LONGEVITY
By Jim Duke
INTRODUCTION
At age 69, Father Time is telling me I'd best dedicate an issue to the problems of aging, especially since even the Journal of the American Medical Association dedicated their Oct. 22/29, 1997 issue to aging. As I heard on CNN News, 5:30 PM. May 24, 1998, the twentieth century was the century of the juniors, the next century will be the century of the seniors. And this senior citizen hopes to live to see that new century and millennium with the help of my herbal crutches. The only medicine I invariably take daily at age 69 is my celery seed extracts, my herbal alternative for allopurinol. While I haven't yet proved that the celery seed is hypouricemic (lowers levels of uric acid), I have been gout free in the two years when I abruptly switched from allopurinol to celery seed extract.
But less regularly and especially when I'm on the road, stressed and restaurant-fed, I have my regular travel kit of herbs, most devoted to problems more prevalent in the geriatric than the juvenile. In my carry-on suitcase, there's bilberry (for failing eyesight), echinacea and garlic (for failing immune system, needing a boost to help me avoid the bugs on the road), pygeum and saw palmetto (for failing prostate), cranberry a/o bearberry (for failing urethra) milk thistle (to spare a busy liver on the road), ginkgo (for failing memory), st.johnswort (in case all these failing systems of the geriatric lead me into a depression; so far; no), rosemary (for flagging CNS), turmeric, glucosamine and chondroitin (for failing joints), and sweet annie when venturing into malaria country. Yes, like some other geriatrics with a half dozen super pharmaceuticals. I have at least a half dozen herbs in my geriatric travel kit. I put a day's capsule assortment into individual baggies, one for each day on the road, so as not to travel with all 6-12 bottles.
-GERONTOLOGY-
Even though records indicate that older people have always existed in human societies, survival beyond age 50 for most members of a population was a rare event until this century. Today, 95 percent of all babies born in the developed world live past 50. Such unprecedented survival means that most of us will experience or at least witness senescence, that variety of physiological changes creeping up on me, that accompany the passage of time. Senescence on such a grand scale is new to the human race and may represent a unique phenomenon in the history of mankind. (Olshansky et al., 1998)
According to Banks and Fossel (1997), no one has ever lived more than 122 years. Although the mean human life span has been increased significantly during the last 2 centuries, the maximum life span has not. I think herbs help more than the hi-tech longevity studies (or starvation) JAMA reports here, "Several laboratories have successfully extended the maximum life spans of at least 2 multicellular species genetically (Drosophila and Caenorhabditis elegans) and several more by dietary restriction." Two gene mutations increase the maximum life span of C. elegans 6-fold), provoking the query of what might lie in store for clinical medicine. "Increased life span occurs predominantly through the genetic control of free radical metabolism." That doesn't exactly gives us free license to promote our antioxidants as life-extenders, but more people than JAMA have often said that oxidative damage is one of the most important causes of aging. Thus I will go so far as to say that antioxidants can slow the ravages of aging. I have always maintained that the synergistic mix of herbal antioxidants are better than any synthetic antioxidant, in the long run. That's what we geriatric longevity seekers are after. Synthetic antioxidants, like synthetic medicines, are not part of your evolutionary past and hence are much more likely to have serious side effects.
The number of Americans 65 or older has risen from 3,100,000 (4% of the US population) in the early 1900s to over 33,000,000 (nearly 13% of the population) in 1995. Over 17% of the American population will be elderly by the year 2020, and 42% of this group will be older than 75 years. The "oldest old"group ( 85 or older) will more than double in size by 2030 and will nearly double again by 2050. If current trends persist, longer life spans may be accompanied by poorer health-related quality of life.
(Clark et al., 1997)
Finch and Tanzi (1997) remind us that genes strongly influence the life-span and patterns of aging. "Who knows why humans live five times longer than cats, cats live five times longer than mice, and mice live 25 times longer than fruit flies or why the onset of Alzheimer's disease (AD) often differs by many years in identical twins." (Finch and Tanzi, 1997) Our society is experiencing unprecedented rates of survival into older ages, but this success has also been accompanied by a rise in frailty and disability in the general population. This is a consequence for which neither the medical community nor society was prepared as is witnessed by the ongoing national concern over crisis in the Social Security program, Medicare, Medicaid and health-care costs in general. The re-emergence of infectious and parasitic diseases we thought we had eradicated suggests that our species has far less control over the environment than we sometimes believe. The introduction of antibiotics in the 1940s may have actually accelerated the evolution of more-virulent strains of microorganisms which now prey on our species. (Olshansky et al., 1998)
Truthfully I believe that our herbal antioxidants like the green tea and olive-leaf antioxidants were made first to protect plants from oxidative damage. Almost all of the oxygen we breathe is produced by green plants in the process called photosynthesis, which not only makes the best foods and medicines, it also liberates oxygen. Photosynthesis only takes place in the green parts of a plant, through the magic of chlorophyll, the vegetarian analogue to hemoglobin. But in that process oxygen is generated, increasing their needs for antioxidant protection. That's why, my good reader, leaves are on average by far our best source of antioxidants. We borrow from the plants those phytochemicals that the plant needed to protect its living cells from oxidative damage.
Just as our eyesight fails, so do our senses of taste and smell, making food less appealing and hence making us less eager to eat and get the nutrition we need now, even more than before. In JAMA we read that losses of smell and taste, common in senior citizens, may result from normal aging, certain disease states (especially Alzheimer disease), medications, surgical interventions, and environmental exposure. Deficits in these chemical senses cannot only reduce the pleasure and comfort from food, but represent risk factors for nutritional and immune deficiencies..." Use of flavor-enhanced food can increase enjoyment of food and have a positive effect on food intake and immune status." "Flavor enhancement of foods for wasting patients has been used over the last 25 years to increase intake of nutrient-dense foods. Flavor amplification of food for elderly retirement home residents resulted in improved immune status."(Schiffman, 1997). Here again some of our antioxidant culinary herbs can spice up our appetites, our foods and our lives. Remember that those green leaves like parsley, sage, rosemary and thyme, not to mention celery, cilantro, marjoram, oregano, and savory are not only good for spicing up your foods if you senses are waning or jaded, but they are loaded with antioxidants. Small wonder oregano is getting so much press. Of seventy five mints I submitted for antioxidant analysis to French Scientist Dr. Lamaison, oregano was tops, even topping rosemary and sage, at least as far as that antioxidant test was concerned. (Lamaison et al., 1993)
Just as the synthetic drug for impotence, Viagra, was reporting sales of the millionth prescription, the fine print started spilling out in the same press that had been praising it for two weeks as the wonder drug. The press reported six deaths, mostly in males who were on nitroglycerine type drugs. These drugs tend to release nitric oxide, which is the mechanism by which Viagra increases blood flow to the corpus cavernosum.
-ADDICTION-
On the CBS morning show, June 4, 1998, Dr. Bernadine Healy noted that addiction to alcohol and prescription drugs was particularly prevalent in the elderly. Among elderly females, the largest single group using antidepressants and tranquilizers and the largest single group visiting the doctor's office, there is a 7% addiction to alcohol, and an 11% addiction rate for prescription drugs. Both kudzu and kava-kava might be useful at curbing the desire for alcohol or drugs, kudzu cutting the desire to drink in experimental animals by some 50%, and kava-kava serving more as an anxiolytic. The serotonin reuptake inhibition induced by St. John's Wort might well be worth a try. Among herbs suggested for addiction in Goldberg's massive book are:
1. Milk thistle to protect the liver of addicts.
2. "Blood cleansing" herbs like burdock, echinacea, licorice, wild oats.
3. "Decaffeinating" herbs like camomile, feverfew, and linden to help break
the caffeine habit.
4. Oats, long used to treat opium addiction and, more recently, smoking.
5. Siberian Ginseng to normalize cerebral neurotransmitters.
6. Natural tranquilizers like balm, skullcap, St. John's Wort, valerian,
and vervain.
7. Ayurvedic herbs like ashawagandha and gotu kola.
Dopaminergic foods like faba beans and velvet beans contain l-dopa which is converted into dopamine in the brain, possibly correcting cerebral dopamine deficiencies which sometimes aggravate addictions. The antidepressant herb St. John's Wort is also said to be dopaminergic
-ALZHEIMER'S-
What can be more depressing to the elderly population than a mate with Alzheimer's, which we covered in our last issue of this newsletter. But the aging issue of JAMA is where ginkgo was finally recognized as a good treatment for senile dementia, if not necessarily all Alzheimer's patients. Since we covered Alzheimer's so recently, I won't devote as much space to it as to the other problems of aging. I should mention one of the Alzheimer papers from JAMA's Aging Issue. It's nice to read in the hallowed halls of JAMA (Le Bars et al., 1997) that the ginkgo extract called EGb 761 is one popular plant extracts used in Europe to alleviate symptoms associated with a range of cognitive disorders. Its main effects seem to derive from its antioxidant properties, which require the synergistic action of the flavonoids, the terpenoids (ginkgolides, bilobalide), and the organic acids, principal constituents of EGb. Each of these acts as free radical scavengers Free radicals are often considered to be the mediators of excessive lipid peroxidation and Alzheimeran cell damage. The EGb extract contains several compounds believed to act synergistically on diverse processes involved in the homeostasis of inflammation and oxidative stress, providing membrane protection and neurotransmission modulation (Le Bars et al., 1997). Such may be ginkgo's effects on the CNS. Another green leaf, a whole suite of synergistic antioxidants, warding off antioxidant damage to the brain. The EGb761 extracts were standardized to 24% Ginkgoflavone-glycosides and additionally EGn761 had 6% terpenlactones (3.1% ginkgolides A, B, C, 2.9% bilobalide)
-ARTHRITIS-
Since our arthritis newsletter in 1997, there has been much positive press on the glucosamine and chondroitin. I found myself benefiting from this combination, following my knee going out on a Mayan Ruin. It was all I could do to get down from that pyramid in Belize. But a month of chondrotin and glucosamine had me believing that they had helped me start rebuilding the collagen cushion in the knee joint. I was also taking gelatin for the same purpose, and my usual herbal anti-inflammatory, celery seed. Others might fare better with other anti-inflammatory herbs: e.g. ashwagandha, bilberry, borage oil, boswellia, burdock, chamomile, cayenne, evening primrose oil, fenugreek, garlic, ginger, ginkgo, horse chestnut, licorice, pineapple, stinging nettle, turmeric and willow. Just as there are many pharmaceutical options for arthritis, there are also numerous herbal alternatives. What works for one person will not necessarily work for another. Some people seemed to be helped by avoiding the nightshade family, while others are clearly helped by the pain relief offered by topical or ingested capsaicin from cayenne, a member of the nightshade family. Matter of fact, those of us who have the time in the kitchen could concoct interesting antiarthrtitic juices and soups loaded with the foods and herbs listed above.
More recently, COX-2 inhibitors are being praised for their potential in arthritis and pain. Pennisi, E. 1998. Building a better aspirin. Science 280 (22 May, 1998); p 1191-2
Replacing willow and other natural salicylates, for the good or bad, happened almost a century ago. Aspirin first introduced 1899 (99 years ago) still relieves pain and soothes aching joints but at a cost, aspirin like most non-steroidal anti-inflammatory drugs may eat the stomach lining, causing bleeding or ulcers, and may damage the kidneys. They block cyclooxygenase-2 (COX-2) which promotes fever, inflammation and pain, but they are better at blocking COX-1, essential also for the health of kidney and stomach. As JAMA started stating in ads last year, COX-2 inhibitors may be the wave of the future. Today, NSAIDS constitute a $14 billion market. "(E)pidemiological data have indicated that aspirin and NSAIDs can protect against certain cancers and Alzheimer's disease, and recent laboratory results suggest that COX-2 inhibition is a key factor in these effectsî. Monsanto scientist compared its drug celecoxib with NSAIDs in 12,000 arthritics (they should have compared with my gingemeric, a mix of ginger and turmeric with a total of at least 6 natural COX inhibitors, to make sure that their synthetics were better and more selective than the naturals.) Monsanto's Philip Needleman, said celecoxib is "fully as efficacious as the NSAIDs"but didn't injure the gut. Pennisi warns as we have come to expect with new synthetics, long term side effects cannot be projected. Potential long-term negative side effects cannot yet be known. Gingemeric would probably be less likely to cause long term side effects as both herbs have been used in food for hundreds of years here, thousands of years elsewhere. (Pennisi, 1998)
-CANCER-
Astute readers of my Green Pharmacy may have noted that I give no herbal remedies for cancer there, but I do have a cancer prevention chapter there. The editors at Rodale apparently shared the belief of many physicians that cancer is too serious a disease for the herbalist. They did not want to include a chapter on herbal approaches to cancer. If you'll look at the layout for the Green Farmacy Garden (Issue___, New from the Herbal Village), you'll see that I do mention a few plants, mostly sources of hard core drugs, like the taxol from yew for ovarian cancer, the superstars vincristine and vinblastine from Madagascar Periwinkle for leukemia and Hodgkins' Disease, and the etoposide from mayapple for lung and testicular cancer.
One dietary and nutritional source of antiangiogenic activity is the legume family (e.g. NH's alfalfa, kudzu, licorice, red clover, and last but by no means least soy). Stakianos et al. (1997) say of soy's genistein that it is an important dietary component with many health-related and clinical benefits. Soy protein consumption is associated with a lower risk for several cancers. "(G)enistein, conjugated to an antibody to the CD-19 receptor, was highly effective in treating leukemia in a nude mouse in a model of pre-B cell human leukemia. . .(G)enistein, and to a lesser extent daidzein,, inhibits proliferative growth . .Both soy and genistein cause chemoprevention effects in vivo animal models of cancer. ...(I)soflavones (particularly genistein) are important contributors to the anticancer effect." In the concluding sentence of their abstract they say "Genistein is highly bioavailable in rats and because of its enterohepatic circulation may accumulate within the gastrointestinal tract". In their discussion: "Although genistein, like many therapeutic drugs used in the treatment of cancer, could be used in the pill form for delivery as a chemopreventive agent, its delivery in soy foods would be far more economical. Such a food delivery mechanism is used by southeast Asians who have the lowest breast and prostate cancer rates. . . and lowest cardiovascular disease risk among nations of the world." My liberal Translation: Genistein, highly available even orally, at least in rats, can help prevent and/or treat cancer, leukemia, and cardiopathy. if not osteoporosis, even when isolated from the soy. Natives of Asia (eating more bean sprouts, kudzu, mung bean and soy than we normally do) have the lowest rates of breast and prostate cancers and cardiovascular disease.
-CARDIOPATHY-
Exercise, good food, good herbs and weight loss, coupled with several of Nature's antiaggregant, antioxidant and hypotensive herbs can help reduce the incidence of cardiopathy in the elderly. Yes that sounds like what used to be called quackery but now is called alternative and/or complementary medicine. And let's take a quote from a very conservative trade magazine
How's this: Food Farmacy from American Medical News
"To our knowledge, there are no single pharmaceutical interventions capable of inducing simultaneous improvements in these cardiovascular risk factors" McCarron, DM et al., Jan 27,( as quoted in American Medical News, Feb 10, 1997. P. 10) 1997) A nutritionally balanced diet (17% fat, 62% carbohydrate, and 21% protein; meeting daily nutritional guidelines for the intake of sodium, fat, cholesterol, refined sugars, fiber and complex carbohydrates, fortified to meet at least 100% of the recommended dietary allowances for adults for moist nutrients except vit D (77%) and copper (91%)) benefits people at risk for cardiovascular disease (hypertension, dyslipidemia, or NIDM diabetes) and also improves quality of life
Noteworthy as antioxidant herbs are grapeseed, green tea, olive leaf, rosemary, and sage. Notable blood thinning herbs include garlic, ginger, ginkgo, saw palmetto, willow Notice: consult a physician before taking any of these if you are on a pharmaceutical blood thinner like coumadin or warfarin!!!.
Among the major hypotensive herbs are celery seed, garlic, and hawthorn.
Several herbs, especially in the carrot family, are well endowed with calcium-antagoinists, some as potent as verapamil; among them angelica, celery seed, dill, fennel, parsley e.g. This relatively new bit of information led me to propose a cardioprotective herbal beverage I call angelade.
ANGELADE (for the heart): Celery is close kin to the herb angelica which contains 15 calcium-antagonistic compounds. Celery has at least five calcium blockers: apigenin, bergapten (1-520 ppm); isopimpinellin (4-122 ppm); psoralen and xanthotoxin (6-183 ppm). Parsnip and parsley are even better endowed with the coumarin calcium-blockers. I'm not about to suggest ingestion of coumarins in foods as calcium-antagonists, just here to ask of our federal health watchers: would ANGELADE be as safe and efficacious and cheap as verapamil as a calcium blocker? It consists of juiced angelica, carrot, celery, fennel, parsley, and parsnip, all recognized food plants, cautiously mixed in with or chased with grapefruit juice. Might all this partially explain the lower incidence of cardiopathy in vegetarians? Celery contains hypotensive, hypocholesterolemic, and calcium-blocker phytochemicals. How about antiarrhythmic compounds? There's apigenin, apiin, magnesium, and potassium. Is heart of celery better for the heart than what your physician suggests? Would ANGELADE, with a wider variety of 6 vegetables be better? Methinks yes! But I'll probably never know. I'd bet however it would exhibit several more heartwise beneficial activities than would the silver bullet verapamil. Will grapefruit potentiate these natural calcium blockers like it does some of the synthetic calcium blockers, maybe even dangerously so? Nobody knows. We should know.
-CATARACTS-
Some 20% of the world's population are afflicted with cataracts, including about half the population over 75. Margolis makes it worse in the US; about 75% of people over 60 show some signs of cataracts. The prevalence of senile cataract is 4.5% in ages 52-64, 18% in ages 65-74, and 45.9% in ages 75-85. New data suggest that smoking causes 20% of US cataract cases. Smokers face an estimated 200% increased risk of developing a posterior subcapsular cataract - a visually disabling condition that strikes the back of the lens - and an estimated 100% increased risk of nuclear sclerosis cataract, a less serious form in which the opacity occurs in the center of the lens. (Science News 142:134, 1992). Murray and Pizzorno (1991) note that about 4 million people have some degree of sight-impairing cataracts, with at least 40,000 blind due to cataracts. Over 541,000 cataract extractions occur each year; over $3.5 billion are spent per year on these extractions and related doctor visits. This is largely a geriatric ailment, and many cases are caused or aggravated by oxidative damage, much of which could be reduced a bit by antioxidant herbs, again grapeseed, green tea, olive leaf, rosemary, and sage. But probably one of the best herbs for cataracts and several other degenerative eye disorders is bilberry. I think Heinerman (1994) is right in crediting bilberry or huckleberry juice and the anthocyanosides which occur generously in many members of the blueberry family, with many useful activities besides specifically cataracts. Purists who like the whole food or juice should also consider bilberry, which is so closely related to our blueberry, that most amateurs cannot tell them apart. The juicers might also consider aronia (chokecherry), cranberry, or huckleberry, or other bluish fruits like blackberries, grapes, plums and wild cherries. I take two 475 mg capsules, standardized at 25% anthocyanocides, at breakfast, and two at supper, chasing with water.
There's promising data on garlic (Allium sativum) and onion (Allium cepa), the latter one of our best sources of quercetin, especially in the outer portions of the bulb. Onion may share many of the biological activities reported for quercetin by Stavric (1994). It has been shown to help with diabetic cataracts (Buist, 1995). Put onions and/or garlic (both Biblical herbs with folk reputations for cataracts), on most of those dishes where you used to consider them optional.
What I call the ACES in the hole (previtamin A {beta-carotene}, vitamin C, vitamin E and Selenium) can apparently reduce cataract risk. People with low antioxidant blood serum levels are 4 to 5 times more likely to get cataracts than people with high status (USDA, VERIS) I have heard so many favorable reports of surgery that I would certainly resort to surgery were I diagnosed with serious cataracts.
-DIABETES-
Don't forget, good balanced diet, exercise, weight loss, when you reach for those herbal crutches. My colleague Dr. Leigh Broadhurst who has done a lot of primary research on diabetes will be in charge of the diabetes issue of this newsletter in the near future. Hence I will treat it only cursorily here today. One of the emerging superstars in the antidiabetic arena, is the bitter melon, Momordia charantia. Wherever I have traveled in the tropics, local folk have praised this herb for "lowering the sugar", alluding to its proven hypoglycemic activity. Few herbs have attracted as much interest as this food plant known both as balsam pear and bitter melon. Fruit juice, dried fruits a/o seed have proven oral hypoglycemic activity, due to several identified compounds, including one called p-insulin (p for plant). Werbach and Murray (1994) recommend 2 oz fresh juice or 100 ml decoction (Chop 100 g fresh fruit and boil in 200 ml water down to 100 ml). Bitter melon delayed the development of cataracts and other diabetic complications in rats. (Srivastava, 1993) Studies in Bilthoven suggest that only 5-10% of diabetes patients are insulin deficient, with most merely showing an increased resistance to insulin. There they use bitter melon as an insulin substitute in insulin-dependent diabetics. Research on the hypoglycaemic properties of Momordica was first published in India in the 1960s. In more recent trials a fall of 54% in blood sugar was achieved. In the 90% of cases where insulin resistance is the problem, treatment includes liver-cleansing agents such as dandelion and milk thistle.
Consider this short list of antidiabetic herbs as checklist on which we will expand with the Diabetes Issue, e.g balsam pear, cat's claw, chicory, celery seed, fenugreek, ginkgo, grapeseed, gurmar, licorice, stevia, and tea,.
Most of us on the run prefer the convenience of the standardized herbal extracts for reliable delivery of known biologically active compounds. But you might also enjoy on a leisurely day, after a half-hour's exercise, my diabetic bean soup recipe. I made my first formal diabetic soup just after Thanksgiving, 1995, having talked about it and modified it for half a decade now. First I boiled the exterior rings and husk of a whole onion, putting half of the meat of the onion in. Here I was hoping to capture some of the quercetin in the onion husks. Letting it steep to cool, I then removed the inedible portions of the onion and garlic, and added a 16 oz can of kidney beans (a dry, fresh or canned bean mix would have done as well). Then I added half a cup of some uncooked peanuts with their testae, and a quarter cup of fenugreek. Then I added 1/2 g of bay leaf, cinnamon, clove and turmeric, all demonstrated to have antidiabetic activity at the USDA (from here on I'll increase the turmeric adding curry powder, diminishing those sweeter spices, and I might be more sparing with the fenugreek). I added diced carrot for its 18% pectin, and its folkloric antiflatulent reputation. Then I simmered it for half an hour. I had it for supper and breakfast, but would have enjoyed it more with less cinnamon and clove, and more turmeric. Topped with capsicum and diced raw onions, I did enjoy this hypoglycemic soup.
-HIGH BLOOD PRESSURE-
We've covered this superficially up under cardiopathy, but we must repeat, exercise, good diet, good herbs and weight loss.
-INSOMNIA-
According to Lamberg (1997) "Nocturnal micturition, pain, and complaints of sleeplessness were cited by 70% of families and caregivers as the key factor in their decision to institutionalize an older person." Of 200 nursing home residents, they were rarely asleep for a full hour and rarely, if ever, awake for a full hour throughout the 24-hour day. While estrogen replacement therapy reduces hot flashes and improves sleep, fewer than 25% of women use it. And we read elsewhere that most of those on ERT are looking for natural alternatives. Women who do not suffer hot flashes, still experience more fragile sleep following menopause. Though sleep-disturbed breathing seems not to be age-related in men, it rarely occurs in women until after menopause. Sleep apnea may affect as many as 24% of community-dwelling and 41% of institutionalized geriatrics. Sleep disordered breathing may increase risk for cardiovascular and cerebrovascular problems and deaths. Though people over 65 comprise only 13% of the US population, they receive 30% of prescriptions for hypnotics. Drivers over age 60 using long-acting benzodiazepines - often prescribed for insomnia or anxiety - had 30% more injurious motor vehicle crashes than comparable drivers using short-term benzodiazepines or not taking such medications at all Of 43 healthy but sedentary adults 50 to 76 years old with moderate sleep complaints, those who exercised fell asleep faster, and reported higher sleep quality, gaining about an hour of sleep per day." (Lamberg, 1997)
-OBESITY-
Go, Geriatric, Go with that exercise. (But don't do it strictly for shedding pounds; see below) Russel and Mayer (1997) note that between 1988 and 1991, Americans gained an average of more than 3.6 kg, with an 8% increase in the prevalence of obesity. "Exercise increases energy expenditure but, in so doing, also reduces the risk of the incidence of obesity-related conditions: coronary artery disease, high blood pressure, non-insulin-dependent diabetes mellitus, colon cancer, and psychological depression." "...Risk for developing coronary artery disease by physical inactivity is as strong as that for smoking, high blood pressure, or high cholesterol."(Russel and Mayer, 1997) "Currently 22.5% of the U.S. population is considered to be clinically obese - compared to only 14.5% in 1980" (Taubes, 1998)
Obesity is not necessarily a disease of the elderly, but obesity aggravates almost all of the lethal problems of the geriatric. "Many studies have linked being overweight to increased risk for heart disease, diabetes, and cancerî, the big killers, leading C. Everet Koop "to declare an epidemic of obesity in the United States"(Wickelgren, 1998). It is estimated that fat people are costing citizens more than 70 billion in direct health care and indirect lost productivity. Americans spend 40 billion annually on weight loss, mostly in diet and dietary foods, an approach that is not working. Wickelgren and the scientists she quotes stress that exercise is the better half of valor. I'm researching this on my stationary bike, trying to ride the ten miles it'll take to burn off that small dish of ice cream I had following my vegetarian soup and salad. There is also evidence that high tryptophan products like evening primrose seed may lead to more serotonin in the brain, sending the same satiety signals that Prozac is alleged to send, telling your obese body that you are not still hungry. Exercise and a high fiber low fat diet, coupled with many of aloe, brindleberry, bitter orange, celery seed, chickweed, dandelion, evening primrose, garlic, guarana, gugulipid, mate, peppermint, and St. John's Wort can help those who are serious about losing weight
But No. Geriatric. Don't overdo it on the slimming. It may be too late to lose weight hoping to add years! Better you had never put on the weight in your youth. Geriatrics often drop back into nutritional deficiencies because of less interest in eating. If someone tells a 75-year old geriatric to lose weight to gain years, that geriatric could challenge them with quotes from Science. "The link between excess weight and increased risk of death apparently does not fold for the elderly." Scientists found no increase in the death rate as BMIs increased, even to very high levels, for subjects 75 or older. A number of prospective epidemiological studies have shown that weigh loss actually increases mortality. "(R)ecommending weight loss is often futile. . .(C)ritics of obligatory weight loss favor emphasizing a healthier lifestyle, including exercise and an improved diet. Last year, researchers reported that that participants in the Dietary Approaches to Stop Hypertension Trial could lower their blood pressure within 2 weeks by consuming more fruits and vegetables and less saturated fat. - without losing weight."(Wickelgren, 1998)
-OSTEOPOROSIS-
The more I read, the more I believe that several legumes especially those estrogenic-isoflavone containers like soy, kudzu, licorice, and red clover can help reduce the ravages of osteoporosis. Much that has been said positive about soy will apply to other food grade legumes. Soy protein, in addition to lowering cholesterol, may contribute to bone health. Urinary calcium excretion can be an indicator of bone mineral density and calcium balance. Some people blame the high rate of osteoporosis in the west on the hypercalciuric content of too much animal protein. Compared to animal protein, soy protein causes less urinary excretion of calcium. Isoflavones may also directly inhibit bone resorption. Many and more of those isoflavones can be found in several other species of more palatable legumes, thank goodness. And as Tori Hudson hints "Much like the drug Tamoxiphen has a beneficial effect on bone density with simultaneous anti-estrogenic effects in breast tissue, medicinal and dietary phytoestrogens may offer these same benefits. But Hudson cautions: evidence to support the use of botanical medicines that contain phytoestrogens for prevention and treatment of osteoporosis is currently theoretical."(They are effective in relieving some of the symptoms of menopause.; Hudson, 1997) And the following hints, as do several studies, that some of genistein's effects may be reversed with high doses. Anderson, Ambrose, and Garner (1995) concluded that low dose genistein (1 mg/day, but not high-dose {10 mg/day}) acts similarly to Premarin, administered orally at 5 ug/day in the feed for preventing bone loss in experimental rats.
On a more positive side, Holt stresses soy, while phaseoliphile (bean lover) Jim Duke thinks that many other legumes may be satisfactorily substituted for soy. "It is recognized that inclusion of soy protein in diets may promote calcium retention in the body. . .(A)nimal protein may tend to increase urinary calcium excretion, and increase uric acid excretion." Dietary isoflavones (daidzein, genistein, glycitein) "have been shown to be preventive and therapeutic in osteoporosis in controlled studies in animals and humans."(Holt, 1998)
And Stakianos et al.(1997) say "The soy isoflavone genistein . . .has recently emerged as an important dietary component associated with many health-related and clinical benefits. . .Much of this development occurred after the discovery that genistein is a potent and specific inhibitor of protein tyrosine kinase. . .As such it is considered to be an important modulation of many mitogen-stimulated signal-transduction events. . .Consumption of soy protein is associated with a reduction in the risk of several cancers . . and causes a reduction in serum hypercholesterolemia in animals and in humans...(B)eneficial effects of soy are due to isoflavones. . . (A) synthetic isoflavone, ipriflavone (7-isopropoxyisoflavone) has been successfully used in the treatment of postmenopausal and senile osteoporosis. Genistein administered in the diet also prevents bone loss."(Stakianos et al., 1997)
Kudzu (Pueraria spp): Hudson (1997) cites animal studies that daidzein and genistein, both better represented in kudzu root than in soybean, directly stop bone demineralization. Kudzu root reportedly contains 950 mg daidzein and 315 mg genistein cf 45 and 15 respectively for soybean (Kaufmann et al., 1997)
Stinging Nettle (Urtica dioica): As one of our best sources of the androgenic mineral boron, the folkloric aphrodisiac, and fluorine and as a good source of calcium and silica, stinging nettle may actually help osteoporosis thru both mineral and androgenic activity. Hudson (1997) notes that in vitro androgens, like testosterone (lower in postmenopausal women with osteoporosis), stimulate osteoblasts to differentiate and proliferate. Androgen derivatives like anabolic steroids, seem to increase bone density of the forearm, femoral diaphysis and vertebrae as well as elevate total body calcium. Their use may also be associated with protection against vertebral fractures. Patients on a mix of estrogen and testosterone showed increases in bone density (2.5-5.7%), while it remained unchanged in patients on just estrogen (Hudson, 1997). But if we are to believe that blocking the conversion of testosterone to DHT help prevent osteoporosis (a mild form of estrogenization), then we should also consider saw palmetto as a candidate for osteoporosis.
-SINUSITIS-
I was surprised to find sinusitis ranking 7th in AOA's geriatric survey. But like allergic rhinitis, asthma, and hay fever, sinusitis seems to be on the rise. There are several herbal crutches for sinusitis, most of them covered well by Yarnell (1998).
Coneflower (Echinacea spp) Yarnell's sinusitis formula includes as its most prominent ingredient Echinacea. His formula consists of 20% echinacea (angustifolia) root, 15% solidago shoot, 15% yerba mansa root, 10% sage, 10% eyebright, 10%horseradish. 10% ephedra(or 5% more each of sage and thyme), 5% bayberry bark and 5% thyme (1 tsp 3 x day, or ½ tsp 6x day for 4-5 days). (Yarnell, 1998). Yarnell (1998) notes that echinacea's proof is in for cold and flu, but not yet proof for sinusitis. But it's "immunologic effects are bound to be helpful for many sinus sufferers." Attributing most of the activity (other than immune stimulating ability) to ma huang, Yarnell notes that the alkaloids ephedrine and pseudoephedrine are perhaps the best known natural drugs for allergic rhinitis and sinusitis. "When used in isolation, ephedrine has many more potential side effects that whole ephedra, as had been confirmed in human studies." Functioning as an adrenergic agonist, ephedra is especially helpful with comorbid asthma or other chronic bronchospastic conditions. (Yarnell, 1998). Sad. The FDA seems poised to take this herb, used medicinally for some 60,000 years away from the herbalist and place reliance on the more risky silver bullet, prescription strength ephedrine. Ma Huang killed some 30 people last year, but mostly people who were abusing it. I don't know how many people were killed by prescription grade ephedrine, being used medicinally or being abused, but the potential for abuse is clearly there. It's another case though where the whole herb seems safer and gentler than the isolated silver bullet.
Elderberry (Sambucus spp): Studies in Israel demonstrate antiviral activity of elderberry flower extracts. That, coupled with the new phytotherapy book out of Germany (Schulz et al., 1998) leads me to add elderberry to the list of promising herbal alternative candidates for sinusitis. Surprisingly the proprietary Sinuset for Sinusitis (with 18 mg each elder flowers, European verbena, primrose flowers and sorrel, and 6 mg gentian root) is Germany's most commonly prescribed medication. Elder was approved by Commission E in 1994 for treating "acute and chronic inflammations of the paranasal sinusesî, available as coated tablets since 1968 or hydroethanolic extracts. In Germany elder flower tea uses 150 ml boiling water over 2 tsp (3 g) dried flowers steeped for 5 minutes and strain. Drink 1-2 cups quite hot. (SHT)
Garlic (Allium sativum): Dr. James Balch, MD, Urologist, and his wife Phyllis Balch, Certified Nutritional Consultant, teamed up to prepare a useful Presciption for Natural Healing (Avery Publishing Group, Garden City Park, NY, 1990) wherein they recommend garlic (2 capsules a day) for sore throat, adding that sore throat is typically an extension of the common cold, sinusitis, tonsillitis or some other viral infection. Surely onion and garlic should also belong in the same category. Dr. Jane Guiltinan, ND, Chief Medical Officer, Bastyr University in Seattle, like me, prefers food grade garlic to capsules or extracts. Garlic can improve the clinical status of AIDs patients fearing opportunistic infections, not the least among them sinusitis (Medical Herbalism {1 & 2}: p. 15, 1995). Hardy (1994) appropriately recommends garlic in the diet or in the capsule, noting that it is effective in bacterial infections. With my perverse affinity for alliterative license, may I suggest my SINUSOUP, an onion/garlic soup heavy with all the hot spices: chile, ginger, horseradish, mustard seed, pepper and turmeric.
Goldenseal (Hydrastis canadensis): Naturopaths (Murray and Pizzorno, 1991) state strongly that goldenseal is the most effective botanical for acute bacterial infection. Hoffmann suggests that the goldenseal, the double whammy for many infections, has anticatarrhal activity. Hoffmann recommends activities of three kinds, anti-catarrhal, antimicrobial and decongestant. Hoffmann suggests drinking a cup of tea every hour of 1 part each of echinacea, goldenrod, goldenseal, and marshmallow leaf. Naturopaths say the goldenseal activity is enhanced by combining with 250-500 mg bromelain from pineapple. Though I enjoy pineapple juice more than goldenseal, I'm still looking for the proof behind this.
Nettle (Urtica dioica) More studied for allergic rhinitis than sinusitis, anti-inflammatory nettle should also benefit the sinusitis, according Yarnell. I believe that nettle greens and pot-likker (the greenish broth or tea left after steeping the nettle in hot water) might be as useful as freeze-dried extract, but so far there have been no clinical trials here in the US, except on freeze-dried leaves. I'll provide 2 pounds of fresh leaves and 1 pound dried leaf to any physician interested in comparing the two in his/her rhinitic/sinusitic patients.
Sage (Salvia officinalis): Yarnell suggests the antimicrobial activities of thyme and sage, the latter containing compounds which arrest staphylococcus, a germ often involved in late sinusitis. Sage is also beneficial as an antisialogogue (drying secretions) (Yarnell, 1998)
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