Archive for July, 2007

10 Ways to Stay Young

You can slow down the Aging Clock, say scientists.

The Old Saying That “you’re only as old as you feel” turns out to have some scientific merit. As researchers at centres such as Tufts’ Jean Mayer USD Human Nutrition Research Center on Aging (HNRCA) probe the secrets of how we age, they continue to find ways in which our biologicalage influences our health and quality of life more than our chronologicalage. The good news is that, while you can’t turn back the calendar, you cando something to affect your biological age - the toll the years take on your body and your health.

To put it another way, your lifespan - how many years you live – is important, but perhaps not as much so as your healthspan: that period of your life when you’re functional and able to perform everyday life tasks for yourself. Isn’t that what most of us want more of in our lives - not merely years but good, independent, enjoyable years? One of the programs for slowing the aging process and adding strength and vitality to your life was laid out 15 years ago in the then-revolutionary book Biomarkers: The 10 Determinants of Aging You Can Control,by two Tufts professors, William J. Evans, PhD, and Irwin H. Rosenberg, MD, with Jacqueline Thompson. How well does that 15-year-old programme for controlling much of your own aging process stand the test of time? While research has of course added to our knowledge about all 10 of the “biomarkers” described in the book, the basic lessons still hold true today. As the authors note, “Our research and that of others, shows that people can reverse - or at the very least retard - many of the physiological declines associated with aging without turning their lives inside out and upside down.”

While diet fads have come and gone in the interventing decade and a half, and researchers have filled in many of the gaps in our know ledge of how the body ages, the bottom line of Biomarkersremains as true now as then: Exercise is the key to a healthy and rewarding old age. Even for the frail elderly - and this is still a bold concept - a regular exercise programme can have a strong positive health impact. A combination of regular aerobics, flexibility and strength training is the best strategy for retarding - even reversing ­ the effects of aging on the 10 biomarkers the authors identify. Since the publication of Biomarkers,subsequent research has continued to support this basic premise. Consider, for example, the research-based recommendations of the latest federal dietary guidelines, released last year. In addition to prescriptions for a healthy diet, the guidelines include goals for exercise, calling for a minimum of 30 minutes of exercise daily - and 60 minutes a day of moderate to vigorous exercise to keep from gaining weight. To lose weight, the guidelines suggest up to 90 minutes a day of physical activity, which could include walking, bicycling, hiking, even gardening. But 15 years ago, the idea that exercise could benefit even the frail elderly was still revolutionary. That’s only one of the many commonly held myths about aging that researchers at the HNRCA and other centres have dispelled. Aging does not have to be synonymous with illness or disability. The onset of most chronic degenerative conditions we associate with old age is governed by your genetic heritage - which you’re stuck with - and your lifestyle, which you can do something about. By making positive changes in your own biomarkers through a combination of exercise and eating right, you can:

  • Prolong vitality by slowing or even reversing the biological deterioration processes that people typically start to suffer after about age 45, such as declining strength, glucose intolerance and metabolism slowdown.
  • Postpone disability by reducing your risk of such chronic conditions as heart disease, type II diabetes, arteriovascular disease, hypertension and osteoporosis.
  • Prevent “sarcopenia” a common old-age malady that results in weakening of the body’s muscles, particularly in the legs, with a loss of muscle mass and replacement by fat. The ultimate price of this condition is loss of balance, reduced mobility and the frailty so often seen in the elderly.

“Biointervention” - making lifestyle changes that positively affect your biomarkers - won’t make you live forever, but it can postpone - sometimes by decades - your entry into what scientists call the “Disability Zone.” Instead of dropping sharply into disability with age, like rolling down a steep hill, an active lifestyle can help you slow and “flatten” that descent into decline.

A crucial first step toward making the lifestyle changes essential to extending your health span is under-standing these 10 biomarkers - each sensitive to your exercise and activity level - that determine your biological age:

1. Your Muscle Mass

The average middle-aged person’s problem is not excess weight as much as it is excess body fat coupled with too little muscle. Simply losing weight is the wrong goal; the key is changing your ratio of body fat (biologically inactive energy storage) to muscle (biologically active tissue). People with a greater ratio of muscle to fat enjoy a higher metabolism and don’t have to worry as much about gaining weight or about how much they eat - that active tissue burns more calories.

Most people’s muscle mass declines with age and the rate of loss accelerate after age 45. The amount of muscle you have - and that you retain - is determined in part simply by how much you use your muscles. If you use your muscles frequently, you can maintain their strength. But if you push your muscles to the limits of their capacity by exercise, you can actually increase their strength - no matter your age.

2. Your Strength

As you age, you lose whole “motor units” - sets of muscles and nerves that work together to make your body go. For example, between ages 30 and 70, it’s been estimated, people typically experience a 20% decrease in the number of motor units in the thigh.

Aging also brings a decline in “fast-twitch” muscle fibres - the kind you use to lift heavy objects or to do high­-intensity, sprint-type activities. This slows you down and partially accounts for age-related loss of strength.

But a decline in muscle strength and size is not inevitable. Landmark research at Tufts in the 1980s debunked the conventional wisdom that age somehow decreases the ability of muscles to benefit and get bigger fromstrength training, such as weight lifting. So don’t think that you’re “too old” forstrength training. The fact is that you can regain muscle mass and strength, no matter what your age, 18 or 80, or what shape you’re in now.

3. Your Basal Metabolic Rate (BMR)

This simply means the rate of your body chemistry - your metabolism - when you’re at rest (”basal,” as in “baseline”). Like other essential measures, your BMR declines with age and you burn fewer calories when your body isn’t in motion. From about age 20 on, every decade that you age reduces the amount of calories you need to maintain a constant body weight by roughly 100 calories. So a typical 70-year-old needs 500 fewer daily calories than a 20-year-old.

But if you keep eating the way you did when you were 20 - or even 40 - you’ll put on weight unless you start burning more calories. It can be a vicious cycle: too many calories, too little exertion, reduced musculature and a declining metabolic rate, all adding up to- more-fat. That’s why you need to exercise to increase your muscle and turn back the clock on your BMR.

4. Your Body Fat Percentage

Even if your body weight hasn’t gone up that much as you’ve gotten older, you’ve probably gained fat. As your musculature shrinks, fat tissue accumulates. Since muscle tissue weighs more than body fat, that number on your bathroom scale can be deceiving. Instead of focusing on losing weight, concentrate on gaining muscle and shedding fat.

While it’s not the same as your body fat percentage, your Body Mass Index (BMI) can still be a useful tool in measuring your risk fordeveloping the chronic diseases associated with aging. You can calculate your BMI with this formula:

BMI = Weight (in kgs) / (Height (in metres) X Height (in metres))

While BMI is often used as a shorthand measure of overweight or obesity, it’s important to recognize that your “ideal BMI” - the figure associated with the lowest risk of chronic disease or mortality - changes with age (see box alongside): For the elderly, a slightly higher BMI seems to be protective; think of elderly people you know who seem to be “wasting away” and are vulnerable to disease. Professional athletes can also get away with a higher BMI, because their body-fat levels are so low. The rest of us, though, need to watch it.

You should also watch your waistline, as studies have shown that the distribution of body fat may be an even better predictor of the risk of chronic disease and mortality. It’s healthier to be shaped like a pear ­with more body fat stored below the hips ­ than like an apple, with fat stored above the hips. Developing a pot belly, in short, increases your risk. Recently, researchers using data from the worldwide Inter-heart study found that waist-to-hip ratio was three times more effective than BMI in predicting cardiovascular risk. To figure your own ratio” simply divide your waist measurement by your hip I measurement; so, for example, a 36-inch waist and 40-inch hips would be a ratio of 0.9. Anything over 0.85 forwomen and 0.9 formen indicates greater risk forheart disease, according to these findings.

If you combinea high BMI with a high waist-to-hip ratio, your risk is magnified. This chart fromthe NHLB shows how risk forcardiovascular disease, type-2 diabetes I and hypertension increases as BMI and waist circumference grow.

So what can you do if you don’t like what this biomarker is telling you? The best way to attack excess body fat is a combination of exercise and moderate caloric restriction. By adding exercise to a “weight-loss” diet, you’ll maintain muscle mass while you lose fat tissue, raise your metabolic rate and, of course, burn more calories.

5. Your Aerobic Capacity

How much oxygen can your body process within a given time? That’s your aerobic capacity, forwhich you need healthy lungs, a strong heart and an effective vascular network. Here’s another biomarker that naturally declines with age in most people: In both men and women, aerobic capacity at age 65 is typically 30-40% less than in young adults. But older people who exercise regularly lose less of their aerobic capacity. Researchers have found, however, that while  both young and older people benefit from regular aerobic exercise - the kind that makes you  huff and puff - the positive changes in older, people come almost entirely in the muscles’ ability to utilizeoxygen (”oxidative capacity”), rather than in the heart of cardiovascular system. That’s another reason why you need strengthening exercises as well as aerobic activity: When you build muscle, you create more muscle cells to consume oxygen. The more demand foroxygen from your muscles, the greater your utilization of oxygen and your aerobic capacity.

6. Your Body’s Blood. Sugar Tolerance

“Glucose tolerance” means your body’s ability to control blood sugar (glucose). Aging takes a toll on your ability to use this sugar from your bloodstream, though you probably don’t realize it - like hypertension, impaired glucose tolerance displays no symptoms. By age 70, some 30% of women and 20% of men have an abnormal glucose-tolerance curve, increasing their risk of developing type-2 diabetes. This creeping blood-sugar intolerance can be among the most devastating changes associated with aging. While aging is one factor in the changing of your glucose metabolism for the worse, so are three factors you can control:

  • increased body fat
  • inactivity
  • a diet high in fat

Combining a proper diet, low in fat and high in raw vegetables and whole grains, with regular workouts can often transform what was previously an insufficient amount of insulin - which stimulates muscle cells to utilize glucose from the blood - into an adequate amount. Strength-training exercises are especially critical to reinvigorating your body’s glucose tolerance and lowering your diabetes risk; besides helping to lower body fat, strength-building exercise has been shown to increase your muscles’ insulin sensitivity.

7. Your Cholesterol/HDL Ratio

You probably already know that not all cholesterol in the blood is bad for you; that’s why you’ll often see HDL-cholesterol labeled “good” and LDL-cholesterol parenthetically explained as “bad”. So it stands to reason that a low totalcholesterol level offers no guaranteed protection against heart disease. Your goal, rather, should be to raise HDL-cholesterol while lowering LDL­ cholesterol levels in your blood.

An easy way to compute how you’re doing is to figure your total cholesterol/HDL ratio: Simply divide your total cholesterol number by your HDL count. For middle-aged and older men and women, the total cholesterol HDL ratio goal should be 4.5 or lower. As you age, your HDL level tends to remain constant, while the harmful components of blood cholesterol increase ­boosting your total cholesterol and thus your total cholesterol HDL ratio. You can work to lower the harmful LDL by changing your diet, especially by reducing the amount of saturated fat you consume. But dietary changes can significantly improve only one side of the equation; to boost your HDL levels, you need to also exercise and lower your body fat. Aerobic exercise in particular seems to be effective in raising HDL-cholesterol levels.

8. Your Blood Pressure

The importance of controlling your blood pressure should come as no surprise. What may surprise you is that an increase in blood pressure with age is not inevitable: Many populations around the world show no increase in blood pressure with age.

You can help defend against hypertension by reducing the salt in your diet. But regular, vigorous exercise can also help prevent and even treat high blood pressure.

9. Your Bone Density

With age, the mineral content of your bones declines, leaving you with a weaker, less dense, more brittle skeleton. On average, a person loses approximately I % of bone mass per year. When this loss reaches the point where your fracture risk is substantially higher, it’s called “osteoporosis,” a condition that can affect men as well as women. But osteoporosis isn’t an inevitable consequence of aging.

The effectiveness of calcium supplements against osteoporosis - the subject of a great deal of publicity in recent years - remains a matter of scientific inquiry. But there’s another way to fight osteoporosis that’s received less attention, even though it may be more effective, whatever your calcium intake: Exercise.

Early evidence of the importance of physical activity to bone strength came from studies of the effects of a lackof activity: Subjects who spent two weeks in complete bed rest showed as much bone calcium loss as ordinarily seen from a full year of aging - a 50-foldincrease in the normal rate of bone mineral loss. That accelerated loss stopped when bed-­rest patients were made to stand for some time every day, even if they didn’t walk, apparently simply from the effect of the stress of gravity on their bones.

Stress repeatedly placed on a bone causes it to grow stronger. A number of studies have shown that a prolonged span of weight-bearing exercise - such as walking or running - can reduce the rate of bone loss. Research at Tufts has further shown that exercise may help foster the body’s calcium absorption. The evidence strongly suggests, in short, that a brisk daily walk can be a crucial factor in preventing the development of osteoporosis.

10. Your Body’s Ability to Regulate Internal Temperature

Your body comes with a built-in thermostat, which works to cool you off by sweating when you’re hot or by shivering when you’re cold. But this important thermo-regulatory ability diminishes with age, due to a complex set of body changes:

  • Older people have a reduced sensation of thirst, so they often fail to replenish fluids lost by sweating.
  • Older people require a warmer internal temperature before they start sweating.
  • Reduced kidney function contributes to dehydration and thermoregulatory problems.
  • Lower fitness and aerobic capacity mean that older people have a lower rate of sweating.

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Add comment July 31st, 2007

Care For The Maturing Skin

Q Why does skin age so visibly?

A Skin aging is a natural and continuous process and our biological clock marks its time on our skin. How fast the signs will show is essentially dependent on our genetic factors or what doctors refer to as internal or intrinsic factors, which we have no control over, as well as on external or extrinsic factors, mainly because of sun damage. It begins in our mid 20’s. Within the skin, collagen production slows and elastin, the substance that enables the skin to snap back into place, has a bit less spring. There is loss of volume owing to changes of fat and lipids which comprise the structure of the skin. Dead skin cells do not shed as quickly and the turnover of new skin cells may decrease slightly, this creates the appearance of a dry, less radiant complexion as compared to our youth. But the visible signs of aging may take some years to show.

What we can cope with are the external or extrinsic factors. Sun damage owing to too much exposure to the sun’s UV radiation is the number one cause of’ premature aging. Dermatologists call it Photoaging. The environment plays havoc when the skin is unprotected and a comparison between the skin on the face, arms, hands and legs which are exposed, with the areas which are always covered like the torso, buttocks, etc. gives an indication of what damage is occurring. The more fair the skin, the more sensitive it is to the sun’s effect. The second most damaging factor that can well be controlled, is smoking. Smoking produces oxygen-free radicals that are known to accelerate wrinkles. When compared with a non-smoker’s skin, under the microscope, the early visible signs can be seen in smokers as young as 20. Those who quit smoking, even after many years of heavy smoking find their skin improves greatly in tone and complexion. To avoid those early wrinkles and early signs of ageing, do not begin smoking and if you are a smoker, quit.

Q What are the signs of skin aging?

A An evaluation of whether the skin is aging prematurely, as done by a dermatologist, is called a skin age analysis. It is based on two aspects:

I. Texture of the skin: This refers to the presence of:

  • Pigmentations which may be dark spots or patches. Basically an uneven, blotchy skin tone.
  • WrinkItes: Wrinkles are again classified under two heads:
  • Dynamic - The wrinkles that are visible when the facial expression changes, ego when one smiles or frowns, such as crow’s feet at the corners of the eyes, lines on the forehead, etc.
  • Static - The wrinkles that show even when the face is at rest.
  • Grooves: These are deep folds or lines running from the corner of the nose to . the comer of the mouth, or on the forehead. The cheeks sag and give these marked lines.
  • Fine lines: They are a precursor of the deep wrinkles that may form later.
  • Sagging skin: Owing to loss of volume and reduced elasticity of the skin, the cheeks droop.
  • Blemishes or what doctors call lesions: This refers to the presence of:
  • Freckles: These are dark irregular spots, often seen on very fair skin.
  • Telangiectasia: This is the technical name for the tiny blood vessels seen through the skin.
  • DPN/Seboreic keratosis: The wart like blemishes which are prominent.
  • Senile Comodones: These are also known as big black heads which commonly occur around the eyes. The total score under the 2 sections, texture and blemishes, will indicate whether the skin displays signs of premature aging or natural aging. The standard is; for under 30 years the score should be less than 12. If it is not within the acceptable range, it can be treated.

Q Are there any particular types of blemishes that appear with advancing age?

A Besides the blemishes mentioned above, one can observe a few others which are harmless, but do make many women anxious. These are:

IGH: These are tiny white spots that may appear anywhere on the skin. They never grow beyond 0.5 mm in size and are not an indication of leucoderma or any other disease.

Cherry angiomas: Tiny bright red spots that may appear on any part of the body. They too remain tiny, 0.5 to 1 mm in diameter and are not a cause of concern.

Senile purpura: A purplish blood clot which may be seen under the skin, even though there has not been any injury.

Solar elastosis: Pale yellow and thickened skin.

Sailor’s skin or farmer’s skin: As one might guess, it is the obvious sun burnt look which gives a leathery brown complexion to people engaged in these occupations.

Q would you please enumerate some simple steps to care for an aging skin?

A The daily routine of cleansing requires the proper toiletries.

  • For the face one should use a gentle face wash as our skin tends to get dry as we get older.
  • A non-drying soap is ideal for bathing and the skin should be promptly lubricated after a bath or shower, with a moisturizing body lotion or a drop or two of oil rubbed on the moist skin.
  • For an extremely dry skin, the use of lotions or creams containing urea or lactic acid is recommended.
  • At night, use an anti-aging cream for the face.
  • Sunscreens are essential if one is going outdoors in the day time. The sunscreen should block out both UV A and UVB radiation and have an SPF (Sun protection factor) factor above 15.
  • Wearing clothing that cover the arms and sunglasses are a good idea, if one does not want a suntanned look on one’s arms. Cotton is by far the best fabric to choose for a warm climate. Nothing can compensate for a healthy diet and lifestyle:
  • Eat a diet with plenty of fresh vegetables, fruits and whole grains. Use of healthy oils like olive oil, benefit the skin. Natural anti-oxidants in the diet are reflected in a glowing/healthy complexion.
  • Exercise daily: It keeps the blood flowing and this brings oxygen to the skin, an important ingredient for a healthy skin.
  • Quit smoking: Smoking increases wrinkles 5 times more than nonsmokers. Studies show that heavy smokers in their 40’s often have as many or more wrinkles as compared to non-smokers in their 60’s. In addition, the risk for squamous cell cancer is 50% higher than for non-smokers.
  • Reduce Stress: It shows on the face.

Q HOW useful are creams / lotions, etc. available in the market in preventing skin from aging fast?
A
AS mentioned above, moisturising creams have a definite effect on the skin. Their function is to retain moisture and prevent drying of the skin that gives a dull look.

  • Anti-aging creams con taining retinoids and hydroxyl acids (AHA) are quite effective in arresting or partially reversing photo-damage.

Q What treatment can a dermatologist offer to rectify excessive skin damage?

A The term “Skin Rejuvenation” is now applied to most facial rectifying treatments. As the words imply, the objective of these treatments is to give a younger look. They are put under 4 different headings beginning with the letter R:

I. RESURFACE

i. The simplest method is the application of creams, lotions, moisturisers, etc. containing retinoids, A I ph a hydroxy acid (AHA )

compounds and similar substances. The dermatologist can prescribe the correct combination to repair cell damage caused by UV radiation and smoking.

ii. The second method is to use dermatologic procedures such as:

  • Microdermabrasion: It involves the use of tiny, rough particles (aluminum oxide or sodium bicarbonate crystals) which are blown on the skin and vacuumed away using a special piece of equipment. It can reduce the size of the pores, create an even skin tone, smoothen fine lines, among other things.

Chemical peels: As the name implies, it involves peeling the skin with the use & of a chemical solution. When the outer .” layer of skin peels off, over a period of days a new skin forms to take its place. Depending on the skin condition, age of the patient and all other factors the dermatologist will determine the strength of the chemical solution to be used.

  • LASER: Laser treatment has many applications in dermatology. It is also used for reduction of wrinkles, lines and age spots by “resurfacing” the skin.
  • IPL (Intense Pulse Light): An alternative to laser skin resurfacing is electrosurgical resurfacing. This technique helps improving superficial to moderate skin damage.

II. RELA Botox injections are fairly well known now. It is particularly used to reduce frown lines and crinkles around the eyes. The purified protein derivative known as botox is injected below the skin into a particular facial muscle to relax it. The blocked nerve prevents crinkle or wrinkle lines from forming when the patient frowns or squints, giving a less harsh appearance. The procedure takes about 30 minutes, the effect lasts for 3 to 6 months.

III. REFILL: Fillers or substances resembling collagen are injected into areas such as the lines or folds below the cheek, lines on the forehead to fill up the grooves. The effects last up to 4 to 7 months.

IV. RESUSPEND OR LIFT: It involves using Radiofrequency, a Aptos threads to lift sagging cheeks.

Q What diseases are an aging skin susceptible to, ego cancer? What are the telltale signs?

A Skin cancers are fairly common in the very fair complexioned, white skin types. It is mostly seen in people over 60 years of age and it is linked to long-term damage from the effect of UVB radiation on the skin. 80% of skin cancers occur on the exposed parts of the body, commonly the face, neck, arms, and extremities. The common skin cancers (also known as cutaneous malignancies) are as follows:

Squamous Cell cancer: It is usually seen on the areas exposed to the sun like face, especially the ears, lips, nose, etc. A long-standing, non-healing ulcer, could be an indication. It is seen more in men than in women.

Basal Cell Cancer: It manifests itself as a lump or ulcer, which is slow growing. 65% of the skin cancers occur in people over 40 years of age. This cancer if properly excised (removed surgically) can be cured permanently.

Malignant Melanomas: The signs to look out for are a sudden increase in the size of a mole, or intense itching, bleeding or ulceration of an existing mole. We are fortunate in the complexion we Indians have. Our brown skin weathers the sun much better and wrinkles much slower than the white skin. Skin cancer too is less prevalent.


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Add comment July 5th, 2007


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