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The Role of Nutrition in Human Health, Disease, and Aging – A Practical Approach

The Role of Nutrition in Human Health, Disease, and Aging – A Practical Approach Christopher B. Heward, Ph.D. President – Kronos Science Laboratories, Inc. IABG 10 th Congress - September 2003. Sound Nutritional Advice.

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The Role of Nutrition in Human Health, Disease, and Aging – A Practical Approach

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  1. The Role of Nutrition in Human Health, Disease, and Aging – A Practical Approach Christopher B. Heward, Ph.D. President – Kronos Science Laboratories, Inc. IABG 10th Congress - September 2003

  2. Sound Nutritional Advice Physician: “We think you ate something that triggered some primitive genes?” Patient: “But Doc, what do I do?” Physician:“Stop eating so much sh__ …garbage!”

  3. The Current Scientific Consensus About Nutrition

  4. USDA Dietary Guidelines THE USDA FOOD PYRAMID Promotes a grain-based low fat / high carbohydrate diet.

  5. Dietary Fat Intake and Obesity (US 1955-1990) 42 % Dietary Calories as Fat % Dietary Calories as Fat 40 38 % of Calories from Fat 36 34 32 1955 1962 1969 1976 1983 1990 Year from Amer Dietetic Assoc 95 417-420(1995)

  6. % Dietary Calories as Fat % Overweight Dietary Fat Intake and Obesity (US 1955-1990) 35 42 40 32 38 29 % of Calories from Fat % Overweight 36 26 23 34 20 32 1955 1962 1969 1976 1983 1990 Year from Amer Dietetic Assoc 95 417-420(1995)

  7. Actual Causes of Death – United States (1990) Cause Estimated Number % of Total McGinnis et al. - JAMA, November 10, 1993

  8. Actual Causes of Death – United States (1990) Cause Estimated Number % of Total McGinnis et al. - JAMA, November 10, 1993

  9. Major Causes of Death in the US Suicide Chronic Liver Disease/Cirrhosis Septicemia Hypertension & Hypertensive Renal Disease Kidney Alzheimers Influenza & Pneumonia Cardiovascular Disease Diabetes Mellitus Accidents Chronic Pulmonary Disease Cerebrovascular Disease Cancer Source: Minino, AM, Arias, E, Kochanek, et al., Summary National Vital Statistics 2000 Not Shown: 17.6 - Other

  10. Visceral Fat The Problem Subcutaneous Fat

  11. Obesity Trends* Among U.S. AdultsBRFSS, 1990 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10.

  12. Height (meters) BMI = [Weight (kilograms)]2 [Height (Inches) / 39.54] BMI = [Weight (Pounds) / 2.2]2 Body Mass Index (BMI)

  13. Weight Ranges For Different BMI Scores Body Type BMI Range Underweight < 18.5 Healthy Weight 18.5 - 24.9 Overweight 25.0 - 29.9 Obese 30.0 - 39.9 Extremely Obese > 40.0

  14. Obesity Trends* Among U.S. AdultsBRFSS, 1991 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10.

  15. Obesity Trends* Among U.S. AdultsBRFSS, 1992 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10.

  16. Obesity Trends* Among U.S. AdultsBRFSS, 1993 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10.

  17. Obesity Trends* Among U.S. AdultsBRFSS, 1994 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10.

  18. Obesity Trends* Among U.S. AdultsBRFSS, 1995 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10.

  19. Obesity Trends* Among U.S. AdultsBRFSS, 1996 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10.

  20. Obesity Trends* Among U.S. AdultsBRFSS, 1997 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10.

  21. Obesity Trends* Among U.S. AdultsBRFSS, 1998 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10.

  22. Obesity Trends* Among U.S. AdultsBRFSS, 1999 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10.

  23. Obesity Trends* Among U.S. AdultsBRFSS, 2000 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10.

  24. Obesity Trends* Among U.S. AdultsBRFSS, 2001 Source: Mokdad A H, et al. J Am Med Assoc1999;282:16, 2001;286:10.

  25. What Do The Experts Say? • Dr. Atkins’ New Diet Revolution - Atkins • Protein Power - Eades • Sugar Busters - Steward • The Zone - Sears • Dieting With The Duchess - Sarah • Volumetrics - Rolls • The Pritikin Principle - Pritikin • Choose To Lose - Goor • Eat More, Weigh Less - Ornish

  26. Comparison of Popular Diets - Macronutrients

  27. Comparison of Popular Diets - Macronutrients

  28. Comparison of Popular Diets - Macronutrients

  29. Comparison of Popular Diets - Macronutrients

  30. Comparison of Popular Diets - Macronutrients

  31. Comparison of Popular Diets - Macronutrients

  32. The Metabolic Imperative Weight Stability Energy Intake Energy Expended =

  33. The Metabolic Imperative Weight Gain Energy Expended > Energy Intake

  34. The Metabolic Imperative Weight Loss Energy Intake < Energy Expended

  35. Does That Mean You Should Go On A Diet? NO!

  36. Rx For Healthy Nutrition and Weight Control • Diet • Carbohydrates - 35% (Fruits & Vegetables) • Proteins - 30% of Calories (Fish, Poultry, Eggs) • Fats - 35% of Calories (Fish, Meat, Nuts, Oils) • 1/3 - Saturated • 1/3 - Monounsaturated • 1/3 - Polyunsaturated • Colorful Fruits and Vegetables • Supplements • Vitamins & Minerals (RDA) • Omega-3 FA’s (fish oil)

  37. Vitamin E and Heart Disease Relative Risk (Age Adjusted) In the 88,000 Nurses Study, Dietary Vitamin E greater than 200 IU per day was associated with a 41% Decreased Risk for Major Coronary Heart Diseases.

  38. Omega-3 Fatty Acids (fish oil) Eicosapentaenoic Acid (EPA, 20:5w3) Docosahexaenoic Acid (DHA, 22:6w3) Health Benefits: • Reduces Risk of Sudden Cardiac Death • Anti-inflammatory Properties • Improves Membrane Fluidity • Increases HDL (good) Cholesterol • Reduces Blood Pressure • Reduces Risk of Blood Clots • Lowers LP(a)

  39. X X • Water • Amino Acids • Fatty Acids X • Vitamins • Minerals X • Phytochemicals Focus On Essentials - Eat Mostly Nutrient-Dense Foods Avoid “Trans” Fats! X X X Consume ONLY those foods with a nutritional payoff - NO EMPTY CALORIES!

  40. USDA Revising The Food Pyramid?

  41. What About Caloric Restriction and Aging?

  42. 50% Calorie Restriction 10% Calorie Restriction 60% Calorie Restriction Fully Fed • Adapted From: R. Weindruch et al. , J. of Nutrition, 116:641, 1986 Typical Survival Curves For Mice On CR Diets

  43. Caloric Restriction In Adult Mice Length Of Life In Days ad libidum 60% of ad libidum intake Median 10th %ile Maximum Group 1 701 822 941 Group 2 1057 1226 1296 Group 3 808 918 1040 Group 4 941 1177 1299 0 6 12 Age (months) 0 6 12 Age (months) Data from Yu et al. (1985) Figure from Masoro (1989)

  44. Caloric Restriction In Adult Mice Length Of Life In Days ad libidum 60% of ad libidum intake Median 10th %ile Maximum Group 1 701 822 941 Group 2 1057 1226 1296 Group 3 808 918 1040 Group 4 941 1177 1299 0 6 12 Age (months) 0 6 12 Age (months) Group 4 Lifespan Increase: ~40% Data from Yu et al. (1985) Figure from Masoro (1989)

  45. Length Of Life In Months Ad libidum Restricted % Increase Study Animal CR Onset Ave Max Ave Max Ave Max 1 Rat 50% 12M 18 30 26 30 44% 0% 2 Mouse 50% 12M 21 26 26 30 24% 15% 3 Hamster 50% 12M 23 28 30 33 30% 18% 4 Mouse 50% 14M 36 41 39 45 8% 10% 5 Rat 50% 12M 31 39 35 41 13% 5% Studies of Late-Onset Caloric Restriction Adapted From Walford & Weindruch (1989)

  46. Length Of Life In Months Ad libidum Restricted % Increase Study Animal CR Onset Ave Max Ave Max Ave Max 1 Rat 50% 12M 18 30 26 30 44% 0% 2 Mouse 50% 12M 21 26 26 30 24% 15% 3 Hamster 50% 12M 23 28 30 33 30% 18% 4 Mouse 50% 14M 36 41 39 45 8% 10% 5 Rat 50% 12M 31 39 35 41 13% 5% Studies of Late-Onset Caloric Restriction Adapted From Walford & Weindruch (1989)

  47. The Payoff From A Successful Caloric Restriction Diet ~33% Retardation of Aging Rate • Constant Hunger • Abnormal Focus On Food (24hrs./day) • Loss of Libido (reproductive function) • Increased Life Expectancy Payoff: • If, starting at age 50, you do CR successfully for 30 years, then when you are 80 years old, you will function as though you were only 70. This is just NOT enough for most people!

  48. Height (meters) BMI = [Weight (kilograms)]2 BMI and All Cause Mortality 25 All Cause Mortality 20 15 Deaths/1000/year 10 5 0 <20 20 22 24 26 28 30 Body Mass Index • Adapted From: British Medical Journal, 1997; 314: 1311-1317 • Adapted From: British Medical Journal, 1997; 314: 1311-1317

  49. Risk of Death <16% 16-25% 25% Lee CD et al. Am J Clin Nutr 1999. Fit-Fat & Mortality In Men % Body Fat

  50. Effect of Exercise On Total and Visceral Body Fat • 173 Sedentary, overweight, post-menopausal women • Exercise group: 45 minutes, 5 day/day X 1 year • 3 months 3 d/week supervised & 2 days unsupervised • 9 months 1 d/week supervised & 4 days unsupervised JAMA- Jan 15, 2003: Vol 289(3)

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