Transcript Aging & inflammation - Saskatoon Community Clinic

Aging & inflammation
Aging well
Hunza Valley
Hunza man
Aging well
Okinawan woman
Beach in Okinawa
Coronary heart disease: 18/100,000 versus 100/100,000 in the USA
Prevailing theory of the
cause of age related
chronic illness
Cumulative damage from oxidative stress
and chronic inflammation leads to illness
What is damaged? Carbohydrates,
proteins, lipids, cell membranes, DNA
Inflammation
oxidative stress
Acute & chronic
inflammation
Acute inflammation occurs when, for example,
we fight infections or heal wounds
When visible, there are classic signs and
symptoms: swelling, redness, heat and pain
Chronic inflammation is an ongoing low grade
type of inflammation that is not noticeable
externally but can be assessed by specific
laboratory tests
Oxidative stress
Oxidative stress damages molecules that
have important functions in living systems
Oxidative stress occurs as a part of normal
metabolism and is balanced by the body’s
anti-oxidant network
Oxidative stress is also triggered when we
are exposed to ultraviolet light, tobacco
smoke, environmental toxins and ionizing
radiation.
Oxidative stress
can set off chain
reactions
Oxidative stress leads to the generation of
reactive oxygen species (ROS)
ROS are unstable molecules that can initiate
destructive chain reactions in the bodydamaging cells and their normal functions
Some examples of reactive oxygen species are:
free radicals and hydrogen peroxide
Oxidative stress and chronic
inflammation are linked to:
Aging
Arthritis
Cancer
Cardiovascular disease
Cataracts
Diabetes
Osteoporosis
Asthma
Heart disease and
inflammation
High sensitivity C-reactive protein (hsCRP)
is a marker of inflammation in the body
Elevated hsCRP has been found to be a
stronger predictor of heart disease than a
high LDL (harmful) cholesterol
Our anti-oxidant
defenses
The body has a complex set of anti-oxidant
defenses to protect itself from the damage from
reactive oxygen species
These include anti-oxidants produced by the
body and anti-oxidants ingested in foods
Anti-oxidant defenses also include special
mechanisms to repair damaged DNA, unique
enzymes and physical barriers
Antioxidant defenses
Vitamins: retinol (vitamin A), niacin, riboflavin, vitamin B6,
vitamin C, vitamin D, vitamin E and vitamin K
Omega 3 PUFA’s: eicosapentanoic acid, docosahexanoic
acid, alpha linolenic acid
Amino acids/peptides/proteins: taurine, glutamine, Larginine, histidine, glycine, thiols, n-acetyl cysteine,
carnosine, lactoferrin, transferrin, etc
Phytochemicals: polyphenols, glucosinolates,
carotenoids, allicin, etc
Minerals: zinc, selenium, copper (+/-), iron (+/-)
Enzymes: SOD (superoxide dismutase), CAT (catalase),
GPX (glutathione peroxidase), glutathione S-transferase,
thioredoxin, Co-enzyme Q10
Controlling excess
inflammation
Inflammation is influenced by the balance
between series 1, 2 and 3 ‘eicosanoids’
Eicosanoids are locally produced compounds
derived from polyunsaturated fatty acids (PUFA’s)
Eicosanoids include prostaglandins,
thromboxanes, leukotrienes
These compounds govern many diverse
physiological processes in the body: cell growth
and differentiation, blood clotting and key aspects
of immune function
Key points
It is important to have a balance between
the different kinds of eicosanoids
The kinds of eicosanoids we produce is
directly influenced by the types of fatty
acids in the diet
Series 1 and 3 eicosanoids have antiinflammatory effects
Series 2 eicosanoids promote
inflammation
Sources of omega 3 fatty acids
Alpha linolenic acid:
flax, walnuts, canola oil,
soy, hemp, chia seeds
EPA/DHA: fatty fish
such as wild salmon,
black cod, herring,
halibut, sardines
Omega 6 pathway
Linoleic acid (LA)
Safflower, sunflower,
corn, peanut oils
Omega 3 pathway
Alpha-linolenic acid
(LNA) Flax, walnuts,
hemp, canola
Delta-6 desaturase
Gamma-linolenic acid
Evening primrose oil
(GLA)
Elongase
Eicosapentanoic acid
halibut
(EPA) Salmon,
sardines, herring
PG1
Arachidonic acid
(AA)
PG2
Meat,
butter
PG3
Docosahexanoic acid
halibut,
(DHA) Salmon,
sardines, herring
Thus…
Over consumption of omega 6 fats can
lead to increased inflammation
Consumption of omega 3 fats has antiinflammatory effects
North American diets tend to have
excessive amounts of omega 6 fatty acids
and high ratio of n-6 to n-3 fatty acids
North American dietary patterns therefore
tend to promote chronic inflammation
Causes of the imbalance between
omega 6 and omega 3 fatty acids
Widespread use of vegetable
oils, such as safflower,
sunflower, corn, peanut, etc
High intake of arachidonic
acid from animal foods
Grain fed (high intake of omega 6’s) as
opposed to pasture fed (high intake omega 3’s
from grasses) animals
Grain fed, grass fed and wild game
Data from J. Animal Sci 80(5):1202-11.
Diet/lifestyle choices that
can increase oxidative
stress and inflammation
Cigarette smoking
Overeating
High glycemic index carbohydrates
Omega 6 fats/trans fats/saturated fats
Lack of antioxidant nutrients in the diet
Chronic stress
Stress hormones:
the adrenal glands
The major stress hormones
are released from the
adrenal glands:
 adrenaline, noradrenaline
 cortisol
Sympathetic Nervous System
(SNS)
Heart rate  RR
 Blood pressure
 Blood glucose
 LDL cholesterol
Senses are sharpened
Blood flow is directed to
exercising muscles
Stress is *catabolic
Our physical reaction to
stress is analogous to
burning the dining room
furniture to stay warm
during a power failure.
*Catabolism: the breakdown of complex materials in an organism
SNS: What’s turned off?
Getting rid of unnecessary energy expenditure
Digestive tract: enzymes,
blood flow, peristalsis
Tissue growth and repair
Immune function
Sex drive
Pain sensation
Testosterone and
estrogen production
Chronic stress and
brain function
During stress, the brain’s ‘executive
functions’ are disengaged (moral
reasoning, judgment, planning)
More primitive, reflex areas of the brain
remain engaged (sleep/wake cycles,
spatial memory)
High cortisol levels interfere with learning
and memory and may lead to permanent
damage to neurons in the brain
Chronic stress & aging
Telomeres protect the ends of
chromosomes during cell division.
Accelerated telomere shortening is
associated with aging, CVD, HIV, etc
Telomerase is a cellular enzyme that
promotes telomere repair
Chronic stress and elevated cortisol levels
have been found to reduce the activity of
telomerase
Chronic stress and
immune function
Stress results in a significant decline in
natural killer (NK) cell cytotoxic activity.
NK cells play a key role in immune system
surveillance against viral-infected cells and
cancer cells.
Stress also reduces the production of
secretory IgA- an important part of
immune response in the gastrointestinal
system, urinary tract and lungs
Results of chronic
stress
Stress has been found to:
 slow wound healing
 diminish the strength of immune responses to
vaccines
 enhance susceptibility to infectious agents
 reactivate latent viruses
Stress, heart disease
& inflammation
Stress can result in inflammation of the
arterial walls and an increased tendency of
the blood to clot leading to atherosclerosis
and an increased risk of heart attack and
stroke
Stress can lead to a more atherosclerotic
lipid profile: increased LDL cholesterol
Stress can raise blood pressure and blood
glucose
Chronic stress
and resiliency
Relatively stress free individuals are
resilient and can more readily rebound
from an acutely stressful event
Chronically stressed individuals are less
able to rebound from an acute stresses.
They may suffer a greater degree of
distress, and exhibit higher peak
adrenaline levels and greater reductions in
NK cell activity
Chronic stress
and visceral fat
Higher cortisol levels are associated with
an increase in visceral fat
Visceral fat is linked to increased risk of
coronary artery disease, stroke,
hypertension and diabetes
Chronic stress: appetite
and food choices
About 70% of people increase their caloric
intake when stressed.
Most people choose calorie dense foods
such as highly processed carbohydrates
(pastries, chips, bread) and or foods rich in
fat such as ice cream and chocolate
High cortisol levels, high insulin levels, and
consuming calorie dense foods all tend to
promote increased visceral fat distribution
What to do?
We can support our body’s antioxidant system and reduce chronic
inflammation and stress by choosing
certain foods and lifestyle behaviors
Foods that support the
anti-oxidant system
Vitamin E: nuts, avocados, olive oil
Vitamin C: oranges, peppers, papayas
Beta carotene: carrots, leafy greens, squash,
sweet potatoes
Selenium: brazil nuts, seafood, oatmeal
Copper, zinc & manganese: nuts, meat, beans,
berries, dark leafy greens, whole grains
Riboflavin: liver, milk, eggs, spinach, brown rice
Sulfur containing amino acids: seafood, meat,
cheese, peanuts, sunflower seeds, lentils,
pumpkin seeds, sesame seeds
The antioxidant network
Vitamin C is the body’s major water soluble
anti-oxidant
Vitamin E is the body’s major fat soluble
anti-oxidant
Vitamin C can regenerate vitamin E and
glutathione
Glutathione can regenerate vitamin C & E
Coenzyme Q10 regenerates vitamin E
Lipoic acid can regenerate vitamin C and E
and raises glutathione levels
‘Anti-inflammatory diet’
Abundant fruits and
vegetables
Healthy fats: olive oil, nuts,
fatty cold water fish, fish oil
Low glycemic index/load
carbohydrates
Green tea, turmeric, ginger
A rainbow of colors
8-10 servings per day of a wide variety of
colors and kinds of fruits and vegetables
Servings of Fruits
and vegetables
One medium sized fruit or vegetable
1 cup of salad
½ cup of cooked vegetables
One 4oz glass of fruit juice
How to get
enough fruits
and vegetables
Have at least 2 servings with breakfast & lunch
 Mixed berries or a glass of fruit juice and an apple
with breakfast
 A salad or raw vegies with dip with lunch
Have at least 3 servings with supper
 Baked squash, green beans and beets
 Swiss chard, carrots and broccoli
Have at least 1 snack (preferably 2) per day
 A pear, some plums, banana, carrot sticks, etc
Fruits and vegetables reduce
oxidative stress and inflammation
 C-reactive protein
(CRP)
 Interleukin-6 (IL-6)
 Tumor necrosis factor-a
(TNF-a )
Healthy fats
Extra virgin olive oil: a good
source of monounsaturated
fats and high in antiinflammatory polyphenols
Omega 3 essential fatty
acids from fatty fish (e.g.
salmon), canola oil, walnuts,
hemp, flax, dark leafy
greens
Avoid/reduce unhealthy fats
Omega 6 vegetable oilssafflower, sunflower,
corn, peanut
Trans fats-margarine,
crackers, peanut butter,
deep fried food
Saturated fats-meat and
dairy products
Low glycemic index carbohydrates
Whole grain breads, cooked whole grains
(quinoa, bulgur, barley), al dente pasta,
large flake oats, Basmati rice, Uncle Ben’s
converted rice, dairy products, beans,
nuts, fruits, vegetables
Spices and teas
Green tea (best if steeped
for at least 3 minutes)
Turmeric, ginger
Rosemary, oregano
Okinawan diet
The Okinawan Centenarian Study (OCS) found
that elder Okinawans ate (per day):
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


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7 servings of vegetables
7 servings of whole grains
2 servings of soy foods
fish 2-3 times per week.
Consumption of meat and dairy products was very
low. They ate very little sugar or added fats.
 They eat primarily whole unrefined grains and do not
eat margarines or hydrogenated fats.
Okinawan diet
Overall, when compared to a western diet,
Okinawans ate:
 more vegetables, grains, soy foods, and fish
 far less meat, poultry, eggs, and dairy
products and less fruit
‘Anti-inflammatory diet
& lifestyle’
Abundant fruits and
vegetables
Healthy fats: olive oil, nuts,
fatty cold water fish, fish oil
Low glycemic index/load
carbohydrates
Green tea, turmeric, ginger
Reduce stress
Get regular exercise