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© 1991-2007 Jerry Emanuelson Chapter 2
HOW WE DIE
These are the top ten causes of death in the United States during 1995 according to the U.S. Centers for Disease Control and Prevention. (The numbers in parenthesis after the listed cause are the approximate number of deaths in thousands.)
(This list has been fairly constant over the last several years, except that liver disease replaced homicide in the tenth position in the early 1990's.) One approach to life extension is to attack the root causes of these major sources of death and disability. Heart disease is, by far, the biggest killer. It is also one of the most preventable. PREVENTING HEART DISEASE Individuals can intervene at five levels to prevent heart attack or stroke.
The main dietary cause of high LDL cholesterol is consumption of certain saturated fats. In most people, the cholesterol content of food has little to do with serum cholesterol, although most cholesterol-containing foods are also high in long-chain saturated fats. Poly-unsaturated fats lower LDL cholesterol, but should be avoided because they cause considerable oxidative damage to the body, Monounsaturated fats and medium chain triglycerides (MCT) are safer types of fats. MCT can dramatically improve LDL/HDL ratios and can be used as a substitute for ordinary fats in many applications. MCT is difficult to use in frying, though, because it decomposes (and smokes) at a lower temperature than other fats. (See the Fats in Your Foods chapter of this manual.) Some types of fats, such as the omega-3 fatty acids in fish oil, are good for you and are very important substances for life extension. Niacin is very effective at reducing LDL cholesterol and raising HDL, especially if taken in doses of 1 to 3 grams. It may be best to take niacin in the form of inositol hexanicotinate (no-flush niacin) since high doses of ordinary niacin cause uncomfortable flushing and since inositol is a beneficial nutrient as well. Inositol hexanicotinate is about 80% niacin and about 20% inositol. It usually comes in 400 or 500 mg. capsules that should be taken at least two or three times a day. Larger amounts may need to be taken by those with naturally high LDL levels. The omega-3 fatty acids, such as those present in fish oils, can significantly improve one's cholesterol profile, and they have many other health benefits. A plant extract called gugulipid has been shown to lower cholesterol by 14% to 27% in various studies. Guglipid works especially well when used in combination with inositol hexanicotinate. Enzymatic Therapy makes a capsule that contains 250 mg. of gugulipid and 250 mg. of inositol hexanicotinate. These capsules should be taken about four times a day. This is a convenient way of getting gugulipid and inositol hexanicotinate in a single capsule. Anyone taking more than about 1000 mg. (1 gram) of niacin or inositol hexanicotinate per day should have liver enzymes checked regularly. This is something that is routinely done for those on cholesterol-lowering drugs, and it should be done for niacin, as well, even though niacin rarely causes a liver problem. Large doses of niacin often do cause some mild elevation of liver enzymes. These liver enzyme tests are part of most routine blood chemistry tests. DHEA (dehydroepiandrosterone) also often lowers LDL and raises HDL. For those with who require a cholesterol-lowering drug, lovastatin (Mevacor) is very effective (as are the other "statin" drugs), but it is mandatory to take at least 30 mg. of coenzyme Q-10 daily since all statin drugs block the liver's production of coenzyme Q-10. Coenzyme Q-10 is a substance essential for proper muscle functioning, especially functioning of the heart muscle. The 30 mg. coenzyme Q-10 is a minimum dose: 60 mg. to 120 mg. is a better dose. (Doses of coenzyme Q-10 larger than 200 mg. should only be taken under medical supervision.) Most people taking a cholesterol-lowering drug would find inositol hexanicotinate and pharmaceutical-grade fish oils to be safer and just as effective, but they should not make the switch except under a physician's supervision and with regular blood chemistry tests. It is prudent to take supplementary coenzyme Q-10. An average intake of about one ounce of alcohol per day in men, or 1/4 ounce per day in women, will raise HDL levels. Even though a little alcohol is good for most people, a little more than this amount can produce very adverse consequences. The differences between the optimal amount for men and women are more than just a matter of differences in average body weight. Men and women metabolize alcohol very differently. For example, the optimal alcohol intake for the average man will increase the breast cancer risk for the average woman. If the alcohol is consumed in the form of red wine, the polyphenols in the red wine will raise the body's level of natural antioxidants. Green tea contains similar polyphenols. Regular exercise and maintenance of normal body weight is very important to maintaining low LDL/HDL ratios. Vigorous aerobic exercise (especially running) is the best method of increasing HDL levels. In some people, supplements of L-carnitine or acetyl-L-carnitine (about 1000 to 2000 mg. per day) will significantly increase HDL levels. This is more likely to be true in vegetarians, since meats are the primary natural source of dietary L-carnitine. Supplementary carnitine can also aid in weight loss. Supplementary chromium polynicotinate can improve LDL/HDL ratios in some people. This is probably due to the beneficial effects of chromium on insulin resistance. A diet that maintains blood sugar levels at a moderately-low and stable level will also improve LDL/HDL ratios. To prevent the buildup of cholesterol on the artery walls, it is important to minimize the levels of homocysteine in the bloodstream. Homocysteine is a toxic byproduct of normal human metabolism. To convert homocysteine to harmless (or even useful) amino acids, the body requires folic acid, vitamin B-6 and vitamin B-12. It is important to get at least 800 micrograms of folic acid, 25 milligrams of vitamin B-6 and 100 micrograms of vitamin B-12. Although a good broad spectrum vitamin supplement will probably supply the necessary B-6 and B-12, it is usually necessary to take a separate folic acid supplement to get adequate folic acid to minimize homocysteine formation. Folic acid has many important benefits at high doses. Although 800 micrograms is the largest folic acid dose generally available in the United States without a prescription, 5000 microgram (5 mg.) folic acid tablets are available in many other countries. It is important to have one's homocysteine levels measured occasionally. Many people with an adequate intake of folic acid and vitamins B-6 and B-12 still have high homocysteine levels. Those individuals need to take enough trimethyglycine (TMG) to keep their homocysteine levels low. TMG is a readily-available nutritional supplement. S-adenosylmethionine (SAM-e) can also reduce homocysteine levels. Creatine (the supplement often used for muscle building) has also been shown to significantly reduce homocysteine levels. To reduce oxidation of cholesterol from LDL, you need at least 100 units of vitamin E, 10,000 units of beta carotene (and/or 5 mg. lycopene), and 500 mg. of vitamin C per day, along with other dietary antioxidants. (These are absolute minimums.) It is important to get a broad spectrum of fat-soluble and water-soluble antioxidants. Many single antioxidants, taken alone, will actually generate free radicals that must be de-activated by other antioxidants. A very important antioxidant in preventing heart disease and many cancers is lycopene, which is very similar to beta carotene, but which has finally become available in pure form as a nutritional supplement. The best food sources of lycopene are canned tomato juice, or juices such as V8 that are high in tomato juice. Another very important antioxidant is alpha lipoic acid. In case all of the above fail, it is important for many people to take 1/4 aspirin tablet (81 mg.) per day. Low dose aspirin is the simplest and least expensive method of heart attack prevention. Low dose aspirin, by itself, reduces the risk of heart attack by at least 40 percent. Low dose aspirin will also reduce the risk of colon cancer, one of the deadliest and most common forms of cancer, by at least 40 percent. There are dangers of aspirin, even at very low doses. Aspirin can cause some bleeding in the digestive tract, and, more importantly, can impair somewhat the absorption of some important nutrients. For most people, though, the benefits of low-dose aspirin are so remarkable that they far outweigh the dangers. Anyone at risk for a heart attack should also carry at least two regular aspirin tablets with them at all times. The two tablets should be chewed up and swallowed at the first sign of a heart attack. The tablets you carry with you should be regular Bayer or other easily chewable aspirin. The aspirin can stop much of the damage inflicted by a heart attack even after it has started. Replace the aspirin tablets every four to six months, or whenever the aspirin tablets begin to smell like vinegar. PREVENTING CANCER Cancer is the most difficult of the major causes of death to prevent, but regular consumption of a broad range of antioxidants, a low-dose aspirin regimen, along with a program to keep the immune system strong, can cut one's cancer risk at least in half. There is good preliminary evidence that melatonin can reduce the risk of breast cancer and that sterols extracted from the saw palmetto berry can reduce the risk of prostate cancer. Dehydroepiandrosterone (DHEA) and melatonin can also cut the risk of breast cancer, and many other types of cancer. The polyphenols in green tea and red wine also have been shown to substantially cut cancer risks. (Melatonin, DHEA, and green tea polyphenols are discussed later in this manual. Saw palmetto extracts are available at health food stores.) There is evidence that coenzyme Q-10 may be an important nutrient for breast cancer prevention. Lycopene, an antioxidant found in tomatoes and other foods, is a potent inhibitor of cancer. Regular checkups to detect cancer early are important. Early detection not only makes cancer easier to cure by conventional means; it also gives the individual time to research and seek out alternative therapies. Also see Appendix B, Notes about Breast Cancer and Prostate Cancer. PREVENTING STROKE Blockage of a blood vessel is the cause of a great majority of strokes. These strokes can be prevented in the same manner as heart disease is prevented. The other kind of stroke is the hemorrhage, which is best prevented by keeping blood pressure low. Many low-cost and easy-to-use devices for measuring one's own blood pressure are now available. PREVENTING LUNG DISEASE, PNEUMONIA & INFLUENZA The best way to prevent all kinds of respiratory diseases is to maintain a strong immune system. In order for the immune system to work properly against respiratory disease, the membranes of the respiratory system must be kept moist. Failure to keep the respiratory membranes moist is the most neglected aspect of respiratory health. In many parts of the country, the humidity of heated indoor air is less than 10 percent during most of the winter. The process of heating the air, no matter what heating method is used, lowers the indoor relative humidity quite dramatically. This low humidity is devastating to the respiratory system. In dry or cold climates, indoor humidifiers are necessary to maintain the relative humidity at 30 percent to 50 percent. (Artificially humidified buildings which maintain humidities much above 50 percent may promote the growth of molds and other allergens and irritants.) Digital relative humidity meters are available for about $20, and are very useful for educating yourself about the humidity problem. Many of these devices only register relative humidities of 20 percent or more. Many people are surprised to learn that, for several months out of the year, there is not enough humidity in their homes to even register on these meters. One can also maintain a moist respiratory system by drinking plenty of water and using a mucolytic agent such as N-Acetyl-Cysteine (500-1500 mg. daily) or guaifenesin (500-1500 mg. daily), or both. N-Acetyl-Cysteine is available at health food stores and from many mail-order suppliers. Guaifenesin is a component in many over-the-counter cold medicines and can also be obtained with a doctor's prescription. (If you by an over-the-counter form of guaifenesin, be very careful about what else is in it. Many of the over-the-counter forms of guaifenesin also contain things that one normally shouldn't take on a regular basis.) People with chronic sinus problems may require up to 2400 mg. of guaifenesin daily. The use of the antihistamines that are available over-the-counter in the United States damages the respiratory system by drying out the respiratory membranes. The antihistamines loratadine (Claritin), and Allegra are relatively free of drying effects. (It is very dangerous to drive after using any of the sedating antihistamines currently available in the U.S. These anti-cholinergic antihistamines impair memory, judgement and reaction time.) Respiratory diseases are a major cause of disability and death. One recent study in France showed that bronchitis alone was the ultimate cause of 5 percent of all deaths. Many elderly people, or others with weak immune systems, are hospitalized for an accidental injury or other illness, but die of pneumonia or bronchitis. A French pharmaceutical company, Roussel Uclaf, developed an immune stimulant that has successfully been used for years to prevent respiratory infections. The immune stimulant is sold under the trade name BIOSTIM, and is useful in enhancing the immune system against a wide variety of viral, bacterial and fungal infections. Biostim is also useful as a vaccine amplifier. It increases the number of antibodies the human immune system produces in response to a vaccine. Biostim is especially useful in preventing viral respiratory infections. Biostim has an extraordinary safety record, but is not available in the U.S. Biostim can be legally imported from Europe for personal use. Usual dosage is two tablets per day for 8 days, then wait 3 weeks and take one tablet per day for 8 days, then wait another 3 weeks and take one tablet a day for 8 days. This sequence can be repeated once a year at a cost of about $40 per year. PREVENTING DIABETES Eating a diet rich in low carbohydrate, low-glycemic-index foods, getting moderate exercise and avoiding obesity are important factors in preventing or reversing diabetes. Carbohydrates with a low glycemic index are those which produce the lowest levels of insulin release per gram of carbohydrate. Also see the Chromium chapter in this manual. Timed-release alpha lipoic acid is also an very important nutrient for the prevention and treatment of diabetes. One of the most important things a person can do for preventing diabetes is to monitor one's glucose levels. Most people on serious life extension programs take about 1000 mg. of metformin (Glucophage) daily if their fasting glucose level is less than ideal. If you want to live a very long and healthy life, your fasting blood glucose level should be between 70 and 90 mg/dl. PREVENTING ACCIDENTS, SUICIDE & HOMICIDE Taking care of one's brain can reduce the risk of these causes of death. For more on this subject, see the books on "smart drugs" and "brain boosters" listed the recommended reading section. Although it may seem strange to suggest that "smart pills" or "brain boosters" could prevent homicide, a significant percentage of homicides can be avoided if the potential victim maintains good enough judgment to avoid or escape a dangerous situation. [An interesting sidelight to this: In animal studies done on fluoxetine (Prozac) before it was released in the U.S., animals became less prone to violence. In one study, in monkeys that normally exhibit a notable dominant/submissive social structure, the dominant monkeys given Prozac became less dominant; and the
submissive monkeys given Prozac became less submissive. In a study with another antidepressant, minaprine, a species of rat that routinely kills mice for no apparent reason, was no longer interested in killing mice after being given minaprine.] References: Dose-related decrease of serum coenzyme Q10 during treatment with HMG-CoA reductase inhibitors. Exogenous CoQ10 supplementation prevents plasma ubiquinone reduction induced by HMG-CoA reductase inhibitors. Lovastatin decreases coenzyme Q levels in humans. Health implications of creatine: can oral creatine supplementation protect against neurological and atherosclerotic disease? Methylation demand and homocysteine metabolism: effects of dietary provision of creatine and guanidinoacetate. The effect of creatine and resistance training on plasma homocysteine concentration in healthy volunteers. |