The Anti-Aging Handbook

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protect your body's five major systems

BONES & JOINTS IMMUNE SYSTEM BRAIN HEART MUSCLES
a guide to hormones

SHOULD YOU SUPPLEMENT?
the longevity care package

10 OPTIONS TO HELP YOU STAY YOUNG

"STOP THE CLOCK!" scream the ads for various products that promise to reverse the aging process.

There's just one problem. "It can't be done," says Andrew Weil, M.D., director of the integrative medicine program at the University of Arizona and author of Healthy Aging: A Lifelong Guide to Your Physical and Spiritual Well-Being. He believes that the denial of aging is counterproductive, which makes it all the more important to distinguish between science and science fiction when it comes to your health.

Happily, researchers have found that anyone can add years of active living to the average natural lifespan (currently 77.6 years in the United States) — in Weil's words, "to live as long and as well as possible."

Examples abound. Consider Winnie Hopfe, 65, of Longmeadow, Mass. Instead of winding down in retirement, she runs in seven or eight competitive events each year, often leaving women half her age in the dust. She took up kayaking last summer, and spent a weekend water-tubing in the Adirondacks.

When you were a child, could you picture your grandmother water-tubing? Hopfe and many others like her are living proof that proper care and maintenance can keep the human body running strong far longer than anyone conceived just a few decades ago.

But it takes work. What follows is the best advice on bolstering the major systems in the human body to stave off age-related decline. And while you're lacing up those walking shoes or seeking out new supplements, remember that adopting the right attitude may be the most important step of all. "The most damaging concept in our culture," says Weil, "is that the worth of life diminishes with age."
bolster your BONES & JOINTS
how they age

All adults begin to lose bone mass in their 30s and 40s — about half a percent per year — and decreasing estrogen levels accelerate the process in women. In the decade after menopause, the average woman will lose about 2 percent to 3 percent of her bone mass each year. When bones shed calcium more quickly than it's absorbed, they become brittle and fracture easily. About 10 million Americans have osteoporosis; eight in 10 of them are women.

When two bones meet, they form a joint. Over time, synovial fluid, which lubricates joints, may dry up, and the protective cartilage that lines joint surfaces erodes, The result can be pain, stiffness, and loss of flexibility. About So percent of people over 55 have some form of degenerative joint disease such as arthritis.
what you can do

The average American woman gets only about 500 milligrams of calcium per day from food, a far cry from the recommended 1,000 to 1,200 mg. Dairy products and leafy greens can help bridge the gap; so can supplements. But some people go overboard, taking more than the upper limit of 2,500 mg. "I spend a fair amount of time counseling patients to decrease their calcium intake," says endocrinologist Nelson B. Watts, M.D., director of the University of Cincinnati Bone Health and Osteoporosis Center.

Your calcium intake won't do you much good if you don't get enough vitamin D to help absorb it. Watts finds the current recommendation for people over 50 — 400 III daily — too low. Sunlight triggers internal production, but to be on the safe side. Watts advises women to take in 1,000 to 2,000 IU of vitamin D per day.

Load-bearing exercise like walking or jogging is the third critical component of bone protection. If you prefer more exotic endeavors, preliminary results at Texas Tech University have shown that the slow, graceful movements of tai chi may help people ages 65 to 85 start strengthening bone in as little as six weeks.

Investigations show that the natural supplement glucosamine can slow the onset of arthritis and ease pain and stiffness. So do deceptively simple strategies such as adjusting your desk chair to offer better back support or taking breaks to stretch and stand every half-hour while on the job.

"Make changes in the workplace early on that allow you to work longer and safer," advises Diana Baldwin, O.T.R., an occupational therapist with the Missouri Arthritis Rehabilitation Research and Training Center. Minimal measures like having frequently used items (e.g., pens, phones, reference books) within easy reach helps reduce arthritis symptoms, she says.
improve your IMMUNE SYSTEM
how it ages

Your body's defense network gradually produces fewer potent white blood cells — especially critical warriors known as T cells — making you more vulnerable to viruses, bacteria, carcinogens, and other disease-causing organisms. Vaccinations (such as flu shots) may become less effective. Wounds take longer to heal.
what you can do

Keeping your immunity strong as you age means keeping yourself running — or walking, swimming, or cycling. Regular exercise can prevent the age-related decline in the immune system's antibody response, says University of Colorado physiologist Monika Fleshner, Ph.D. In a 2004 study, Fleshner and colleagues gathered 46 men — some old, some young, some dedicated jocks, some not — and injected them with a harmless protein designed to mimic an infection. Blood samples showed that the active older men mounted a robust immune response, while the sedentary older males had a reduction in their ability to generate antibodies. Most intriguingly, the samples from active men over 60 were indistinguishable from active guys in their 20s and 30s.

While a low-fat diet rich in fruits and vegetables strengthens the immune system, one nutrient in particular offers a powerful defense. The antioxidant vitamin E cleans up free radicals that can challenge immunity; it also reduces production of certain prostaglandins that interfere with the work of T cells. Older bodies manufacture more prostaglandins, which has led researchers to ask whether supplementing with extra doses of vitamin E bolsters immunity. The answer appears to be yes, according to a 2004 study published in The Journal of the American Medical Association. A team at Tufts University found that people over 65 who took a daily supplement containing 200 IU of vitamin E cut their risk for colds and other upper-respiratory tract infections by 30 percent.
fortify your BRAIN
how it ages

The brain shrinks a couple of grams per decade as axons — the "wires" that transmit information from one neuron to another — weaken or die off. Memory, especially for things like names and phone numbers, becomes less reliable. While these changes are natural and mostly harmless, the risk of dementia, or the loss of intellectual ability, rises with age. About 4.5 million Americans have Alzheimer's disease, the most common form of dementia among the elderly.
what you can do

Keep your mind in motion. "If you challenge the brain to take on new tasks, there's evidence that it has the ability to rewire itself," says George T. Grossberg, M.D., a psychiatrist at Saint Louis University School of Medicine. In a 2002 study in The Journal of the American Medical Association, people who spent the most time in mentally stimulating activities like reading, playing games, or doing puzzles cut their dementia risk by nearly half.

Keeping your feet in motion is critical, too. Neuroscientist Arthur Kramer, Ph.D., and colleagues at the University of Illinois found that sofa-surfers who take up a walking program of just 45 minutes, three times a week, improve their scores on tests of mental sharpness by up to 20 percent. "As people become more fit, the circuits that support cognition and perception become more efficient," Kramer explains.

Finally, some food for thought: Studies have shown that the omega-3 fatty acids in cold-water fish may reduce the risk of Alzheimei's disease. Grossberg recommends fish oil capsules or flaxseed oil supplements, another good source of omega-3s. Either way, start with at least 1,000 mg per day. (Consult your doctor on this or any other change to your nutrition or exercise plan.)

To further preserve your brain, Grossberg suggests this daily regimen: 200 IU vitamin E, 500 mg vitamin C, and a vitamin B-complex supplement with folic acid.
guard your HEART
how it ages

The arteries that deliver blood from the heart to every tissue in the body gradually lose elasticity; calcium deposits may form inside them, too. These changes cause the arteries to stiffen, raising blood pressure. Depending on your genes, diet, activity level, and other lifestyle habits (such as smoking), you may also begin to develop clumps of fat, cholesterol, and other gunk along the artery walls. These "plaques" narrow the arteries, slowing blood flow and increasing the risk of heart attack and stroke.
what you can do

A major breakthrough in recent years was the discovery that arterial inflammation is a leading cause of heart attacks. Fortunately, many of the same steps for lowering artery-clogging cholesterol also ease inflammation, including exercising, avoiding saturated fat, and not smoking. Fish oil, which has other proven heart-healthy benefits, fights inflammation, too, says David L. Katz, M.D., author of Cut Your Cholesterol. Even if you have no risk factors for heart disease, Katz feels it may be worth popping fish oil capsules (1,000 mg, twice daily) to prevent the damage that inflammation can cause over the years. "I take it myself," he says.

If you have a family history of cardiovascular disease or high cholesterol, your doctor may instruct you to take aspirin every day to prevent artery-clogging blood clots. If so, you might be getting a longevity bonus: Recent research suggests aspirin has other benefits that could increase lifespan, says Christiaan Leeuwenburgh, Ph.D., director of the Biochemistry of Aging Laboratory at the University of Florida.

In addition to reducing inflammation, aspirin is a potent antioxidant. What's more, it likely stifles production of compounds that form when carbohydrates interact with amino acids to form advanced glycation end products.

"They're nasty," declares Leeuwenburgh of the aptly named AGEs, which some scientists think contribute to age-related diseases like cancer, hypertension, and arthritis. (One baby aspirin — 81 mg — is generally sufficient for a daily prevention regimen. However, any amount can cause stomach distress, so don't take aspirin regularly without a doctor's consent.)

Insulin resistance syndrome, a common condition that requires extra insulin to make energy from glucose, also boosts heart-disease risk. Over time, levels of the mineral chromium — which helps insulin function — diminish. Some doctors recommend chromium picolinate supplements (200 to 1,000 micrograms daily) to lower insulin resistance. Adding soluble fiber (found in oats and beans) to the diet helps as well, notes Katz.

Depending on your blood profile, other supplements may be useful, says cardiologist Erminia Guaraeri, M.D., of the Scripps Center for Integrative Medicine in La Jolla, Calif. Niacin ups artery-cleaning HDL cholesterol; folic acid and other B vitamins lower heart-unhealthy homocysteine; and magnesium controls irregular heartbeats. However, she believes — and research confirms — that age-proofing the heart begins at the dinner table. "Let food be your medicine," she advises. (See "Live Long & Eat Well" on page 70.)
maintain your MUSCLES
how they age

At around 40, a woman's muscle fibers begin to shrink; the decline starts before age 30 in men. And with each passing year, muscle cells lose mitochondria, which provide energy to cells. Weakened muscles impair balance and reaction time, and absorb sugar from the bloodstream less efficiently, leading to fatigue and increasing the risk for diabetes.
what you can do

Plenty. "It is possible to reduce the decline of muscle strength by 50 percent with an exercise plan that includes strength training," says kinesiologist C. Jessie Jones, Ph.D., co-director of the Center for Successful Aging at California State University, Fullerton. People who lift weights or engage in some other form of regular resistance training build muscle more efficiently and lose fewer mitochondria than people who don't pump iron. The key is to keep your limbs working. "You must overload the muscle," notes Jones.

But you don't have to overload your schedule. In as little as two 45-minute sessions per week — pairing 15 minutes of strength training with a brisk 30-minute walk, for example — you can maintain muscle tissue and preserve metabolism and bone density; this deters both weight gain and osteoporosis as you age, plus it helps refresh your appearance and boost your self-esteem.

Adding the cardiovascular exercise improves blood flow to the heart and brain, and you will achieve even better results by including several extra minutes of core-based movement to restore balance and relieve tension. (See "Fluid, Flexible, Fabulous" on page 43.)

If you don't want to join a gym, you can purchase a set of dumbbells to use at home, advises fitness consultant Lori Incledon, author of Strength Training for Women. This will allow you to perform a basic workout, such as the four moves that follow. If possible, work with a trainer, at least initially, to learn proper technique.
must-do moves

"Genetic influences on an individual's aging process have been highly overrated," declares C. Normal Shealy, M.D., author of Life Beyond 100: Secrets of the Fountain of Youth. "In fact, physical exercise may be the single most important determinant of health."

These four moves work many muscles at the same time, providing an effective, complete, and time-efficient total-body program in just 15 to 20 minutes.

What to do: Twice a week, perform 2 sets of 8 to 12 reps for each move using 3- to 15-pound dumbbells and resting 60 seconds between sets. Use as much weight as you can, maintaining good form. Warm up for 5 minutes on the treadmill or by stepping in place, and finish with gentle stretching, holding each stretch for 30 seconds without bouncing. (To add cardio and core elements, see above.)
— Linda Shelton

lunge, row, and rotate

Holding a dumbbell in each hand on your hips, stand with feet separated hip-width apart. Step forward with your left foot, bending your knees so the left knee aligns over the left ankle, right heel lifted. Hinge forward from your hips and extend your right arm and dumbbell toward the outside of your left ankle, rotating your torso [A], Bend your right elbow and pull the dumbbell back in a rowing motion toward your right hip, squaring your torso [B]. Extend your right arm and do one more row, then straighten your torso and return your legs to the starting position. Repeat, this time on the opposite side, to complete 1 rep. Continue to alternate sides. Strengthens the legs, buttocks, shoulders, back, biceps, and abdominals.
more must-do moves squat with knee lift

Hold a dumbbell in each hand with your arms at your sides, palms facing in, feet hip-width apart, and abs pulled up and in. Keep your body weight toward your heels and bend your knees, lowering your hips toward the floor [A]. Straighten your legs to the starting position and bend your elbows, bringing the dumbbells up to rest against your shoulders. As you finish, bring your right knee to hip height so you're standing on your left foot [B]. Bend your left knee into a quarter squat, then straighten the left knee, placing the right foot on the floor and lowering your arms. Repeat the entire move, alternating the knee lift to complete 1 set. Strengthens the legs, buttocks, biceps, and hip and knee stabilizers; improves balance and coordination.
chair chest press

Sit on the edge of a chair, then lean back so your upper back is firmly against the chair back, feet flat on the floor, knees bent and aligned over your ankles. Hold a dumbbell in each hand, arms extended at collarbone height, palms facing down. Squeeze your shoulder blades down and together, keeping your shoulders relaxed and chest lifted so your spine is straight and supported [A]. Bend both elbows back until they align with your shoulders [B]. Contract your chest to straighten your arms, then repeat. Strengthens the chest, front shoulders, and triceps; abs and spine extensors work as stabilizers.
seated row to press

Sit on the edge of a chair with your feet flat, knees bent and aligned over your ankles. Holding a dumbbell in each hand, hinge forward at your hips until your torso hovers over your thighs. Let your arms hang down in line with your shoulders, palms facing rear. Pull your abs up and in, and squeeze the shoulder blades down and together as you bend the elbows out and up to shoulder height [A], Lift your torso to an erect position, rotating your shoulders back, bringing your elbows down and hands up; then press your arms up and in front of you, palms in [B], Bend your elbows down to your waist, then straighten your arms as you hinge forward and repeat the entire combination. Strengthens the upper and middle back, shoulders, and spine stabilizers.
Balance your HORMONES
how they age

Hormone levels change throughout our lifetime. Insulin and cortisol don't diminish with age, but others do, including human growth hormone (HGH) and the sex hormones estrogen. progesterone, and testosterone. While they're not "the whole story," hormones do contribute to increased body fat and intra-abdominal fat, and some loss of muscle mass and bone density, explains S. Mitchell Harman, M.D., Ph.D., director and president of the Kronos Longevity Research Institute in Phoenix. "Undoubtedly, a portion of the 'aging' changes in many people is due to hormone alterations."

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By ANGELA HYNES
what you can do

Supplementing with hormones is a possible, albeit controversial, way to promote quality of life over the long term. Listed below are the six major hormones considered — or touted — to have anti-aging benefits. Weigh the risks and benefits of hormone supplementation with your physician. Take only those hormones you're deficient in, which you can determine via a blood test. Home test kits are available from testmyhormones.com and testsymptomsathome.com. (Harman says the ones in which your saliva is absorbed into a paper disc produce the most accurate results.) Confirm the results with your doctor, who will then prescribe the correct dosage.
human growth hormone

Its primary function is helping children grow to adult height, so it's not surprising that HGH diminishes with age. Yet adults still need a supply, and supplemental HGH is an effective remedy for those with a deficiency or pituitary disease, notes Harman. In 1990, an investigation from the Medical College of Wisconsin in Milwaukee showed HGH to reverse fat gains and muscle decline in elderly men, leading to its use on healthy patients. But this same study and subsequent others have revealed long-term adverse effects, including carpal tunnel syndrome, edema, joint swelling, and glucose intolerance.

Real HGH is available only by prescription. Products in stores are HGH "releasers" or "promoters." While they're unlikely to be harmful, "evidence that any actually works is slim to none," says Harman.
DHEA

This sex-hormone precursor, more lengthily known as dehydroepiandrosterone, is secreted by the adrenal glands. Available over-the-counter, DHEA was once lauded as the fountain of youth, but has lost its luster. Studies are small, not double blind,and mostly based on reported feelings — "I don't think there's much there," says Howard N. Hodis, M.D., director of atherosclerosis research at the University of Southern California School of Medicine in Los Angeles. Even in Europe, where DHEA has been used as an alternative to hormone replacement therapy (HRT) or testosterone replacement in women, investigations have found no major age-related benefits.
estrogen and progesterone

Two news items from the Women's Health Initiative concerned many hormone supplementers. First, an increase in heart-disease risk seemed to be linked to mixing estrogen and a synthetic progestin (which mimics progesterone), and was most apparent in the first year.

However, when you look at large studies using estrogen alone, "there is none of this increased risk in the first year," notes Hodis. "With all the investigation so far, we've seen that [with estrogen alone] there appears to be long-term benefit on reducing hardening of the arteries, as well as in reducing heart attacks."

The second WHI statistic indicated higher risk of breast cancer from a combination of estrogen and progestin. To be on the safe side, you could argue there appears to be a slight increased risk in this case, says Hodis. "Yet a very important study coming out at the same time showed that 25 years of using estrogen alone does not increase the risk of breast cancer and, in fact, showed a reduction in it."

Supplemental estrogen also seems to have a positive effect on aging bones. "Osteoporosis in women is probably the best documented example of something that can be prevented effectively by replacing the missing hormone [estrogen]," declares Harman.

If you are considering HRT for its long-term benefits, talk to your doctor about taking estrogen alone. Ask about bio-identical hormones, such as estradiol, the most potent naturally occurring estrogen. "One can surmise that the downside is less," says Hodis. Also, low-dose bio-identical progesterone treatments can still be valuable In helping to offset excess estrogen levels and regulate other hormones.
melatonin

Available OTC, melatonin is the hormone that helps promote sleep and regulate your body clock. For some people, it's an effective treatment for jet lag. While touted as an anti-aging agent, current data does not bear out such claims. Unless, that is, you consider getting a good night's sleep to be of value in looking and feeling younger, and there's something to be said for that. When needed, take 1 mg of time-release melatonin 30 minutes before bed.
testosterone

"This hormone changes slowly in men, decreasing between 1 and 2 percent per year from the 305 on," says Harman. Supplementing by way of injections, patches, or gels is available for testosterone-deficient men who report fatigue, depression, and loss of libido. Women lose testosterone, too, but there is debate about whether this affects sexual desire and performance. A study at Cedars-Sinai Medical Center in Los Angeles did show that post-hysterectomy patients experienced more and better sex when given testosterone via skin patches. If side effects occur (deepening voice, facial hair), dosage can be adjusted.
THE LONGEVITY CARE PACKAGE
There is no quick-fix solution to aging, but there are effective ways to boost your mental and physical well-being that will help you age gracefully and remain fit in mind and body.
1 flaxseed

Toss ground flaxseeds in yogurt, salads, or cereals to fight disease-causing inflammation, suggests Cynthia Sass, M.P.H., R.D., a spokeswoman for the American Dietetic Association. A diet rich in alpha-linolenic acid, which is found in flaxseeds, may cut the risk of recurrent heart disease in half, according to the American Heart Association.
2 ginger

A quick fix for any rumbling tummy, ginger also eases arthritis pain. "Antioxidants and anti-inflammatories slow aging — and ginger is well endowed with both," declares James A. Duke, Ph.D., author of The Green Pharmacy Anti-Aging Prescriptions.
3 sunscreen

Applying a sunscreen like Zia Daily Moisture Screen SPF 15 (middle row, left) — even if you're not spending much time outdoors — may prevent premature aging and skin cancer. One report in the Archives of Dermatology found that people who wore sunblock daily developed 24 percent fewer solar keratoses.
4 rosemary, sage, and lemon balm

These herbs have compounds that prevent the breakdown of acetylcholine, a neurotiansmitter that is diminished in the brains of Alzheimer's patients, says Duke. A topical application is the easiest way to get this benefit; try John Masters Organics Lavender Rosemary Shampoo (middle row, center); you can also take the herbs in teas.
5 soy

A daily 25 grams of soy protein as part of a low-fat diet may reduce heart-disease risk. Plus, research sponsored by Revival found that energy bars with 160 mg of soy isoflavones (the amount that's in their Autumn Apple Frost bar) can restore skin, nails, and hair.
6 bingo

Everyone wins with bingo; A study from the University of Southampton in England found that bingo players score higher than non-bingo players on tests measuring mental speed, memory, and the ability to scan surroundings for information.
7 neurobics

The simple mental exercises in Keep Your Brain Alive may forge new connections in the brain. Partly based on Duke University research, these do-anywhere mind strengtheners teach you to use your senses in unexpected ways, shaking up everyday routines and boosting brainpower.
8 mozart

Simply listening to a Mozart sonata for 10 minutes can temporarily raise your I.Q., research shows. Try a compilation of nine ear-pleasing compositions with Music for the Mozart Effect: Strengthen the Mind.
9 blueberries

"The antioxidants in blueberries neutralize free radicals, protecting cells from being attacked and damaged," notes Sass. Tops in antioxidant activity, blueberries may also slow age-related mental decline and reduce harmful LDL cholesterol.
10 garlic

"If I were reduced to one herb for all-around medicine, garlic would be it," says Duke. Garlic protects against certain cancers, lowers blood pressure, and may even help prevent Alzheimer's disease. Duke recommends adding one clove a day to your diet.

See the Buyer's Guide on page 107 for retail information.

PHOTO (COLOR)

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By Timothy Gower

Photography by Zee Wendell; Illustrations by Dung Hoang

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