had mild-to-moderate osteoarthritis. Nothing broken, nothing torn. This time, my options were: a) Steroid injection in the knee, b) Injecting gel, if I got permission from the insurance company, c) Take ibuprofen, or d) Do nothing.  Learned that the steroid injection was not simply to relieve the pain but was also therapeutic, since it would relieve the inflammation. So, I chose to get the injection.

Other options offered at the orthopedic specialist’s office are arthroscopic surgery and knee replacement surgery.

Orthoscopic surgery was very popular up to a decade or so ago. These have lately fallen out of favor. Clinical trials done during the last few years have shown that orthoscopic surgery is no more effective than the placebo in the form of sham surgery.

Knee Replacement is an option only when the pain is so severe that you can no longer tolerate the pain whether awake or sleeping since the cartilage has pretty much worn out.

My experience – Orthopedic specialists are a great resource to find out if I broke anything or tore anything for which they have solutions. For osteoarthritis, other than a steroid injection basically, wait until the knee is ready for replacement.

Resource #2 – Hyaluronic Acid

A quick take on hyaluronic acid from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4469223/

“…Viscosupplementation with intra-articular hyaluronic acid is a treatment option in knee OA that is included in the professional guidelines for treatment of this joint disease, but potentially should apply to all synovial joints in order to reduce pain and improve joint lubrication. Exogenous HA can enhance chondrocyte HA synthesis, prevent the degradation of cartilage and promote its regeneration. Moreover it can reduce the production of proinflammatory mediators and matrix metalloproteinases involved in OA pathogenesis. This mini review highlights the evidence of hyaluronic acid in reducing osteoarthritis symptoms and structural damage, as well as its ability to delay prosthetic surgery. Viscosupplementation should be considered as a long-term therapy.”

Basically, hyaluronic acid is a gel that if injected into the knee joint improves joint lubrication, reduces inflammation and may also regenerate cartilage improving the structure of the joint. Treatment may have to be repeated over time as a long-term therapy.

Typically, insurance companies do not cover this therapy. It is known to relieve knee pain and improve joint functions. Some orthopedic specialists may offer it. But mostly these are offered by those doctors practicing alternative therapies, e.g., functional doctors, chiropractors or doctors of osteopathy.

Resource #3 – Platelet Rich Plasma (PRP) Therapy

PRP therapy for osteoarthritis of the knee works by injecting platelet-rich blood into the area surrounding the knee to help reverse existing tissue damage. Blood is comprised of four components. Most of your blood is liquid, known as plasma. The other three components are platelets, white blood cells, and red blood cells.

Platelets play a key role in the clotting of the blood. They also contain growth factors that could help tissues repair themselves by causing new cells to form.

PRP Therapy involves taking blood from the veins, about the quantity typically used for blood tests. They spin it to separate plasma and platelets from the red blood cells. They then inject plasma into the joint, where the cartilage might be damaged, typically where it hurts to touch and/or where inflammation in the joint is.

PRP is still not mainstream as a standard of care. Here is one article, comparting results of various studies on PRP And Hyaluronic Acid,  https://pubmed.ncbi.nlm.nih.gov/34785294/ . The bottom line from this study is: Patients undergoing treatment for hip or knee OA with either PRP or HA injections can expect to experience similarly beneficial short-term clinical outcomes.

My experience – I underwent three different applications of PRP. And found those to be beneficial.

Resource #4 – Stem cell Therapy

Stem Cell Therapy procedures are non-surgical injection-based procedures for people suffering from knee pain due to common injuries to the knee Meniscus, ACL, MCL, and other structures, or who are experiencing degenerative conditions such as Osteoarthritis. These procedures utilize concentrated repair cells that are obtained from your own bone marrow or blood to promote your body’s own natural ability to heal.

I visited folks at StemCellArts to see what they could do for my knee. The procedures they perform are done by orthopedic doctors who have a lot of experience and have developed specific protocols. However, the procedure tends to be quite expensive and is also quite involved, especially the part about extracting stem cells from bone marrow and culturing those cells.

Later, I also learned about the stem cells that are now harvested from umbilical cords, packaged and then distributed for doctors to use. This approach seemed to be rather inexpensive compared to using bone marrow. I underwent this procedure and found it to be quite helpful. In fact, a few months after the stem cell procedure, I asked the doctor if he would recommend repeating it. He recommended that once the joint is seeded with the stem cell, it was more helpful to do a PRP procedure to provide the joint more “fertilizer” in the form of growth factors. That is why I ended up doing the third PRP procedure.

My experience – My knee used to be tender to touch on the left side of the knee, where X-rays showed cartilage had eroded. After the stem cell and PRP procedures the tenderness and accompanying pain totally went away.

Bottom Line:

From my research and experience, I have found that it is important to find out what is the underlying structural issue for knee pain. It could be osteoarthritis, meniscus tears, tendon & ligament tears, overuse injuries or some other condition. In my case, it was osteoarthritis, clearly showing eroded cartilage in certain part of the knee joint. The resources that were useful to diagnose and repair the structural damage were:  

  1. Visit to the Orthopedic surgeon and imaging
  2. Steroid injection for relieving inflammation.
  3. Alternatively, ibuprofen for relieving inflammation.
  4. Hyaluronic acid or PRP treatment for joint lubrication and repair.
  5. Stem Cell therapy for repair or regeneration.

Of course, this is not medical advice, and you should check with a medical doctor about your specific situation.

 What are your thoughts or experience 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 #63 – Fasting, the old new technology and panacea for Optimal Health – Part I

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Posted by in Autophagy, Fasting, Optimal Health, wellness

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For the last few years, I have been hearing a lot about fasting from friends, family and the media. I am sure you may have been as well. The words like intermittent fasting, time-restricted eating, etc. have been becoming common place terms.

Until recently, I have pretty much ignored this topic as simply yet another fad. As you can see from my blog post, I have not even mentioned this topic even once.  There has been absolutely no mention of these terms in my posts, although I did mention that when to eat and how often to eat do play part in good health and longevity.

Well, over the last few months, I took a deep dive into fasting. I really got intrigued when I learned about the 2016 Nobel Prize in Physiology of Medicine award of Yoshinori Ohsumi. Here is the summary of his work from  the Nobel Prize website, highlights are mine.

“In the lysosomes of our cells its components are processed for reuse. The mechanisms of this process were mostly unknown until the early 1990s, when Yoshinori Ohsumi conducted a series of groundbreaking experiments with yeast, where he detected autophagy and identified genes important for the process. Yoshinori Ohsumi’s discoveries laid the foundation for a better understanding of the ability of cells to manage malnutrition and infections, the causes of certain hereditary and neurological diseases, and cancer.”

There is a lot here, so let me unpack it. 

Autophagy is an amazing process for healing our bodies using its own intelligence that led me to the journey through this rabbit hole.

The term ‘autophagy’ is derived from the Greek meaning ‘eating of self’. The term was first coined by Christian de Duve over 40 years ago, who received his Nobel Prize for discovering subcomponent of cells (aka organelles) called lysosomes. He showed that lysosomes were the garbage collectors for the cells. Even better yet, lysosomes convert the cellular garbage into amino acids for the body to reuse just like it would protein you would eat through food.  Amazing, isn’t it?

Ohsumi’s Nobel Prize brought this concept of autophagy to the forefront and unleashed renewed interest in this topic.

Autophagy is a very important aspect of human cell’s ability to collect garbage and then allow the body to rebuild the damaged parts from stem cells. So, let us say, you break a part in your car, you leave the car alone for a little while, and it takes the old broken parts, converts them into the basic material they were made of,  turns them into any usable parts or disposable garbage, and then grabs some brand-new material off-the-shelf and 3D prints a brand new part. And, it is off and running again just like new.  Sounds, just like in the movie Transformers.

If you up-regulate autophagy, i.e., you get body to do more of it, then you get lots of healing. If you down-regulate it, i.e., your body does less of it, and you get all kinds of diseases.

So, what does fasting have got to do with all this?

Turns out, fasting is currently the only sure way known right now, to put body into the state of autophagy. And, hence my intrigue with fasting.

In the next post, I would discuss how fasting induces autophagy, other benefits or side effects of fasting, different methods of fasting and my experience so far.

Summary

  1. In autophagy, lysosomes in our cells collect garbage and covert those for reuse.
  2. Do more of autophagy and body heals itself. Less of autophagy leads to diseases.
  3. Fasting is currently the only way to get the body into autophagy.

What do you think?

Have you an experience with fasting? Have you learned about autophagy?

I and the readers of this blog 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 #61 – How much sleep do we need for optimal health?

16 Sunday Sep 2018

Posted by in Living to 120, Mental Health, Optimal Health, Optimal Sleep, Uncategorized, Vigor, Vitality, wellness

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In Post #59, I talked about the lifestyle choices that are important to maximizing health and lifespan:
1. Benchmarking Health
2. Nutrition
3. Exercise
4. Maintaining Musco-skelatal Integrity
5. Maintaining Mind-body Connection
6. Enhancing and Maintaining Brain
7. Stress Management
8. Adequate Sleep
9. Social Engagement
10. Purposeful Living
11. Making full-use of all modalities of medical care
12. Make use of Genetics Science

These were of course not in any particular order. For example, Adequate Sleep would rate much higher in priority, probably towards the top. After all, most of us cannot even function if deprived of sleep over even a few days.

I recently read the book, Why We Sleep by Mathew Walker, Ph.D. He is a professor at University of California Berkeley and has dedicated his career to research in sleep. This is a pretty definitive book on sleep and covers the topic from almost all angles.

Why we sleep cover

I have been generally aware that 7 to 9 hours of sleep is considered a must for optimal health. And, since I learned that I do make the effort to catch that much sleep and when I don’t I would make effort to catch up on that sleep during the weekends.

However, reading this book has been seriously eye opener for me. As a result, I am taking sleep as a lifestyle choice for living for optimal health now much more seriously than I used to.

Sleep Myths – Busted

Here are some myths about sleep that the research cited in the book has busted for me.

1. I can live quite well with 6 to 6.5 hours of sleep. Dr. Mathews is very definitive on research that the range of sleep for optimal health for healthy adults is between 7 to 9 hours. Of course, children have different needs for sleep and so do sick people to allow their body to recover.

He also makes distinction between “opportunity to sleep”, e.g., how long I kept my head on the pillow, and actual sleep. So, if I was “in bed” for 7 hours, it took me half an hour to fall sleep, I got up twice to go to the bathroom and each time it took me half hour to fall back to sleep, then I slept for 5.5 hour. There is some research that more than 9 hour sleep is not optimal, but that research is still controversial.

One test for adequate sleep is that if during the day you close your eyes and see yourself falling asleep, then you are not getting enough sleep.

2. Early morning sleep is more important that the late-night sleep. There are two broad categories of sleep: Rapid Eye Movement or REM happens when we are in deep dream state. In early sleep cycles, which generally happen before and shortly after mid night, most of the sleep is not REM or NREM. In early morning hours, sleep is mostly REM. Each REM and NREM have their very distinct function for brain and our physiology and we need both. The following figure from scielo.br illustrates how amount of REM sleep increases as the sleep progresses and NREM shown here as Stages 1 through 4 decreases.

Sleep Cycle 2

In NREM sleep, for example, our brain takes information stored in short-term memory and shuffles it over to the long-term memory regions of the brain. In REM sleep then our brain builds interconnection with pre-existing long-term elements. If we miss NREM sleep, short-term memory buffers get over-written. If we miss REM sleep, we don’t get a chance to develop ways to access and use the information on the long term.

3. If I don’t sleep enough during the week day, I can always catch up during the weekend. From the REM and NREM sleep discussion above, you can probably quickly extrapolate that if we short change sleep, certain functions are not optimal on a daily basis. Information once lost, probably is lost forever – unless of course you relearn it.

Sleep is driven by two cycles: Circadian clock and a hormone Adenosine, see the picture below (from hackyourgut.com). Circadian clock drives our urge to awake while adenosine drives our urge to sleep.  Adenosine only goes up after we wake up until we clear it again during sleep. More adenosine in our body the more is our urge to fall asleep.  Our body’s energy level changes with change in circadian rhythm. When energy is increasing, we have the urge to wake up.

Two-process-model-sleep-circadian-homestatic-sleep-drive

When we skip sleep, it feels that we have energy to keep going based on our circadian clock. But we may still have the urge to sleep because adenosine is still high. So, when we sleep extra during the weekend, we are clearing up any residual adenosine which clears the urge to sleep. So, we feel like we have caught up on sleep. But remember, we did not really catch up on the mental benefits of sleep for memory capture and reorganization. And, that is the missed opportunity, when we try to catch up on sleep during the weekends.

4. Alcohol and sleeping pills can make you sleep better. Alcohol makes you sleepy, so clearly it must make you sleep better. Right. Wrong. Both alcohol and sleeping pills have similar effect on the brain. They are sedatives and make you drowsy by shutting down you neo-cortex, i.e., thinking brain, activities. When monitored, your brain does not have the same physiology as if you were sleeping in either REM or NREM sleep. Hence, you find that people who take sleeping pills or night caps as sleep aids, are often groggy, lacking motor skills, lethargic, and forgetful during the next day.

5. If I am short of sleep, I will know so I can correct it. And, that is the same thing someone who is drunk would say, ”I am not drunk. I don’t feel drunk.” We just discussed above the effect of alcohol on the thinking brain, which is also the decision-making brain. Lack of sleep has exactly the same effect as being drunk. And, that is one of the reason, lack of sleep leads to car accidents.

In fact, did you know, lack of sleep causes more accidents than drunk driving. If you have slept only 4 hours or less the previous 24 hours, your chance of car crash increase by a factor of 10.

And, if you are short of sleep, it is the micro sleeps that make driving fatal. if you are sleep deprived, brain just shuts down for a second or two. And, a second or two while going at 60 miles an hour is sufficient to cause serious crashes.

6. Coffee, slapping myself, or loud music can keep me going: Turns out that research shows none of these are effective at preventing micro sleeps. The only thing that is found effective is, you pull over, stop and take a nap.

7. Caffeine is not a problem, if don’t ingest caffeinated drinks at dinner time. Half-life of caffeine is 8 hours. So, it can take up to 16 hours to purge effect of just a cup of coffee from the body. So, any caffeinated drink after lunch can probably disrupt the sleep and should be avoided to obtain highest quality of sleep.

8. Melatonin will help me sleep better. Actually this is yes and no depends upon the nuance. Melatonin does not improve the quality of sleep. It does, however, tell your brain and body when it is time to go to sleep and to start to get ready. Generally, it is released as the darkness sets in.

In our modern worlds, where darkness hardly sets in or if our body clock is messed up due to jetlag from travel, it may be helpful to have melatonin supplement to tell the body that it is time for bed. Dimming lights and shutting down screens (TV, smart phones iPads, laptops) as the bed time appraoches is an excellent way of getting your body to start producing its own melatonin.

If you do take mealtonin supplements, just be warned that melatonin pills available over the counter have great variability in the melatonin content when you compare actual vs. printed on the label. In one test, FDA found -89% to +473% variability. I recently learned that a great source of melatonin is raw pistachio. Just a few kernels of pistachio release enough melatonin that is in most pills. Check out this link from NutritionFacts.Org.

Sleep Hygiene – Best Method to Improve Quality of Sleep

Instead of taking any sleeping pills, Dr. Walker recommends the same sleep protocol that NIH recommend, see NIH published Your Guide to Healthy Sleep,
1. Stick to a sleep schedule.
2. Exercise is great, but not too late in the day.
3. Avoid caffeine and nicotine.
4. Avoid alcoholic drinks before bed.
5. Avoid large meals and beverages late at night.
6. If possible, avoid medicines that delay or disrupt your sleep.
7. Don’t take naps after 3 p.m
8. Relax before bed.
9. Take a hot bath before bed.
10. Have a good sleeping environment.
11. Have the right sunlight exposure.
12. Don’t lie in bed awake.
13. See a doctor if you continue to have trouble sleeping

Summary
Sleep is way at the top of lifestyle choices for optimal health. Statistics show again and again that most of us do not get enough sleep.

Dr. Mathew Walker’s book Why We Sleep is a great book if you want to learn about latest on every aspect of sleep. NIH published Your Guide to Healthy Sleep is also a great resource that summarizes healthful practices.

In this post, I covered several myths on sleep
1. I can live quite well with 6 to 6.5 hours of sleep
2. Early morning sleep is more important that the late-night sleep
3. If I don’t sleep enough during the week day, I can always catch up on the weekend
4. Alcohol and sleeping pills can make you sleep better
5. If I am short of sleep, I will know so I can correct it
6. Coffee, slapping myself, or loud music can keep me going
7. Caffeine is not a problem, if don’t ingest caffeinated drinks at dinner time
8. Melatonin will help me sleep better

If you want to improve the quality of your sleep, check out the 13 step Sleep Hygiene protocols that I summarized above. Dr. Walker and NIH recommend this method of improving your sleep quality and is proven to work better than sleeping pills.

NIH published Your Guide to Healthy Sleep and Dr. Walker’s book have more details on this method of improving sleep quality.

What do you think?

Have you learnt something about sleep, that you can share?

I 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 #60 – 10 Books on Health and Wellness I Read Over the Last Year

06 Sunday May 2018

Posted by in Aging, Life-Span, Living to 120, meditation, Mental Health, Nutrition, Optimal Exercise, Optimal Health, Optimal Nutrition, Puposely Living, Reversing Chronic Diseases, Stress, TM, Uncategorized, wellness, Yoga

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I thought I would share titles, quick summary and my takeaways of the books I recently read on the subject of health and wellness. May be one or more might intrigue you or inspire you for you to explore further. Or, even adopt some practices recommended in these books to improve you health and wellness.

How Not to Die Cook Book As I mentioned in my previous post #58, I consider Michael Greger’s website http://www.NutiritionFacts.com as the go-to site for all information related to nutrition. This cookbook is a good companion book to the website and his earlier best-selling book How Not To Die. Recipes are practical way of adapting to the latest in nutrition science. I have tried few recipes. They are very good.

The End of Heart Disease In my blog post #9 – When it comes to health, vitality and aging what is really possible?, I had discussed the book, Prevent and Reverse Hearth Disease by Caldwell B. Esselstyn, Jr. M.D. In this book, Dr. Fuhrman’s has updated research on preventing and reversing heart disease. Case studies are mind blowing. He not only gives research but actually prescription on what you should actually eat and even very specific meal plans.  Dr. Furhman promises his patients to let him decide what they eat for six weeks and then based on the result they can then decide what to eat. Most of them become converts to his prescription of nutrition after seeing the results.

Super ImmunityI did a series for posts #51-#54 on How to Optimize Your Immune System. In this book, Dr. Fuhrman offers a lot more research and very practical ways to build immunity so your body can fight whatever comes its way – not only flues and colds, but also other infections and even cancer. Cancer after-all is just DNA mutation that body fights all day long. Only when our immune system is NOT capable of handling the mutated DNA, it starts to take over the organs unchecked. Again, the book includes nutrition meal plans, recipes to put into practice his philosophy – not just eat food that is packed with desired micro-nutrients, but eat a lot of it.

The Telomere Effect In blog post #50, I discussed how to optimize your health by maximizing your telomeres. Elizabeth Blackburh received Nobel Prize for her research in telomeres. Telomeres are the end-caps at the ends of our DNA strands like little plastic wraps at the end of shoe laces. If the little plastic wraps are damaged shoe laces become useless, so is the case with the DNA. The length of telomeres correlate with the remaining lifespan. Dr. Blackburn shares the latest research in lay-person language and shares the different methods by which we can increase the length of our telomeres. Reading this book, it should not come as surprise to you that the  lifestyle choices I discussed in my Post #59, all help increase the lengths of your telomeres.

The Science of ExerciseTime did a fantastic job in summarizing the latest in science of exercise in this special Time Magazine publication. If you needed any further evidence how exercise impacts health and lifespan, I believe this publication will deliver, without having to read some big tome. The issue spans many diverse topics: cardio vs. weights, high intensity interval training, running, swimming, yoga and other exercise modalities.

The Science of Being and Art of LivingIn my blog post #17 – Is meditation an effective antidote to stress, I talk about Transcendental Meditation or TM as a very effective and well-researched means for combating stress. Science of Being and Art of Living is book compiled based on lectures by Maharishi Mahesh, who introduced TM to the West. He also founded the TM movement that has established TM Centers pretty much in all major cities throughout the world. While first part of the book serves as evidence and motivation for TM, the later parts are more for the practitioners and advanced students of TM and Yoga.

Heart Health KitA few months ago, I got a chance to meet and attend a work shop by Dr. Levy, who has spent all his life building bridges between Western medicine and Eastern philosophies of yoga and meditation. Dr. Levy talks about how to prevent and reverse heart diseases by tackling the most insidious of the issues that impact heart health, i.e., Stress. This manual is accompanied by CDs on which you will find and can actually use his hypnosis techniques for relieving stress and anxiety.

The Happiness SutraIn this more recent publication, The Happiness Sutra, Dr. Levy further delves into the four different types of stresses humans face and how best to deal with all four types of stresses. This book also has a CD that you can listen to to get the benefit of Dr. Levy’s hypnosis methods for relieving stress.

Mind over Medicine Lissa Rankin, M.D.’s  book Mind Over Medicine is a great case study of extreme stress brought on modern living and by our current medical system. Dr. Rankin, a practicing OB GYN, quit her practice of medicine  because of the numerous health and personal issues brought on by stress from her profession. She eventually found ways to heal herself and then learned to apply her new found knowledge to become a true healer,  without becoming slave to the medical system.

 

Have you read books on health and wellness that you would like to share?

I 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 #59 – What are our lifestyle choices for maximizing health and lifespan?

11 Sunday Feb 2018

Posted by in Life-Span, Living to 120, meditation, Mental Health, Nutrition, Optimal Exercise, Optimal Health, Optimal Nutrition, Puposely Living, Quality of Life, Stress, Supplements, TM, Uncategorized, Vitality, wellness, Yoga

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Lifestyle Choices for Maximizing Health and Lifespan

Unless you have been living under a rock on an isolated island, I am sure you have heard that lifestyle choices have big impact on both your health and how long you live.

Living longer means not dying sooner.  And, to not die sooner, you must take actions that eliminate the various ways one dies.

Living healthy, means taking actions to prevent all the ways one loses their abilities to enjoy day-to-day activities of life. Or, at least postpone the time as far into the future as possible before developing disabilities.

In both case, i.e., living longer and living healthy, lifestyle choices play crucial roles. But what are these life choices, besides the ones you hear all the time:  Eat Better and Exercise.

When I started to systematically pursue this topic of living optimal lifespan possible (my goal being 120 years), with optimal health span (my goal being no disabilities), I started enumerating all areas of life in which one can take some action to make this impact.

Of course, not everything is in our control. We did not come to this earth with guarantees. Unforeseen, random event, or events that are not in our control can ruin all our goals and plans. But the objective is to not let the possibility of events not in our control prevent us from taking actions that are indeed in our control.

So, here are all 13 dimensions of lifestyle that I have discovered so far that impact health span and life span. Each subject is a very extensive topic by itself.  I just very briefly summarize my personal take on these and may be an example of how I am attempting to address them in my lifestyle and where you can read about further in these blog posts.

1. Benchmarking Health: Knowing where you are is where I believe it has to all start. You go to doctor’s office and they take your physical measurements (height, weight), you vitals (pulse, blood pressure), order some measurements from the lab and then compare those with what should be “normal” for you. In Post #7 – Can biomarkers help in the quest for vitality and longevity?, I discuss the various measurements you can use as biomarkers for health. These days I measure:

Daily: Weight, waist, fat near navel and thigh, BP, SPO2, pulse, my over-all subjective state of my physical, emotional and mental health

Weekly: pH, Nitric Oxide, fasting glucose

Quarterly: Bloodwork through my primary physician – CBC (complete blood count), typical chemistry panel, Lipids (Cholesterol total, HDL, LDL, VLDL, Triglysrides), TSH, T3, T4 (Thyroid hormones), Male Hormones (Total and Free Testosterone, Estrogen, LH, FSH), Hydroxy-D, fasting glucose, A1c, PSA (for prostrate tumor screening), CRP, (for inflammation), Homocysteine (for heart condition)

Annually or Biennially: Telomere Measurements (DNA strands that dictate how long cells live), X-Rays of joints if I suspect arthritis etc., Ultrasound Study of Carotid and Aorta arteries, MRI’s to detect any tumors, eye-exam, hearing test, EKG.

Every 5 years: Colonoscopy, Stress-test.    

2.  Nutrition – That is everything that crosses our lips, what we eat or drink. I discussed the topic of nutrition in a series of eight blog posts on this subject of Optimal Nutrition, Posts #22 through #29.  additionally, Post #15, #31 and #32 discuss the topic of how and when to complement the nutrition with supplements.

 3. Exercise – Exercise is indispensable for building and maintaining muscle strength, flexibility, balance, endurance. There is also abundant proof that it helps with the metabolism, overall health and health of specific organs. I discussed this topic of exercise in blog post #30 – How much and what type of exercise do you need for optimal health?

 4. Maintaining Musco-skelatal Integrity: Pains in the back, knees, hips, shoulder, wrists and other various joints creep up. We may think that these pains just come out of nowhere. After all, we often notice that “yesterday it did not hurt and today it hurts”. So, it got be a random event. Right?

Reality is that unless there was a trauma caused by an accident, most of these are the result of repetitive movement in un-aligned joints. The underlying cause could be neglect of the muscles, ligaments and tendons surrounding joints or prolonged asymmetrical movements, e.g., always carrying a bag on the same shoulder, or playing games such tennis or golf that inherently require asymmetrical movement.

Yoga, myofascial massages, Rolfing, rolling with foam rollers, visiting a chiropractor for body alignment, weight bearing exercises for join strengths, e-cise routines designed by Pete Egoscue are methods I have learned for maintaining musco-skeletal integrity.  I discuss some of these in Post #30 – How much and what type of exercise do you need for optimal health? And Post #49 – What is the role of massage therapy in Optimal Health? Also, I discuss how you can use foam rolling for body alignment in Post #39 – Ever heard of foam rolling.

5. Maintaining Optimal Dental Health: Good dental health not only impacts quality of your life, it can also impact how long you live.

The American Heart Association published a Statement in April 2012 supporting an association between gum disease and heart disease. The article noted that current scientific data do not indicate if regular brushing and flossing or treatment of gum disease will decrease the incidence, rate or severity of the narrowing of the arteries (called atherosclerosis) that can lead to heart attacks and strokes. However, many studies show an as-yet-unexplained association between gum disease and several serious health conditions, including heart disease, even after adjusting for common risk factors.

You may also have seen health and lifestyle surveys used for estimating life-expectancy that want to know if you floss daily. If you do the models give you credit for an extra 2 to 4 years of life.

In Post #47 – What does optimal dental health look like and how to achieve it?, I discuss this topic in greater detail.

 6. Maintaining Mind-body Connection: Our mind and body are inherently connected. Maintaining the connection between the two is essential for optimal health. Yoga, Tai Chi, Qigong, are some ways to develop and maintain mind-body connection.  I have very limited experience with Tai Chi and Qigong. I do, however, perform Yoga as part of my lifestyle.  In Post #11 – My first year of experience with Bikram Yoga, Post #12 – My second year of experience with Bikram Yoga, I describe how I incorporated Bikram Yoga into my lifestyle.

 7. Enhancing and Maintaining Brain: If we lose vitality of the brain, the quality of life suffers dramatically. Alzheimer and other forms of Dementia can often be very painful way of living. Evidence is mounting that for optimal brain health, we must keep the brain stimulated with right activities. All my life, I have been very focused on left brain type of activities. As I was turning 60, I decided to do something about it and started taking piano lessons to stimulate my right brain and prevent any premature aging of the brain. I discuss the activities for maintaining optimal health in Post #57 – Optimal Mental Health – what is it and how to achieve it?

 8. Stress Management: Stress is a root cause of many diseases. We have all experienced how stress can bring about disturbances in the digestive systems, back pain, high blood pressures, even heart attacks and strokes. Yoga and Meditation are two of the ways to manage stress. Perspective management is another powerful method. I got initiated in Transcendental Meditation over 30 years ago and I have been doing TM ever since with good benefits. I tackle the subject in Post #16 – What is stress really and why is it bad for longevity and health and Post #17 – Is meditation an effective antidote to stress.

9. Adequate Sleep: There is more and more evidence every day that inadequate sleep can cause all sorts of ailments. 7 to 9 hours of restful sleep is considered optimal. All my life, I thought the object of the game was to get away with as little a sleep as possible. Sleeping more than 6 hours every night is still a challenge for me. Although I am working on it to extend sleeping hours during the week and may be do some catch up sleeping during the weekends. Maybe I will tackle this topic in a future post. In Post #61 – How much sleep do we need? – I discuss the latest in sleep research.

10. Social Engagement: World-wide Study of Blue Zones, i.e., geographical areas where longest living people are clustered, showed a very surprising factor that contributed to long healthy life of people living there. Researchers found that people in Blue Zones are socially very engaged. Centenarians in these areas are engaged with tight knit groups of friends and family. So, the conclusion is that social engagement is an important factor in living longer and healthier.

 11. Purposeful Living: It is well known that death rates spike after the holidays and after major life events. Researchers deduce from studies of such phenomena that people live only as long as they find life meaningful.

Of course, it needs an ongoing effort to figure out what one can derive meaning from. One may find meaning in raising kids or grand kids, contributions to society, being the best spouse one can be or from “slaying some dragon”. Some people find meaning in their faith and service to God. Others find meaning in being of service to mankind or their fellow human beings. Yet others can find meaning in their job or career.

Viktor Frankel in his book: Man’s Search for Meaning, explores this topic beautifully. 

12. Make Full-use of All Modalities of Medical Care: Modern medicine has developed amazing and miraculous treatments. By making use of the modern medicine one can live much healthier and much longer.  In general, the earlier you are able to catch a disease and the sooner you start treatment, better your chances are of a cure or at least minimizing the damage. Mantra for modern medicine is “early detection, early cure”

 Alternative schools of medicine, such as Ayurvedic, Homeopathy, Aquapuncture, Naturopathy, offer valid means for preventative care and whole-person healing.  Leveraging these modalities of medical care as appropriate can offer means for optimal healing and living. Here the rule is the age old wisdom: An ounce of prevention is better than a pound of cure.

I was even able to eliminate my severe seasonal allergies by working with doctors of Naturopathy and thus was able to totally change the vector of my health as I discuss in Post #8 – So, did I you tell you the story of my allergies. Also strengthening your immune system can have major consequences on how your body deals with diseases as I discuss in a series of Posts #51 – 54 – How to Optimize Your Immune System – Part I through Part IV

13. Making use of Genetics Science: There is of course the truth of genetics. Genes do play a role in how long we will live and what diseases we may have the tendencies to develop. Over the last few years, however, scientists are finding that inherited genes often do not determine your destiny, it is the lifestyle that can either turn those genes on or off. This is the exciting field of epigenetics.

 Studies from the filed of epigenetics do  give us opportunities to leverage genes.  Through genome mapping, we can find out what might be our tendencies and to what aspects of our life, therefore, we should pay particular attention. Over the last few years, I have gotten my telomeres measured – these are tips at the ends of genes that are considered to act like our lifespan clocks.  I discussed this in Post #50 – How to optimize your health by maximizing your telomeres. More recently, I have sent for genetic testing to be able to receive personalized genetics bases lifestyle coaching. I will share results of that experiences in a future post.

The percent of role of genes that we cannot do anything about is constantly shrinking all the time. Now it is believed that only between 5% to 15% of lifespan and health span is determined by genes that we have no control over.

Bottomline:

In summary, researchers have shown again and again that health span and life span depend upon one’s lifestyle choices. A holistic look at lifestyle choices means many different and distinct areas of life.

I shared my take on these dimension of lifestyle and some of my experience. Also, gave references to where you can find more information, whenever, I have already discussed that topic in more detail in my blog posts.

  1. Benchmarking Health
  2. Nutrition
  3. Exercise
  4. Maintaining Musco-skelatal Integrity
  5. Maintaining Optimal Dental Health
  6. Maintaining Mind-body Connection
  7. Enhancing and Maintaining Brain
  8. Stress Management
  9. Adequate Sleep
  10. Social Engagement
  11. Purposeful Living
  12. Making full-use of all modalities of medical care
  13. Making use of Genetics Science

What do you think?

Do you think there some other dimension of lifestyle that I did not address here that is also important?

I 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 #58 – One Stop Shop to Find Information About Optimal Nutrition

14 Friday Jul 2017

Posted by in Living to 120, Nutrition, Optimal Health, Optimal Nutrition, Reversing Chronic Diseases, Supplements, Uncategorized, wellness

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It has been a few months since I last wrote a blog post. It seemed like I ran out of material to write about.

As you know, the purpose of these posts is to share only information 1) that is based on research and is not a merely hearsay, 2) that I have personal experience with, and 3) that I feel contribute towards a goal of living the longest with optimal health.

For a while I had plenty of such information that fit the scope of this blog. And, then I hit the wall.

About a year and a half ago, I found a source that has troves of nutritional information for optimal health. This information is available in videos and text form – all for FREE.

Using this information, I have been further optimizing my own lifestyle. And, it has already showing further improvements in my bio-markers.

The source is:  www.NutritionFacts.org  

This site is a labor of love for Michael Greger M.D. FACLM.  He seems to be on a personal crusade to share this knowledge and information. He and his staff of volunteers comb through over 20,000 research papers on nutritional studies published every year. They summarize this information in few minutes long byte-sized chunks and even as annual summaries, which last about an hour.

You can even subscribe to their site and you will receive a tip every day in your email.  I actually look forward to these emails. That way I can learn over time and don’t take in more than I can digest.

I got introduced to Dr. Greger’s work by reading his book: How Not to Die.

Gregor book

Some startling things I learned from this site:

  1. How you can reverse your diabetes by changing what you eat.
  2. How you can shrink you prostrates by adding certain fruits to your diet.
  3. How you can reduce blood pressure with certain plant based foods.

And, for every claim, he gives his rationale based on specific research studies and papers that you can further read up yourself, if you wish.

MY LIFE STYLE CHANGES

Here are some things I have already incorporated in my lifestyle, as a result of the research information I learned from Dr. Greger:

  1. I am now working on replacing, whenever possible, to get as many micro-nutrients as possible using whole foods rather than supplements.
  2. I started adding one tablespoon of freshly ground Flax Seeds and a quarter teaspoon of Turmeric in my shakes every morning. As you will see from the research, flax seeds and turmeric are effective for a whole bunch of issues, e.g., blood pressure, diabetes, inflammation.
  3. I started adding one table spoon of Apple Cider Vinegar in my salads at lunch to lower my blood sugar resulting from food at lunch, which tends to be my heaviest meal.
  4. I have been eating 2 to 4 pieces of Brazil Nuts as snack every night to further lower my LDL Cholesterol.
  5. I am now more conscious of making sure that I add Cruciferous Vegetables in my salads to boost my anti-oxidants.
  6. I have started sprinkling pomegranates seeds on my oat meal for my prostrate health.

RESULTS SO FAR

I have been quite pleased with the results of these changes so far. Here are a few:

  1. My most recent blood-work on 7/7/2017 shows, an Hemoglobin A1C of 5.4%! It was 5.5% three months ago.  My A1C was stuck at or above 5.8% for the last three years, ever since I have been measuring it.  Ever since then, I have been working on getting it out of the pre-diabetes range, considered to be over 5.6%.
  2. All my inflammation markers, CRP, Homocysteine, WBC are all trending down.
  3. LDL and Triglycerides are 86 and 57 in the latest blood-work – without any meds. These are on the low end of where they ever been.
  4. My blood pressure measured on my last doctor’s visit was 108/70! As I have mentioned in previous posts, I have working on reducing my BP.

Bottom Line:

I highly recommend that you checkout www.NutrtionFacts.org.  An evidence-based nutrition advice that is labor of love of Dr. Michael Greger. You can search for a specific topic, browse the site in general for useful information and/or subscribe to the daily email.

This site has become a go-to site for me for all things nutritional for Optimal Health. I have found the information is research-based, concise, well-presented and at-times with profound implications.

Most of the time, information is very actionable.

 

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 #48 – Is cancer preventable through optimal healthy living?

10 Sunday Jan 2016

Posted by in Causes of Death, Ideal Body Weight, Living to 120, Nutrition, Optimal Exercise, Optimal Health, Optimal Nutrition, Supplements, Uncategorized, Vitality, wellness

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My wife Kimberly was telling me the other day that 2015 has been quite a remarkable year in that we had several cancer episodes among our friends and families.  Even a couple of them died.

So, that got me thinking… is cancer preventable through optimal healthy living?

What is cancer anyways?

According National Institute of Health (NIH), National Cancer Institute (NCI) website www.cancer.gov, cancer is the name given to a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues.

Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and divide to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.

When cancer develops, however, this orderly process breaks down. As cells become more and more abnormal, old or damaged cells survive when they should die, and new cells form when they are not needed. These extra cells can divide without stopping and may form growths called tumors.

Many cancers form solid tumors, which are masses of tissue. Cancers of the blood, such as leukemias, generally do not form solid tumors.

Cancerous tumors are malignant, which means they can spread into, or invade, nearby tissues. In addition, as these tumors grow, some cancer cells can break off and travel to distant places in the body through the blood or the lymph system and form new tumors far from the original tumor.

A cancer that has spread from the place where it first started to another place in the body is called metastatic cancer. Under a microscope, metastatic cancer cells generally look the same as cells of the original cancer.

How does cancer arise?

Cancer is a genetic disease—that is, it is caused by changes to genes that control the way our cells function, especially how they grow and divide. Three main types of genes may be involved—proto-oncogenes or genes involved in normal cell growth, tumor suppressor genes, and DNA repair genes. These changes are sometimes called “drivers” of cancer.

Genetic changes that cause cancer can be inherited from our parents. They can also arise during a person’s lifetime as a result of errors that occur as cells divide or because of damage to DNA caused by certain environmental exposures. Cancer-causing environmental exposures include substances, such as the chemicals in tobacco smoke, and radiation, such as ultraviolet rays from the sun. (Our Cancer Causes and Risk Factors page has more information.)

Inherited genetic mutations play a major role in about 5 to 10 percent of all cancers. Researchers have associated mutations in specific genes with more than 50 hereditary cancer syndromes, which are disorders that may predispose individuals to developing certain cancers.

How to prevent cancer?

So, now finally getting to the topic we started with – how to prevent cancer. Here are the four major ways to help prevent cancer:

  1. Avoid or control things known to cause cancer.
  2. Changes in diet and lifestyle.
  3. Finding precancerous conditions early. Precancerous conditions are conditions that may become cancer.
  4. Chemoprevention (medicines to treat a precancerous condition or to keep cancer from starting).

Let us take these items one at a time.

  1. Avoid or control things known to cause cancer.

Factors that are known to increase the risk of cancer:

  • Cigarette Smoking and Tobacco Use
  • Infections: HPV, Hepatitis B and C, Espstein-Barr virus, Helcobater pylori
  • Radiation: Ultraviolet sunlight, medical radiation, radon gas in homes
  • Immunosuppressive Medicines
  1. Changes in diet and lifestyle

Factors that may affect the risk of cancer:

  • Diet
  • Alcohol
  • Physical Activity
  • Obesity
  • Environmental Risk Factors: second hand smoke, asbestos, air pollution, pesticides, arsenic in drinking ware

Diet is anything we put in our mouths on a regular basis.

Diet is always a controversial subject. Media loves to talk about any new tidbit that comes out through research regarding diet.

Some studies show that fruits and non-starchy vegetables may protect against cancers of the mouth, esophagus, and stomach. Fruits may also protect against lung cancer.

Some studies have shown that a diet high in fat, proteins, calories, and red meat increases the risk of colorectal cancer, but other studies have not shown this.

It is not known if a diet low in fat and high in fiber, fruits, and vegetables lowers the risk of colorectal cancer.

According to American Cancer Society website www.cancer.org, here are the dietary guidelines to prevent cancer:

  • Be as lean as possible throughout life without being underweight.
  • Avoid excess weight gain at all ages. For those who are overweight or obese, losing even a small amount of weight has health benefits and is a good place to start.
  • Choose foods and drinks in amounts that help you get to and maintain a healthy weight.
  • Limit how much processed meat and red meat you eat.
  • Eat at least 2½ cups of vegetables and fruits each day.
  • Choose whole grains instead of refined grain products.
  • Avoid alcohol or drink no more than 1 drink per day for women or 2 per day for men.

T. Colin Campbell, PhD distills his 30 years of research on cancer and diet in “The China Study”. He concludes that a vegan diet minimizes the risk of all types of cancers as well as many other types of health risks.

For Physical Activity, American Cancer Society recommendation is for cancer prevention:

  • Exercise:
    • Adults: Get at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity each week (or a combination of these), preferably spread throughout the week.
    • Children and teens: Get at least 1 hour of moderate or vigorous intensity activity each day, with vigorous activity on at least 3 days each week.
  • Limit sedentary behavior such as sitting, lying down, watching TV, and other forms of screen-based entertainment.

Doing some physical activity above usual activities, no matter what one’s level of activity, can have many health benefits.

  1. Finding cancer or precancerous conditions early. Precancerous conditions are conditions that may become cancer.

Then there is the matter of “early detection and early cure.”

Cancer is a group of diseases that can cause almost any sign or symptom. The signs and symptoms will depend on where the cancer is, how big it is, and how much it affects the organs or tissues. If a cancer has spread (metastasized), signs or symptoms may appear in different parts of the body.

 Treatments work best when cancer is found early – while it’s still small and is less likely to have spread to other parts of the body. This often means a better chance for a cure, especially if the cancer can be removed with surgery.

A good example of the importance of finding cancer early is melanoma skin cancer. It can be easy to remove if it has not grown deep into the skin. The 5-year survival rate (percentage of people who live at least 5 years after diagnosis) at this early stage is around 98%. Once melanoma has spread to other parts of the body, the 5-year survival rate drops to about 16%.

Some symptoms, such as tiredness or coughing, are more likely caused by something other than cancer. Symptoms can seem unimportant, especially if there’s a clear cause or the problem only lasts a short time. In the same way, a person may reason that a symptom like a breast lump is probably a cyst that will go away by itself. But no symptom should be ignored or overlooked, especially if it has lasted a long time or is getting worse.

Most likely, symptoms are not caused by cancer, but it’s important to have them checked out, just in case. If cancer is not the cause, a doctor can help figure out what the cause is and treat it, if needed.

These days it is not that difficult to get one’s genome mapped and find out any cancer syndromes that might be present and actively take the necessary preventative actions.

The American Cancer Society recommends these cancer screening guidelines for early detection of cancer  for most adults. Screening tests are used to find cancer before a person has any symptoms.

  1. Chemoprevention (medicines to treat a precancerous condition or to keep cancer from starting).

Chemoprevention is the use of substances to lower the risk of cancer, or keep it from recurring. The substances may be natural or made in the laboratory. Some chemopreventive agents are tested in people who are at high risk for a certain type of cancer. The risk may be because of a precancerous condition, family history, or lifestyle factors.

Some chemoprevention studies have shown good results. For example, selective estrogen receptor modulators (SERMS) such as tamoxifen or raloxifene have been shown to reduce the risk of breast cancer in women at high risk. Finasteride and dutasteride have been shown to reduce the risk of prostate cancer.

Bottomline

Cancer is a genetic disease that may be the result of either mutated inherited genes or the ones occur later due to health, lifestyle and environment issues.  Only about 5 to 10% of the risk of cancer is due to mutated inherited genes.

Yes, healthy lifestyle choices we have been discussing in other blog posts do lead to decreasing the chances of cancer.  To minimize the risk of cancer:

  1. Be of Lean weight
  2. Eat clean with lots of fruits and vegetables and only sparing amount of white meats
  3. Avoid the use of alcohol or tobacco
  4. Avoid second-hand smoke, pesticides and other environmental carcinogens
  5. Stay active and exercise
  6. Get regular checkups and screening tests
  7. In case of any signs or symptoms, get a quick check up to rule out any cancerous or precancerous condition.

 

Your thoughts on this subject?

Would love to hear, learn and share information.

If possible, please do leave comment in the blog itself, so others can share and learn.

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 #27 – Eating for Optimal Health Part VI – Incorporate sufficient protein in your diet

02 Sunday Nov 2014

Posted by in Ideal Body Weight, Lean Mass, Living to 120, Nutrition, Optimal Health, Optimal Nutrition

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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 four of these principles. Today, let’s focus on the fifth principle: Incorporate sufficient protein in your diet. And, as usual without any fluff stuff, let’s get to it.

First, what are proteins and what is the big deal?

Proteins are the main building blocks of the body. They’re used to make muscles, tendons, organs and skin. Proteins are also used to make enzymes, hormones, neurotransmitters and various tiny molecules that serve important functions.

Without protein, life as we know it would not be possible.

Proteins are made out of smaller molecules called amino acids, which are linked together like beads on a string. The linked amino acids form long protein chains, which are then folded into complex shapes.

Some of these amino acids can be produced by the body, while we must get others from the diet. The ones we cannot produce and must get from our foods are called the “indispensable” (sometimes also called “essential”) amino acids.

Protein from animal sources such as meat, poultry, fish, eggs, milk, cheese, and yogurt provide all nine indispensable amino acids, and for this reason are referred to as “complete proteins.”

Proteins from plants, legumes, grains, nuts, seeds, and vegetables tend to be deficient in one or more of the indispensable amino acids and are called “incomplete proteins.”

So, how much protein do we need?

There are different opinions on how much protein we actually need.

Most official nutrition organizations recommend a fairly modest protein intake. Food and Nutrition Board of Institute of Medicine of the National Academies in their Dietary Reference Intakes (DRI) reference manual recommends 0.8 grams of protein per kilogram of body weight, or 0.36 grams per pound. This amounts to:

  • 56 grams per day for the average sedentary man.
  • 46 grams per day for the average sedentary woman.

These are clearly amounts below which nutritional deficiency will result. Interestingly, DRI reference manual does not specify any upper limit at which protein might be harmful, although there is quite a bit of discussion about adverse effects of taking too much of a specific amino acid.

Most experts agrees that protein needs depends upon a number of factors that include activity level, age, muscle (or lean) mass and current state of health. 

But still, how much?

The range seems to be from 0.5 gram to 1.0 grams per pound of body weight. In case one is overweight, it is recommended to use lean mass weight to calculate the protein need.

Most optimal health experts, such as Joe Dillon (The Joe Dillon Difference), Dr. Life (Life Plan), Bill Phillips (Body for Life) whose focus is on building optimal muscle mass, recommend amounts on the higher end of the range. That is, 1.0 or 1.2 grams per pound of body weight per day.

What are the best sources of protein?

The factors often discussed in terms of quality of protein are efficiency of absorption, and how “complete” the protein is, i.e., does it contain all indispensable  amino acids. Another important factor I believe is whether eating enough protein will bust your carbs, fats or calories budget.

Eating lots of breads may give you sufficient proteins but it will probably bust the carbs and calories budgets.  Also, eating lots of rich or fatty meats for sufficient protein will most likely bust your fats budget.

Joe Dillon offers the following hierarchy for selecting optimal sources of lean, quality protein (from highest to lowest):

  • 100% Whey protein isolate powder
  • Egg whites
  • Wild Game (venison, buffalo, elk, moose, etc.)
  • Salmon, Ahi Tuna
  • Turkey (white meat, dark meat, no skin)
  • Fish (all kinds)
  • Chicken (white meat only, no skin)
  • Shellfish (oysters, mussels, clams, lobster, shrimp, crab)
  • Nonfat Dairy (nonfat milk, nonfat cheese, nonfat cottage cheese, nonfat plain yogurt)

But how much of these foods should I eat?

Here is a quick guide:

  • 3 ounces of lean meat or poultry contain about 25 g of protein,
  • 3 ounces of fish contain about 20 g of protein
  • 1 cup of soybeans supplies about 20 g of protein.
  • 1 cup of yogurt is approximately 8 g,
  • 1 cup of milk is 8 g
  • 1 egg or 1 ounce of cheese contains about 6 g
  • One cup of legumes has approximately 15 g of protein
  • Cereals, grains, nuts, and vegetables contain about 2 g of protein per serving.

Bottom Line:

Still confused? May be this will help. Looking for optimal nutrition, this is what I am doing:

  1. Since I am interested in continuing to build my lean mass reserves, I decided to budget protein in the upper end of the range, about 1 gram per pound of my body weight. I weigh 161 plus minus 2 pounds these days, so 160 grams of protein per day is my target.
  2. I am a vegetarian, I assume I get about 10 to 20 grams from vegetables, legumes and eggs and egg whites.
  3. I supplement the remaining using shakes of whey isolates or whey concentrates and isolates mixed. That makes for shakes 4 to 5 times a day: breakfast, lunch, while going home from work, post-exercise and sometime before going to bed. If I ate meat, I will do just one or two shakes a day.

What do you think of this approach?

Do you feel that this simplifies the confusion about proteins?

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

Post #26 – Eating for Optimal Health Part V – Eat Only Healthy Fats and Fat Sources

27 Monday Oct 2014

Posted by in Living to 120, Nutrition, Optimal Health, Optimal Nutrition, 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 two posts, we discussed the first three of these principles. Today, let’s focus on the fourth principle: Eat only healthy fats and fat sources. And, as usual without any fluff stuff, let’s get to it.

How much and what types of fats one should for optimal health is definitely a very controversial topic. Let’s see if I can put this controversy in proper perspective and reach some workable conclusions in this post.

To make sure that we can intelligently talk about this topics without having to get a graduate degree in biochemistry, first some basic terminology. Lipids, triglycerides, fatty acids, essential fatty acids, fats, saturated fats, monounsaturated fats and polyunsaturated fats, trans fats, and oils are some common terms we need to understand to really talk about fats. Here are a layman’s definitions of these terms.

Lipids are group of molecules that are used by the body for storing energy, signaling, and acting as structural components of cell membranes. Lipids include waxes, triglycerides, and fat-soluble vitamins.

Triglycerides are lipids derived from glycerol and three fatty acids.

Fatty acids are made up of long chain of carbon hydrogen atoms and are important source of fuel for the body when metabolized. Based on the bond structures, fatty acids can be Monounsaturated, Polyunsaturated, Trans or Saturated.

If Polyunsaturated, based on where the double bonds are located on the chain, fatty acids can be omega-3, omega-6, omega-7 or omenga-9.

Essential fatty acids are those fatty acids that body cannot make. These are of two types: alpha-linolenic acid (an Omega-3 fatty acid) and linoleic acid (an omega-6 fatty acid)

Fats are a wide group of compounds whose basis is a fatty acid. Fats are called Monounsaturated, Polyunsaturated, Trans fats, or Saturated fats based on the structure of their corresponding fatty acid.

Oils are fats that are liquids at normal room temperature.   As you can see below, most oils and fats contain all three types of fats: saturated, monounsaturated, and polyunsaturated.

Oils and fat content

What most researchers seem to agree on?

  1. Trans Fats are bad – So, Crisco (or Dalda in India) is out. It is definitely bad for your health. Most people have already learned that and taken it out of their kitchens. But it is still quite prevalent for frying at home, baking pies and cookies and in processed food. In the US, since FDA has taken Trans Fats off of the Generally Regarded As Safe (GRAS) list, it is starting to disappear from processed and restaurant foods.
  2. Adding Essential Fats to your diet is good: While most people get sufficient Omega-6 in their diets they do not get enough Omega-3. So, adding alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) is good. Good sources of Omega-3 are fish, flax seeds and oil, safflor oil and Hemp. USDA recommends that at least 10% of the fat budget be Omega-3 fats.
  3. Small amount of saturated fats in diet is good: Saturated fats are needed for cell walls, hormone balance, cellular signaling and increasing HDL (the so called good cholesterol).

What is controversial?

  1. What percent of calories should come from fats: There are researchers who have demonstrated that by reducing the fat intake to 10%, you can dramatically change the lipid profile in the body, cholesterol, triglycerides issues can be totally eliminated, while significantly improving the health of cardio-vascular system (For example, see Prevent and Reverse Heart Disease by Caldewell Esselystyn, Jr. MD., The Perfect 10 diet by Michael Aziz, MD). However, to get to these levels for fat intakes, it means adopting vegan or almost-vegan lifestyle and that of course leads to the controversy.
  2. Whether to totally eliminate saturated fats from the diet: It is well-known that too much saturated fat leads to poor cardio-vascular health. However, very small amount of saturated fats are needed and found beneficial for cellular health, hormone balance and cellular signaling and increasing HDL. Controversy therefore comes when people arguing all or nothing approach to saturated fats.
  3. Fats vs. Carbs: When government and media started touting benefits of low fat diets starting in 1960’s and 70’s, people in the US started to replace their high (saturated) fat diets with low-fat high-sugar diet. If you look at any package in the grocery store, if it says, low fat, it usually means high carbs or sugars, or vice versa. This led to obesity and other issues. So, all this means sugars are bad, which means fats must be good, right?
  4. Trans Fats vs. saturated fats: Unfortunately, this controversy was created on purpose. Proctor and Gamble deployed a sales strategy to displace lards as saturated fats by Crisco vegetable shortening. This plot thickens, since P&G was the original funding source for American Heart Association. With 100 years of marketing behind it, there is got to be sufficient confusion prevalent.

Bottom line: So, what is one to do? Here is what I have decided to do, in pursuit of optimal health, based on the best current information I have:

  1. Keep fat intake to less than 15% of daily calories. So, for a 2000 calorie diet, 300 calories or 33 grams from fat in a day.
  2. Take four grams of fish oil and 2 grams of flax seed oil every day. One capsule with each meal or snack.
  3. Limit saturated fats to under  5% of daily calories. Most sources of fats, as we saw in the table above contain some saturate fats, so I don’t really need to add saturated fats, even if we do all the cooking with olive oil. Occasional egg yoke or dab of butter is okay. Since I am a vegetarian,  limiting saturated fats to under 5%is not a big issue. But if I were eating meat, I will have to eat very lean cuts of meat to be able to stay within this constraint.
  4. No Trans Fats.
  5. Manage all macronutrients, fats, carbs and proteins to make sure they all are in the optimal range.

What do you think of this approach?

Do you feel that this simplifies the confusion about fats and good/bad fats?

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