Health conditions for baby boomers and how to prevent and/or treat them

OSTEOPOROSIS: Despite the high level of physical fitness among baby boomers, an alarming number are afflicted with osteoporosis. The National Osteoporosis Foundation says 44 million American men and women aged 50 and older have either low bone mass or osteoporosis, and by the year 2020, that number will climb to about 61 million if bone health does not become a top priority in this generation. In fact, osteoporosis accounts for more than 1.3 million fractures in people over age 45 with both sexes losing 1 percent of bone mass each year after age 40. Osteoporosis is not just an American disease either. It is widespread around the world. According to the World Health Organization, as large populations age, osteoporosis will become more of a disease burden predominantly because of its risk for major fractures of the hip and vertebral bodies, which can cause serious debilitation and dependent lifestyle changes.

Causes: The causes of osteoporosis can be many and cumulative. Sedentary lifestyle and lack of bone-building exercise such as running or walking on pavement (the vibration/pounding of the foot hitting a hard surface stimulates bone mass to increase), smoking, a family history of low-density bone mass, estrogen decrease in women, androgen decrease in men, as well as the use of certain medications such as long-term corticosteroids and glucocorticoids (used to treat asthma and lupus), as well as thyroxine (used to treat hypothyroidism) can all contribute to developing osteoporosis. In addition, a higher number of baby boomers are likely to be vegetarians and have not adequately replaced calcium and/or vitamin D in their diet, which can set the stage for osteoporosis.

Who’s at Risk? The disease typically affects women more than men because the bone-protecting effects of estrogen are lost in menopause unless hormone replacement therapy (HRT) is instituted. However, osteoporosis is also an important concern for men over age 50 as well. In fact, according to a study cited in the Australian Family Physician Journal, osteoporosis is relatively underdiagnosed in men as it may not be considered a male issue whereas cardiovascular health and hypertension typically is. In a Spanish study, researchers found that bone thinning was high in men over 50 and is associated with lower testosterone levels in much the same way that osteoporosis in women is associated with lower estrogen levels. Treatments with the bisphonate class of osteoporotic drugs, specifically alendronate, along with calcium and vitamin D, along with supplementation of androgens (male hormones) were successful in improving bone density in the male skeleton, and preventing fractures and loss of height.

Prevention: Prevention of osteoporosis can be successfully accomplished by engaging in regular physical exercise, especially exercise that stimulates bone building like weight-lifting, running or walking on pavement, etc. Quitting smoking and cutting down on alcohol goes a long way to both prevent osteoporosis and help treat it. Specific supplements that can offset or prevent osteoporosis are calcium and vitamin D. Maintaining an adequate intake of calcium and vitamin D helps assure that osteoporosis will not develop. People need approximately 1,000 milligrams of calcium a day or 1,500 milligrams for postmenopausal women. Spending at least 15 to 30 minutes in the sun every day also helps the body manufacture usable vitamin D that aids the maintenance of good bone tissue. Drinking tea several times a day may also help prevent osteoporosis as research done at the University of Cambridge School of Medicine in 2000 revealed that tea drinkers have higher bone-mineral density than people who don’t drink tea. On his Web site, Cocoon Nutrition, naturopathic expert Stephen Heuer recommends taking cod liver oil daily as it supports proper mineral absorption and bone density. The National Osteoporosis Foundation also recommends everyone ages 50 and over have a bone mineral density test and/or a DEXA scan to assess your risk for fractures.

Treatments: Treatments for osteoporosis can be managed with estrogen replacement therapy (ERT), selective estrogen receptor modulator (SRMEs), vibration exercise (VE), bone-building physical exercise, cessation of smoking and excessive alcohol use, re-assessment of steroid use and dosage to treat chronic conditions, and an array of selective drug therapies. ERT is the most common treatment of osteoporosis and typically consists of replacing estrogen as postmenopausal osteoporosis in women is caused by the lack of estrogen. SERMs are derived from steroid hormones and have both estrogenic and anti-estrogenic properties according to the substance and the target tissue. Relative to bone tissue, SERMs have an estrogenic effect and protect bone mass. The drug Raloxifene currently in use for treatment of osteoporosis is a SERM. It increases bone mass by 1 percent to 3 percent, and after three years of therapy at the dose of 60 milligrams per day, it reduces the incidence of vertebral fractures by 30 percent to 50 percent and is approved for the prevention of vertebral fractures in post-menopausal women at increased risk. Vibration exercise is a new mode of exercising muscle that is touted as equivalent to a strenuous weight-training workout, building bone like weight training does. It involves passive exercise that is performed while standing on a vibrating plate for 12 minutes. Vibration exercise works by causing vigorous vibrations in the muscles, which then have to flex to “right” themselves. Doing this uses 100 percent of the muscle’s capacity and therefore, over time, makes it denser and more toned. Old-fashioned weight training, however, seems to be the bone-building method of choice. Weight training causes muscles to pull on and against bone, which in turn stimulates the bone to both retain their density and also grow more dense.

Drugs: Two classes of drugs for treatment of osteoporosis include biphosphanates and SERMs. The biphosphanates include risedronate, alendronate and pamidronate, which help the bones absorb calcium. The SERMs include the drug Raloxifene. Tamoxifen is also a SERM used in breast cancer treatment that may have some protective bone benefit. A different class of drugs that just became available in 2002 is teriparatide, or Forteo. Made from a parathyroid hormone, Forteo actually builds bone density as well as preserves bone density. Studies show Forteo significantly increases bone density in 90 percent of the men who were given daily injections of the hormone. Richard Bockman, M.D., Ph.D., from the Weill College of Medicine/Cornell University in New York, says, “Forteo is indicated for the treatment of postmenopausal women with osteoporosis who are at high risk for fracture. These include women with a history of prior fragility fractures.” He warns certain patients should not be treated with Forteo, including patients with Paget’s Disease of bone, pediatric patients, patients with a history of skeletal irradiation, and patients with bone metastases or prior history of bone cancers. Dr. Bockman also comments that, “The safety and efficacy of Forteo have not been evaluated beyond two years of therapy, consequently, treatment beyond two years is not recommended.”

THE AGING BRAIN: The brain starts to really show wear and tear by age 40 with increasing memory loss and cognitive decline including the inability to learn new concepts as quickly as in younger years. But, the brain starts to lose memory as early as age 18 with memorizing tasks becoming much more difficult by age 30. Even diseases typically thought of as geriatric concerns (Alzheimer’s and Parkinson’s) can start taking a foothold at age 50. Other neurological symptoms typically found in this age group include numbness and tingling in extremities, especially in people with diabetes, and headaches caused by stress, hormone changes or even a misaligned spine, or cervical disc disease with pinched nerves.

Is it Normal to Forget? Jeff Victoroff, M.D., from the University of Southern California, and author of “Saving Your Brain: The Revolutionary Plan to Boost Brain Power, Improve Memory, and Protect Yourself against Aging and Alzheimer’s” [Bantam Books, New York], has this to say about memory loss: “[Baby boomers] complain of forgetfulness and worry that it might be the first sign of Alzheimer’s. I have good news for them — the forgetfulness is normal and universal and usually does not interfere significantly with everyday functions until age 75 to 80. The bad news is that everyone will get Alzheimer’s if they live long enough”.

Preventing Brain Aging: There are a number of things that can be done to allay, lessen and/or prevent the symptoms of brain aging. Dr. Victoroff asserts that diet plays a big role in how well the brain functions short-term and maintains function long-term. In his book, “Saving Your Brain,” Dr.Victoroff says, “The American diet is almost perfectly designed to interfere with brain function and accelerate memory loss.” He reconstructs the traditional USDA food pyramid to reflect food choices and the amount that will keep the brain functioning optimally. He recommends red meat and eggs eaten rarely with whole grains like wheat, bulgur, buckwheat, potatoes and rice eaten the most, seven to eight times a day. At least twice a week, he recommends a fatty fish like salmon or sardines, and tuna be eaten in addition to drinking red wine one to five times a week. He also recommends taking 400 international units of natural vitamin E and maintaining aerobic fitness by brisk walking for at least 30 minutes a day.

Supplements: Important supplements found by researchers to support brain function are acetyl-l-carnitine, alpha lipoic acid, CoQ10, glyceryl-phosphorylcholine (GPC), melatonin and essential fatty acids (EFAs). A 2002 study (Liu, et al) published in the Proceedings of the National Academy of Science revealed that elderly rats given lipoic acid and acetyl-l-carnitine resulted in improved memory as well as reversed age-associated mitochondrial structural. With 95 percent of the brain’s function occurring in the mitochondria, the “power center” of the cell, researchers say it is a significant finding when a supplement is shown to have the ability to restore and/or enhance that power. CoQ10 is thought to be a mitochondrial energizer. It regulates the oxidation of fats and sugars and converts them into usable brain energy. Its superior anti-oxidant effects have been proven in clinical studies [Shults, et al, 2002] to slow down the progression of Parkinson’s disease. Another brain mitochondrial energizer is glyceryl-phosphorylcholine, or GPC. A review of the multiple effects of GPC in 13 clinical trials and 4,054 patients with varying brain disorders and impairments shows that GPC in doses of 600 to 1200 milligrams a day significantly improves a patient’s clinical condition in terms of memory and attention-deficit. Melatonin, an antioxidant, is manufactured in the pineal gland. It regulates the internal time clock of the body, keeping sleep cycles balanced. Many researchers feel melatonin holds the key to aging. When the pineal gland shrinks with age, less melatonin is manufactured. The normal sleep rhythms become disrupted, growth hormone release slows down, and the normal repair and regeneration of tissues that took place in younger years when melatonin levels were higher slows down and degeneration of tissues and organs occurs. Thus, aging begins. The typical dose of melatonin in the 50-plus age group is three milligrams to start with, increasing to six milligrams per day, taken 30 minutes before bedtime. Essential fatty acids are very important to brain function as the basic building blocks of the brain are docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which are essential fatty acids, with DHA being the most important. Studies on DHA have shown that supplementation in elderly rats decreased reference memory errors and working memory errors in younger rats. The hope is that supplementation in humans will have the same results.

THE AGING HEART: In middle age, the heart also begins to show the insults of younger years, displaying the damage that smoking, too much alcohol consumption, a sedentary lifestyle, and poor diet can do. Despite statistics that show baby boomers are more physically fit than previous populations their age, USA Today Health reported recently that baby boomers are “beginning to have heart attacks and strokes tilting the statistical scales and driving up cardiovascular deaths for the first time since 1980.” Nearly three out of four baby boomer’s restaurant meals are fast foods, and compared to the rest of the population, baby boomers are also less likely to read food labels than any other groups — factors that could contribute to high cholesterol levels. High cholesterol levels set the stage for coronary artery disease, heart attack or stroke from plaque-blocked arteries. According to the American Heart and Lung Association, smoking is one of the worst things you can do to your heart. It robs the heart and lungs of vital oxygen, which damages or kills heart cells that regenerate much more slowly, or not at all, in middle age. Alcohol, in large quantities, damages cardiac muscles by weakening them, decreasing pumping ability of the heart with a resultant condition of congestive heart failure.

Prevention: Heart attack and stroke can be prevented with lifestyle changes along with supplementation of certain drugs and vitamin therapies. In an interview with AgeVenture News Service, University of Michigan assistant research scientist, Marvin O. Boluyt, Ph.D., author of “Advances in Organ Biology,” instructs that if people want to know how to prevent heart disease as they age, they must know how the heart itself ages. He explains that it is a progression of conditions that weaken the heart rather than anything that occurs suddenly. By age 20, the human heart begins to slow by one beat a year. By age 30, the heart produces less of a key protein, SR calcium ATPase, that regulates the length of each beat so that the heart has to work harder on each beat to keep up its normal output. Boluyt goes on to explain that the heart changes in two ways — from normal wear and tear such as disease and hormonal natural changes such as the decrease in SR calcium ATPase. Boluyt believes that exercise and a healthy lifestyle can reverse and/or prevent some of the changes of the heart that occur such as the decrease in SR calcium ATPase. Regular exercise seems to boost the amount of SR calcium ATPase, which increases the reserve capacity of the heart that normally decreases with age. The better the reserve capacity of the heart, the better it is able to deal with sudden “insults.” In this way, exercise not only decreases the chances of having a heart attack but it increases surviving a heart attack.

Exercise Helps: To prevent heart disease, researchers agree that aerobic exercise (running, walking, swimming, bicycling, etc.) for one hour at least three times a week to strengthen heart and lungs, eating a healthy diet (low saturated/animal fat), and maintaining a healthy lifestyle (no smoking or excessive alcohol, six to eight hours of sleep a night) are mandatory for a healthy heart. Previously, it was thought that elevated stress levels played a large part in keeping a healthy heart. However, this may not be the case. According to the American Heart Association, current data does not support specific recommendations regarding stress reduction as a proven therapy for cardiovascular disease. More importantly, a clearer relationship does exist between cardiovascular disease and environmental and psychosocial factors such as job strain, isolation, and certain personality traits (type A, “hyper” personalities have a higher incidence of hypertensive heart disease). Preventing second heart attacks in patients is more successful if the patient’s environmental and psychosocial factors are addressed successfully rather than if the patient feels “stress” in relation to having the heart attack.

Vitamins and Supplements: Certain foods, vitamins and supplements can also help prolong a healthy heart. A 1995 study shows that drinking a glass of dark red wine a day improves heart health by decreasing ADP-induced platelet aggregation and increasing HDL (the good kind) cholesterol. More recent studies by researchers at University of California, Davis, have discovered saponins in the skin of dark blue/purple grapes that also contribute to red wine’s cholesterol-lowering properties. Saponins are also present in soy beans and peas. Resveratrol, another anti-oxidant present in dark red, blue grapes, has also recently been proven to not only cut cholesterol but fight general body aging as well. A 2003 Harvard Medical School study reported in “Nature” magazine (August 2003) on resveratrol experiments on yeast cells. Those treated with resveratrol lived 80-percent longer than the nontreated cells. The researchers had similar results on human cells with resveratrol. Thirty percent of the treated cells were able to withstand gamma radiation compared to 10 percent of the untreated cells. The findings in both studies imply that food and drugs that contain resveratrol will prolong the life of the cell. However, one does not have to drink red wine to get the benefits of resveratrol. Indeed, the American Heart Association cautions that too much wine (of any color) can raise triglycerides to a dangerous level as well as adding extra calories that may contribute to obesity, two of the heart’s worst enemies. Two important antioxidant supplements are CoQ10, which increases oxygen to the heart muscle, and vitamin E, which helps blood maintain a healthy viscosity and prevent clots. Folic acid normalizes homocysteine, a blood protein recently discovered to aggravate plaque buildup. The herbal supplement hawthorn berry is revered by alternative health practitioners as beneficial to heart function. It stimulates increased enzyme metabolism in the heart muscle and improves oxygen usage. Uses for hawthorn berry include dilation of coronary artery vessels, strengthening of heart muscles, and lowering blood pressure to name a few of its heart-helping properties.

Cutting calories while maintaining optimal nutrition has recently been proven to have a beneficial anti-aging effect on the heart as well. In a study led by University of Wisconsin-Madison genetics Professor Tomas A. Prolla and Medical School professor, Stephen Weindruch, middle-aged mice were put on a calorie-restricted diet, which caused “uptick” in their heart beats and function in old age. Caloric restriction, among other things, inhibited the genes involved in cell death and inflammation, suggesting that the heart cells of animals on a restricted calorie diet are healthier overall.

Other Measures: Other preventative measures include an annual heart check up including echocardiogram which can show dangerous blockages before they cause a heart attack, electrocardiogram which can detect abnormalities of heart rhythms — irregular rhythms can lead to sudden cardiac death; and a C-reactive protein level monitoring. C-reactive protein, or CRP, level testing can predict risk for heart attack even in people who don’t have other risk factors such as smoking, bad diet, or sedentary lifestyle. However, people with elevated CRPs and elevated cholesterol levels run a five-times higher risk for heart attack.

GENERAL BODY AGING: Middle age is the time when aging concerns include slowing metabolisms and hormone decreases which can result in weight gain, loss of stamina, and strength, as well as changing reproductive and sexual health. According to the American Medical Association, 56 million male and female baby boomers are living with heart disease, osteoporosis, arthritis or diabetes. Hearing loss (especially in those who frequently listened to loud music from booming speakers or even headphones) is common in the 45 to 64 age group with 10 million people suffering from the condition — higher than people over age 65 with hearing loss at 9 million.

The Body’s Reaction: While getting older is inevitable, the debilitating conditions and diseases of aging, may not be in the near future. A recent report published in the Proceedings of the National Academy of Sciences, Septemer 5, 2003, showed the human body has a built-in defect in its self-defense mechanism. The human body cannot defend itself, it seems, against mitochondrial DNA damage. Mitochondria are the “power centers” of cells that cause growth and activity in the cell. Aging cells constantly undergo genetic mutations, but are also constantly being repaired by DNA mitochondria. When this process slows down, or is blocked, the repair process either becomes less effective or does not occur at all and the effects of aging begin to be seen and felt as the damaged, or faultily repaired cell, replicates itself. The important aspect of this study is that the researchers found the biochemical “roadblock” that prevents the DNA repair enzyme from doing its job effectively, i.e., reaching the mitochondrial damage in aging cells. Finding this roadblock means that they can now devise a chemical process to open the roadblock within the cell and allow the repair enzyme to do its work in a “youthful” way.

Possible Treatments: Having reached middle age now, baby boomer medical and scientific researchers seek to prolong the strength and longevity of both their generation and future generations by finding medical treatments, drugs, supplements and other modalities that will mitigate or completely do away with the debilitating conditions of aging. Indeed, by the year 2003, entire institutes devoted to Anti-Aging, or Age-Management, Medicine have sprung up across America — the American Anti-Aging Society, the American Cenegenics Institute, and the American Association of Anti-Aging Medicine, to name a few. Entire departments of Anti-Aging Medicine attached to renowned medical schools around the country and world have come into being with more medical health care practitioners shifting their traditional practices to include more futuristic, preventative, anti-aging regimes. Alan Mintz, M.D., CEO of the Cenegenics Institute in Nevada, says: “The focus of Age Management Medicine is truly preventive medicine, regaining and maintaining optimal health and vigor. Our therapies are scientifically and evidenced-based and individually structured based on a full (patient) evaluation”. A large, and controversial, focus of anti-aging therapies surround supplementation of deficient hormones, including human growth hormone, or HGH. It is believed that when HGH levels decline, the human body begins to age, often times prematurely. Dr. Mintz has this to say about HGH and other hormone supplementation: “Most individuals over 35 need hormone supplementation including human growth hormone, sex hormones, thyroid, and possibly others. Life gets better when we have a full tank of gas. Hormone supplementation improves sexual desire and performance, increases energy and lean muscle, reduces body fat, improves cognitive function, and reduces the risk of disease. The goal is to return all of your hormones to the upper end of the normal range. Balancing your hormonal levels at the upper 25 percent of the normal range, the optimal range, is where success occurs. That is when we can achieve optimal health and vigor”.

Human Genome Project: Even the Human Genome Project, which is mapping the DNA of the human body, will play a pivotal role in anti-aging medicine. Ironically, the “double helix” of DNA was discovered during the baby boomer era, 1953, and turned 50 years old itself on April 25, 2003. It seems only fitting then, perhaps even providential, that as the Human Genome Project documents the structure of human DNA, so will researchers learn what physical and chemical changes causes human cells to age and how gene therapy (i.e., replacing defective genes with healthy genes through either cloning or chemical intervention) and stem cell therapy (regenerating defective organs and tissues with the cells of young, healthy tissues) can mitigate or bypass certain aspects of aging and/or disease entirely. Anti-aging medicine researchers have predicted that soon it will be commoplace for human beings to live 120 years and longer with many years spent in good, vital health and productive living.

CONCLUSION: It is conceivable, then, that baby boomers might just be pioneers in another area — the first generation of people in large numbers to live well past their 100th birthdays in good, and productive health. Dr. Mintz says: “Perhaps the most important message that we can give to the baby boomer generation and anyone interested in living healthy is not to do anything to shorten your life (bad lifestyle habits, nutritional habits, or exercise habits). The focused goal is to stay alive so we can take advantage of the new breakthroughs that will occur in the next 20 years. These breakthroughs will include things like stem cell therapy, the ability to prevent chromosome aging, gene replacement, and other concepts we have not yet developed.”

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