~ 121807 It's Never Too Late

Weill Cornell Medical College professor of medicine Richard S. Rivlin believes that it is not too late for older individuals to change unhealthy lifestyle practices in order to prevent disease and promote well-being.

Dr. Rivlin, who served as the editor for the Keeping the Young-Elderly Healthy symposium summarized in a supplement to the November, 2007 issue of the American Journal of Clinical Nutrition, conducted a review of the medical literature which revealed a number of encouraging studies concerning older individuals. The first challenge he suggests we recognize is the dramatic body composition changes that occur with aging, characterized by increased body fat and weight, and decreased bone and muscle mass. These changes can be modified by improvements in diet, supplementation, and exercise.

Among the findings noted by Dr Rivlin was that reducing high blood pressure through improved diet and exercise had a greater benefit for the elderly than any other age group, and could potentially prevent 20 percent of coronary heart disease cases in men and 30 percent in women. Additionally, up to 45 percent of the future cardiac event risk experienced by older men and women with heart disease can be prevented by improving serum lipid concentrations.

Other findings included the ability of a low calorie diet combined with exercise to cut cancer risk by a third to one-half, increased calorie burning and osteoporosis prevention through weight training, and a reduction in bone loss and bone fractures among older individuals who used calcium and vitamin D supplements for three years.

"I think this is an extremely important and positive message," stated Dr Rivlin, who is an attending physician at New York-Presbyterian/Weill Cornell. "Many elderly people feel that it is too late for them to improve their health, but that is simply not true.”

“When measures to combat chronic disease are started in one's 60s and 70s, there are still definite benefits,” he added. “But older adults must realize that there is no quick fix. They must change their lifestyles."

"Our study reviews and presents the most up-to-date information showing the influence a healthy lifestyle may have on cardiovascular disease, cancer and osteoporosis," Dr. Rivlin concluded. "I also believe that the risk for other diseases, like diabetes and pulmonary disease, can also be avoided through later intervention. But, the earlier, the better."

Health Concern: Osteoporosis

Bone is living tissue comprising both organic protein matrix (30 percent) and various minerals (70 percent). Throughout life, cells known as osteoblasts construct bone matrix and fill it with calcium. At the same time, cells called osteoclasts work just as busily to tear down and resorb the bone. This fine balance is regulated by many factors, including systemic hormones and cytokines. Bone mass reaches its peak by the middle of the third decade of life and plateaus for about 10 years. During this time bone turnover is constant, meaning bone formation approximately equals bone resorption.

As our bodies age, this fine balance is lost. As the relative hormone levels shift in midlife—more drastically in women than in men—the osteoclasts gain the upper hand, and bone mass begins dwindling. Some bone is already being lost by the time women reach menopause, but the rate of loss can increase as much as tenfold during the first six years after menopause. This is the essence of primary osteoporosis, or osteoporosis that occurs as a natural part of aging.

Many studies have shown that calcium can reduce bone loss and suppress bone turnover. Calcium intake is a foundation of osteoporosis prevention (Kasper DL et al 2005). Calcium requires the presence of vitamin D for maximum absorption. Although calcium is readily available in dairy products and other dietary sources, many Americans are calcium deficient. There are a few possible explanations for calcium deficiencies:
  • Decreased vitamin D availability, possibly due to kidney or liver problems or insufficient exposure to sunshine (ultraviolet radiation)
  • Decreased gastrointestinal tract absorption due to stomach or intestinal problems
  • Increased loss of calcium from the kidneys
  • Increased loss of calcium from the colon and bowels
  • Low dietary calcium intake
  • Medications that inhibit calcium absorption

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