Healthy, Vibrant Aging – What Works?
Erica Goode, M.D.
"In ancient times, people understood universal energy and the numbers of heaven. They understood how to choose and control their diet. They knew what time to wake up and what time to go to sleep. They did not exhaust their minds and physical bodies. Their body and mind were harmonized, which meant they could live for over 120 years."
— Chi Po, Scholar to Huangdi, the Yellow Emperor of China
No one can say for sure what healthy aging is. With the average age of death advancing in the United States, the focus often shifts to quality of life, especially when illnesses emerge and we feel challenged to reconsider our relationship to our bodies.
One lovely example of a healthy older person is that of Belle,(5) a 109-year-old African-American lady from rural Texas who lived alone in a cabin without running water until the ripe old age of 100. At that time she moved into a Houston nursing home. She is lean, alert, amusing and reasonably active. She had none of the "advantages" in terms of supplements, skin creams, spa retreats, surgery and the myriad other "youth-enhancing behaviors" that many people pursue.
What we know about the characteristics of the healthy elderly comes from studies like that reported by Dr. Albert Rosenfeld,(17) who summarized the findings of a l990 survey of 1,200 centenarian Social Security recipients.
Dr. Rosenfeld said, "It was clear that, though these individuals worked hard and enjoyed their work, there was a marked lack of high ambition. They had tended to live relatively quiet and independent lives, were generally happy with their jobs, their families, and their religion, and had few regrets. Nearly all expressed a strong will to live and a high appreciation for the simple experiences and pleasures of life."
Another interview study conducted by Dr. Stephen Jewett as reported by Deepak Chopra(5), included 79 people of 87 years of age or more. Jewett found no particular "longevity personality" per se, and stated that subjects could be "selfish, sarcastic, and unsociable." The common threads were an ability to be self-sufficient, to possess a superior native intelligence, and a keen interest in current events, along with a degree of optimism and a good sense of humor. Subjects also had limited illnesses, maintained fairly steady weight through adulthood and engaged in moderate activity. None was preoccupied with death.
However, not everyone evolves with the equanimity of these subjects and many people face daunting challenges to healthy aging. Hence for most adults, the need for some health care maintenance and treatment is obvious. However, the raging debate in the 21st century between the longevity people (those advocating early use of growth hormone and multiple supplements) versus those who have serious doubts about the extension of life(14) misses the point. Many of us would prefer quality over extreme quantity.
Thousands of rigorous studies have been conducted that prove the beneficial effects of taking certain vitamins, minerals and herbs. While these studies may generate controversy among some of my more conservative colleagues, here is my list of recommendations for maintaining good health.
Weight Management
Weight should be maintained at plus or minus l0 percent of optimum. Weight changes should be made slowly and consciously through exercise and nutritious diets, which include high fiber, fruit and vegetables (organic if possible), some protein (range-fed animals are preferred if meat is eaten), ample liquids, limited saturated fat, no trans-fatty acids, adequate omega 3 (linolenic acid) fats, and two to five servings of red wine, red grapes or grape juice a week. Meals should be fairly regularly times and whole grains should be emphasized along with low or nonfat, certified, or organic dairy products. This may sound boring, but using cookbooks like Laurel's Kitchen, Chez Panisse Cooking or Whole Foods Cookbook, can make meal preparation and consumption exotic, delightful and healthy.
Eye Care
Macular degeneration is best avoided through the ingestion of lutein and other carotenoids derived from spinach, kale, collards and broccoli. Measurable improvement has occurred in patients with early advanced macular degeneration (AMD) who eat these foods. For cataracts, protection from ultraviolet rays, avoidance of tobacco, a diet rich in vitamin C and antioxidants protects the eyes as they age.(18)
Optimum Bone Density
Calcium (from dietary sources supplemented with calcium magnesium citrate capsules to a level of l,200 milligrams for men and 1,500 milligrams for post-menopausal women, plus adequate folate, vitamin B-6 and B-12 to avoid increased homocysteine (which interferes with collagen cross-linking) and weight-bearing exercise, is enough for healthy bone maintenance. With osteoporosis, etidronates for osteoclast blockade (Fosamax, Actonel), or the new teriparatide, an osteoblast stimulant (Forteo) are often necessary. Calcitonin is of less benefit. Toning several times a week helps improve arm and leg strength. Vitamin D at 400 to 800 international units (iu) a day is also recommended.
Skin Care
Avoid tobacco and stay out of the mid-day sun. Use sunscreens to protect against ultraviolet A and B wavelengths that produce glycation, collagen-elastin damage, and enhanced free-radical injury.(13) Retinyls such as Retin-A cream enhance apoptosis of aged cells. Nicholas Perricone, MD,(16) has developed both a vitamin C ester cream (which enhances collagen and elastin formation) and alpha lipoic acid cream, (which acts as an antioxidant). My favorite skin-care product for sunburn is aloe liquid from the aloe vera leaf, or 95 percent aloe gel. An inexpensive and effective brand is Lily of the Desert. Be warned, however, that this product does not protect against sunburn.
Cardiovascular Health
An excellent life-long anti-aging remedy for cardiovascular health is a diet rich in Omega-3 fats and low in saturated and trans-fatty acids. One and a half tablespoons of ground flax seed supplies approximately two grams of Omega-3 fats. Ground flax seed can be eaten in cereal, cottage cheese, salad, soup or yogurt and it tastes like wheat germ. It should be fresh ground seed or purchased in a vacuum-packed container and always refrigerated after opening.(10) Hawthorne leaves or flowers act as an inotrope in mild congestive heart failure (CHF).(14) The recommended dose is 100 milligrams twice a day.
Coenzyme Q-l0 is a normal component of cells but declines with age. Because it facilitates muscle metabolism and acts as an antioxidant, many studies have shown its benefit in the elderly, particularly post-myocardial infarction (MI) and pre-operatively for those undergoing cardiac surgery.(17) The recommended dose is l20 milligrams taken with meals containing some fat. Low dose aspirin has a proven track record for decreasing stroke and cardiac arrest through platelet inhibition in men and women. Willow bark may do this as well, but no standardized aspirin equivalent exists. To enhance circulation, ginkgo biloba at approximately 120 milligrams per day has been shown to improve brain circulation, and in some studies, to assist with claudication.(14) Folate (from a healthy diet or supplemented with the usual 400 milligrams found in an adult multivitamin), prevents harmful elevation of homocysteine levels. Red yeast rice, (not currently available in the U.S.) is an hydroxy-3-methl-glutaryl-coenzyme A (HMG–CoA) reductase inhibitor used by the older Chinese in several provinces prior to it's development as Mevacor, Lipitor and other drugs in this class.
Vitamin E (400 iu mixed tocopherols) despite "iffy" studies, is very likely cardio-protective.C A large hypertension trial showed that adequate dietary calcium, magnesium, potassium and omega-3 fats all are useful in maintaining normal blood pressure.(10)
Digestive System Health
Ample fiber — both water-soluble and insoluble — ample liquids, vegetables, and fruits, and adequate, balanced calcium and magnesium helps to keep the digestive system eliminating properly. If this doesn't keep bowels soft, two to three teaspoons a day of aloe liquid will. Epidemiological studies have shown a statistical reduction in colon carcinoma in those taking low-dose aspirin and adequate dietary calcium.
Joint Care
Glucosamine sulfate may be insufficiently produced or otherwise interfered with in people who develop osteoarthritis. A dose of l,500 milligrams a day can help significantly with pain, stiffness and possibly osteoarthritic progression. Omega-3 fats (flaxseed, eicosopentanoic acid (EFA)and decosa hexanoic acid (DHA), all suppress inflammation. Some patients find further pain relief from the gamma linolenic acid found in borage, evening primrose, or black currant seed oils.
Finally SAM-e (s-adenosyl methionine) at 400 milligrams to 1,200 milligrams a day often helps joint or tendon pain and inflammation. It must be an individually foil-wrapped product, such as that by Nature Made, Natrol or Twin-Lab, and must be taken with water. I advise taking SAM-e in the early morning, even a few minutes before breakfast, as some people experience sleep delay if it is taken in the evening.
Brain Functioning
Lecithin in 1,200 milligram capsules acts as an acetylcholine source. In some people it is apparantly transported across the blood brain barrier. Ginkgo biloba at 120 milligrams to 80 milligrams per day of the flavonoglycoside extract enhances brain circulation. SAM-e provides a notable mood improvement. It is my experience that this is true for roughly 40 percent of mildly depressed patients. SAM-e is a normal component of cells, so we infer that suboptimal production of this substance leads to mood disorders.
Muscle Maintenance
Muscle function is sometimes compromised due people losing large amounts of weight, experiencing poor digestive absorption, or following a prolonged illness, including CHF. Carnitine, which is often limited in these debilitated individuals, facilitates muscle access to intracellular fats for contractility and can be supplemented in the range of one gram twice per day. Following vigorous exercise, micro-tears and inflammation occur routinely, but symptoms can be relieved by pre-and post-exercise and taking 800 to 1,000 international units of vitamin E for two days.(20) Mixed tocopherols are best, and several brands are available. Carnosine, a putative membrane-protective antioxidant, also is helpful in some older individuals beginning an exercise program.(10)
Prostate Health
Prostate size almost universally increases in older men and may cause delayed stream, nocturia and sleep-disruption. It can be significantly improved through the intake of saw palmetto (Serenoa repens.(3) The recommended dose is l60 milligrams once or twice per day.
Immune System
Optimal immune system functioning is supported broadly by the aforementioned healthy diet, plus zinc supplements of 15 to 30 milligrams a day to enhance T-cell function.(4) I generally recommend a good multivitamin/mineral capsule with 10 milligrams or less of iron, for everyone over the age of 50. Several components help with immune and other physiological system functions.(9)
Finally, on an intriguing note, since 1998, increasing research has demonstrated the gene for telemerase, which maintains and rebuilds telomeres. In normal aging with each replication of a gene, the ends of the DNA molecule tend to shorten. This is thought to be primse reason for aging. These studies may eventually lead to meaningful prolongation of healthy cell lines in humans.(8)
If stem cell research is freed up politically we may indeed make major strides in the business of anti-aging remedies. Stem cell research also could provide retinal cells, chondrocytes, and possible relief for Parkinsons' disease and other afflictions.
A final quote from one of the oldest humans, ever:
"I had to wait 110 years to become famous, and I intend to enjoy it as long as possible." — Jean Calment, age 120
Erica T. Goode, M.D., MPH, nutrition, works with patients with a variety of nutritional and medical illnesses at the Institute for Health and Healing at CPMC in San Francisco. She teaches in the department of family and community medicine at UCSF.
References
Bidlack, WR. Nutritional requirements of the elderly, Morley, J.E, Geriatric Nutrition: a comprehensive review, Raven Press, N.Y., 1991.
Evans W, Rosenberg, I. Biomarkers: The l0 determinants of aging you can control, Simon-Schuster, N.Y., 1992.
Braeckman, J. The extract of serenoa repens in the treatment of BPH, Curr Ther Res 55: 776-785, 1994.
Chandra, RK. Nutrition, an important determinant of immunity in old age, Pro Clin Biol Research, 326:321-327, 1990.
Chopra, Deepak, Ageless Body, Timeless Mind. Crown Publ, N.Y. 1993.
Dawson-Hughes, B, et al. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years and older, NEJM, 337: 701-702, 1997.
DeSmet, P, Herbal remedies, NEJM, 347: 2046-2056, 1902.
Fossel, M., Reversing Human Aging, Morrow-Avon, 1996.
Gershwin, M, et al. Trace minerals, aging, and immunity, J Am Geriatrics Soc, 31: 374-378, 1983.
Hypertension trials, Phase I, Calcium, magnesium , KCl, Fish oil, JAMA 267: 1213, 1992.
Kaplan, GA. Epidemiologic observation on the compression of morbidity:evidence from the Alameda County Study, J Aging Health, 3: 155-171, 1991.
Morley, J.E., Nutritional status of the elderly, Am J Med 81:680-688, 1986.
Murad, H. The effect of an oral supplement containing glucosamine, amino acids, minerals, and antioxidants on cutaneous aging:a preliminary study, J Derm Treatment, 12:47-51, 2001.
Murray, M., Pizzorno, Journal Encyclopedia of Natural Medicine, 2nd edition, Prima Publ, 1997.
Olshansky, S.J., Hayflick, L., Carnes, B., No truth to the fountain of youth, Scientific American, 92-95, 6/02.
Perricone, N., The Wrinkle Cure, Warner Books, 2001.
Rosenfeld, A., Prolongevity II, Harper Collins, 1992.
Seddon, J., et al "Dietary carotenoids, Vitamins A,C,E, and advanced age—related macular degeneration, JAMA 272: 1413-1420, 1994.
Stuerenberg, H., "Concentrations of free carnosine (a putative membrane-protective antioxidant) in human muscle biopsies and rat muscles" Arch Gerontol Geriatrics 29:107 – 113, 1999.
Tufts Newsletter 20 g. 3, 5/02.
Additional Resources:
A. Buck Center for Research in Aging, 505 A. San Marin Drive, #300, Novato, CA 94945. (415) 899-1800.
B. Established Populations for Epidemiologic Studies for the Elderly, East Boston, Mass., Iowa and Washington Counties in Iowa and New Haven, Conn.
C. Gladstone Foundation for Lipid Disorders. Tom Bersot, MD, PhD, Director.
D. National Center for Complementary and Alternative Medicine (CAM), Bethesda, MD, 20892. Stephen E. Strauss, MD, Director.
E. National Institute on Aging. Richard Suzman, MD, Director.
F. New England Centenarian Study. Thomas T. Peaes, MD, Director.
G. UCLA School of Medicine, Dept. of Nutrition. Daniel Heber, MD, Director.
H. USDA Human Nutrition Research Center on Aging, Tufts University. Tom Evans, MD, Chief, Human Physiology Lab. Irwin Rosenberg, MD, Director.
http://www.sfms.org/sfm/sfm203b.htm
"In ancient times, people understood universal energy and the numbers of heaven. They understood how to choose and control their diet. They knew what time to wake up and what time to go to sleep. They did not exhaust their minds and physical bodies. Their body and mind were harmonized, which meant they could live for over 120 years."
— Chi Po, Scholar to Huangdi, the Yellow Emperor of China
No one can say for sure what healthy aging is. With the average age of death advancing in the United States, the focus often shifts to quality of life, especially when illnesses emerge and we feel challenged to reconsider our relationship to our bodies.
One lovely example of a healthy older person is that of Belle,(5) a 109-year-old African-American lady from rural Texas who lived alone in a cabin without running water until the ripe old age of 100. At that time she moved into a Houston nursing home. She is lean, alert, amusing and reasonably active. She had none of the "advantages" in terms of supplements, skin creams, spa retreats, surgery and the myriad other "youth-enhancing behaviors" that many people pursue.
What we know about the characteristics of the healthy elderly comes from studies like that reported by Dr. Albert Rosenfeld,(17) who summarized the findings of a l990 survey of 1,200 centenarian Social Security recipients.
Dr. Rosenfeld said, "It was clear that, though these individuals worked hard and enjoyed their work, there was a marked lack of high ambition. They had tended to live relatively quiet and independent lives, were generally happy with their jobs, their families, and their religion, and had few regrets. Nearly all expressed a strong will to live and a high appreciation for the simple experiences and pleasures of life."
Another interview study conducted by Dr. Stephen Jewett as reported by Deepak Chopra(5), included 79 people of 87 years of age or more. Jewett found no particular "longevity personality" per se, and stated that subjects could be "selfish, sarcastic, and unsociable." The common threads were an ability to be self-sufficient, to possess a superior native intelligence, and a keen interest in current events, along with a degree of optimism and a good sense of humor. Subjects also had limited illnesses, maintained fairly steady weight through adulthood and engaged in moderate activity. None was preoccupied with death.
However, not everyone evolves with the equanimity of these subjects and many people face daunting challenges to healthy aging. Hence for most adults, the need for some health care maintenance and treatment is obvious. However, the raging debate in the 21st century between the longevity people (those advocating early use of growth hormone and multiple supplements) versus those who have serious doubts about the extension of life(14) misses the point. Many of us would prefer quality over extreme quantity.
Thousands of rigorous studies have been conducted that prove the beneficial effects of taking certain vitamins, minerals and herbs. While these studies may generate controversy among some of my more conservative colleagues, here is my list of recommendations for maintaining good health.
Weight Management
Weight should be maintained at plus or minus l0 percent of optimum. Weight changes should be made slowly and consciously through exercise and nutritious diets, which include high fiber, fruit and vegetables (organic if possible), some protein (range-fed animals are preferred if meat is eaten), ample liquids, limited saturated fat, no trans-fatty acids, adequate omega 3 (linolenic acid) fats, and two to five servings of red wine, red grapes or grape juice a week. Meals should be fairly regularly times and whole grains should be emphasized along with low or nonfat, certified, or organic dairy products. This may sound boring, but using cookbooks like Laurel's Kitchen, Chez Panisse Cooking or Whole Foods Cookbook, can make meal preparation and consumption exotic, delightful and healthy.
Eye Care
Macular degeneration is best avoided through the ingestion of lutein and other carotenoids derived from spinach, kale, collards and broccoli. Measurable improvement has occurred in patients with early advanced macular degeneration (AMD) who eat these foods. For cataracts, protection from ultraviolet rays, avoidance of tobacco, a diet rich in vitamin C and antioxidants protects the eyes as they age.(18)
Optimum Bone Density
Calcium (from dietary sources supplemented with calcium magnesium citrate capsules to a level of l,200 milligrams for men and 1,500 milligrams for post-menopausal women, plus adequate folate, vitamin B-6 and B-12 to avoid increased homocysteine (which interferes with collagen cross-linking) and weight-bearing exercise, is enough for healthy bone maintenance. With osteoporosis, etidronates for osteoclast blockade (Fosamax, Actonel), or the new teriparatide, an osteoblast stimulant (Forteo) are often necessary. Calcitonin is of less benefit. Toning several times a week helps improve arm and leg strength. Vitamin D at 400 to 800 international units (iu) a day is also recommended.
Skin Care
Avoid tobacco and stay out of the mid-day sun. Use sunscreens to protect against ultraviolet A and B wavelengths that produce glycation, collagen-elastin damage, and enhanced free-radical injury.(13) Retinyls such as Retin-A cream enhance apoptosis of aged cells. Nicholas Perricone, MD,(16) has developed both a vitamin C ester cream (which enhances collagen and elastin formation) and alpha lipoic acid cream, (which acts as an antioxidant). My favorite skin-care product for sunburn is aloe liquid from the aloe vera leaf, or 95 percent aloe gel. An inexpensive and effective brand is Lily of the Desert. Be warned, however, that this product does not protect against sunburn.
Cardiovascular Health
An excellent life-long anti-aging remedy for cardiovascular health is a diet rich in Omega-3 fats and low in saturated and trans-fatty acids. One and a half tablespoons of ground flax seed supplies approximately two grams of Omega-3 fats. Ground flax seed can be eaten in cereal, cottage cheese, salad, soup or yogurt and it tastes like wheat germ. It should be fresh ground seed or purchased in a vacuum-packed container and always refrigerated after opening.(10) Hawthorne leaves or flowers act as an inotrope in mild congestive heart failure (CHF).(14) The recommended dose is 100 milligrams twice a day.
Coenzyme Q-l0 is a normal component of cells but declines with age. Because it facilitates muscle metabolism and acts as an antioxidant, many studies have shown its benefit in the elderly, particularly post-myocardial infarction (MI) and pre-operatively for those undergoing cardiac surgery.(17) The recommended dose is l20 milligrams taken with meals containing some fat. Low dose aspirin has a proven track record for decreasing stroke and cardiac arrest through platelet inhibition in men and women. Willow bark may do this as well, but no standardized aspirin equivalent exists. To enhance circulation, ginkgo biloba at approximately 120 milligrams per day has been shown to improve brain circulation, and in some studies, to assist with claudication.(14) Folate (from a healthy diet or supplemented with the usual 400 milligrams found in an adult multivitamin), prevents harmful elevation of homocysteine levels. Red yeast rice, (not currently available in the U.S.) is an hydroxy-3-methl-glutaryl-coenzyme A (HMG–CoA) reductase inhibitor used by the older Chinese in several provinces prior to it's development as Mevacor, Lipitor and other drugs in this class.
Vitamin E (400 iu mixed tocopherols) despite "iffy" studies, is very likely cardio-protective.C A large hypertension trial showed that adequate dietary calcium, magnesium, potassium and omega-3 fats all are useful in maintaining normal blood pressure.(10)
Digestive System Health
Ample fiber — both water-soluble and insoluble — ample liquids, vegetables, and fruits, and adequate, balanced calcium and magnesium helps to keep the digestive system eliminating properly. If this doesn't keep bowels soft, two to three teaspoons a day of aloe liquid will. Epidemiological studies have shown a statistical reduction in colon carcinoma in those taking low-dose aspirin and adequate dietary calcium.
Joint Care
Glucosamine sulfate may be insufficiently produced or otherwise interfered with in people who develop osteoarthritis. A dose of l,500 milligrams a day can help significantly with pain, stiffness and possibly osteoarthritic progression. Omega-3 fats (flaxseed, eicosopentanoic acid (EFA)and decosa hexanoic acid (DHA), all suppress inflammation. Some patients find further pain relief from the gamma linolenic acid found in borage, evening primrose, or black currant seed oils.
Finally SAM-e (s-adenosyl methionine) at 400 milligrams to 1,200 milligrams a day often helps joint or tendon pain and inflammation. It must be an individually foil-wrapped product, such as that by Nature Made, Natrol or Twin-Lab, and must be taken with water. I advise taking SAM-e in the early morning, even a few minutes before breakfast, as some people experience sleep delay if it is taken in the evening.
Brain Functioning
Lecithin in 1,200 milligram capsules acts as an acetylcholine source. In some people it is apparantly transported across the blood brain barrier. Ginkgo biloba at 120 milligrams to 80 milligrams per day of the flavonoglycoside extract enhances brain circulation. SAM-e provides a notable mood improvement. It is my experience that this is true for roughly 40 percent of mildly depressed patients. SAM-e is a normal component of cells, so we infer that suboptimal production of this substance leads to mood disorders.
Muscle Maintenance
Muscle function is sometimes compromised due people losing large amounts of weight, experiencing poor digestive absorption, or following a prolonged illness, including CHF. Carnitine, which is often limited in these debilitated individuals, facilitates muscle access to intracellular fats for contractility and can be supplemented in the range of one gram twice per day. Following vigorous exercise, micro-tears and inflammation occur routinely, but symptoms can be relieved by pre-and post-exercise and taking 800 to 1,000 international units of vitamin E for two days.(20) Mixed tocopherols are best, and several brands are available. Carnosine, a putative membrane-protective antioxidant, also is helpful in some older individuals beginning an exercise program.(10)
Prostate Health
Prostate size almost universally increases in older men and may cause delayed stream, nocturia and sleep-disruption. It can be significantly improved through the intake of saw palmetto (Serenoa repens.(3) The recommended dose is l60 milligrams once or twice per day.
Immune System
Optimal immune system functioning is supported broadly by the aforementioned healthy diet, plus zinc supplements of 15 to 30 milligrams a day to enhance T-cell function.(4) I generally recommend a good multivitamin/mineral capsule with 10 milligrams or less of iron, for everyone over the age of 50. Several components help with immune and other physiological system functions.(9)
Finally, on an intriguing note, since 1998, increasing research has demonstrated the gene for telemerase, which maintains and rebuilds telomeres. In normal aging with each replication of a gene, the ends of the DNA molecule tend to shorten. This is thought to be primse reason for aging. These studies may eventually lead to meaningful prolongation of healthy cell lines in humans.(8)
If stem cell research is freed up politically we may indeed make major strides in the business of anti-aging remedies. Stem cell research also could provide retinal cells, chondrocytes, and possible relief for Parkinsons' disease and other afflictions.
A final quote from one of the oldest humans, ever:
"I had to wait 110 years to become famous, and I intend to enjoy it as long as possible." — Jean Calment, age 120
Erica T. Goode, M.D., MPH, nutrition, works with patients with a variety of nutritional and medical illnesses at the Institute for Health and Healing at CPMC in San Francisco. She teaches in the department of family and community medicine at UCSF.
References
Bidlack, WR. Nutritional requirements of the elderly, Morley, J.E, Geriatric Nutrition: a comprehensive review, Raven Press, N.Y., 1991.
Evans W, Rosenberg, I. Biomarkers: The l0 determinants of aging you can control, Simon-Schuster, N.Y., 1992.
Braeckman, J. The extract of serenoa repens in the treatment of BPH, Curr Ther Res 55: 776-785, 1994.
Chandra, RK. Nutrition, an important determinant of immunity in old age, Pro Clin Biol Research, 326:321-327, 1990.
Chopra, Deepak, Ageless Body, Timeless Mind. Crown Publ, N.Y. 1993.
Dawson-Hughes, B, et al. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years and older, NEJM, 337: 701-702, 1997.
DeSmet, P, Herbal remedies, NEJM, 347: 2046-2056, 1902.
Fossel, M., Reversing Human Aging, Morrow-Avon, 1996.
Gershwin, M, et al. Trace minerals, aging, and immunity, J Am Geriatrics Soc, 31: 374-378, 1983.
Hypertension trials, Phase I, Calcium, magnesium , KCl, Fish oil, JAMA 267: 1213, 1992.
Kaplan, GA. Epidemiologic observation on the compression of morbidity:evidence from the Alameda County Study, J Aging Health, 3: 155-171, 1991.
Morley, J.E., Nutritional status of the elderly, Am J Med 81:680-688, 1986.
Murad, H. The effect of an oral supplement containing glucosamine, amino acids, minerals, and antioxidants on cutaneous aging:a preliminary study, J Derm Treatment, 12:47-51, 2001.
Murray, M., Pizzorno, Journal Encyclopedia of Natural Medicine, 2nd edition, Prima Publ, 1997.
Olshansky, S.J., Hayflick, L., Carnes, B., No truth to the fountain of youth, Scientific American, 92-95, 6/02.
Perricone, N., The Wrinkle Cure, Warner Books, 2001.
Rosenfeld, A., Prolongevity II, Harper Collins, 1992.
Seddon, J., et al "Dietary carotenoids, Vitamins A,C,E, and advanced age—related macular degeneration, JAMA 272: 1413-1420, 1994.
Stuerenberg, H., "Concentrations of free carnosine (a putative membrane-protective antioxidant) in human muscle biopsies and rat muscles" Arch Gerontol Geriatrics 29:107 – 113, 1999.
Tufts Newsletter 20 g. 3, 5/02.
Additional Resources:
A. Buck Center for Research in Aging, 505 A. San Marin Drive, #300, Novato, CA 94945. (415) 899-1800.
B. Established Populations for Epidemiologic Studies for the Elderly, East Boston, Mass., Iowa and Washington Counties in Iowa and New Haven, Conn.
C. Gladstone Foundation for Lipid Disorders. Tom Bersot, MD, PhD, Director.
D. National Center for Complementary and Alternative Medicine (CAM), Bethesda, MD, 20892. Stephen E. Strauss, MD, Director.
E. National Institute on Aging. Richard Suzman, MD, Director.
F. New England Centenarian Study. Thomas T. Peaes, MD, Director.
G. UCLA School of Medicine, Dept. of Nutrition. Daniel Heber, MD, Director.
H. USDA Human Nutrition Research Center on Aging, Tufts University. Tom Evans, MD, Chief, Human Physiology Lab. Irwin Rosenberg, MD, Director.
http://www.sfms.org/sfm/sfm203b.htm
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