Nutrition Articles by Richard Kunin, MD

Until lately it was believed that the best, and perhaps the only, way to achieve a healthy old age is via genetics, ie. as a gift of nature. The search for the elixir of life or the fountain of youth, on the other hand, reflects a nurturing approach to longevity. The nature-nurture debate about human traits is ongoing but the current trend is increasingly in favor of nurture, as in nutrition. We have arrived at a consensus on diet and aging: intake of fresh fruits and vegetables can increase longevity and decrease disease.

The science behind this consensus is the free radical theory of cell damage as proposed by Dr. Denham Harman in 1956. Free radicals, molecules with an unpaired electron, are generated by the process of normal body chemistry but they can react with the enzymes, membranes and even the nucleic acids within cells, thus causing damage that shows up as loss of function and withered appearance typical of the aging process.

Free radical production is mostly in mitochondria, that part of the cell that performs oxidation of carbohydrates and fats, thus producing end products, ie. energy, carbon dioxide and water. The mitochondrial membranes are subject to accidental damage from the free radicals they produce. In addition the free radicals cause electronic chain reactions when they interact with unsaturated fatty acids stored in cell membranes, causing electrons to leap through the membranes and into the DNA within the cell nucleus. The cumulative end result of decades of this sort of thing is aging: the damaged cells produce altered products, eg. thin hair, wrinkled skin, pigment spots and in a worst case, the cell is transformed into a cancer cell.

Because free radicals are inevitable by-products of normal body chemistry, Mother Nature has evolved a comprehensive system of anti-oxidant protection, based on antioxidant enzymes within the cells and antioxidant vitamins and minerals from the diet. Glutathione peroxidase, Superoxide dismutase and Catalase are the best known of the enzymes that capture free radicals before they can do much damage. Each depends on a steady supply of key nutrients, such as methionine, cysteine, selenium, zinc, manganese, copper and iron. When these nutrients are in short supply our anti-oxidant defenses may fail. Bad nutrition does not only make you sick, it also can make you old before your time.

Antioxoidant vitamins, such as vitamins C and E, have the property of electronic duality, changing from oxidized to reduced form and back again by means of giving or taking up electrons (negative charge) or protons (positive charge). This redox property serves to stabilize surrounding molecules, particularly the unsaurated fatty acids in cell membranes. Saturated fats are stable; they do not peroxidize and hence their presence serves to stabilize cell membranes and nerve transmission.

Unsaturated fatty acids are reactive, they readily gain or lose electrons from their double bond carbons or lose protons from their acidic portions. Two of these unsaturated fats, linoleic and alpha-linolenic acids, cannot be made in the body but are required for survival; therefore they are classified as essential. The primary sources are vegetables, particularly salad oils (linoleic acid) and oils from flax, walnut or soy (linolenic acid).

Since molecules of life must pass through the cell membranes, in order for life chemistry to operate, the cell membrane fats must be poised at the optimal reactivity. The vitamin antioxidants provide a supply of electrons (negative charge) and protons (positive charge) to stabilize and preserve the membrane redox balance. Without this supply of redox elements, the fatty acids are vulnerable to altered regulation, eg. lower energy ouput, and also to peroxidation, whereby the free radical is passed on throughout the cell and causing damage to the genetic material.

Increased intake of fat, particularly unsaturated fats, increases the requirement for antioxidant protection. Pathological states, such as fever or increased excess thyroid hormone amplify the metabolic rate and the production of free radicals. Extraordinary physical activity, particularly endurance exercise, such as long distance running, also increases the oxidant load and the requirement for antioxidant protection. Without antioxidant supplementation, these conditions lead to premature aging.

There is more to this free radical theory than just abstract science. Your own rate of aging and your claim to ongoing good health depend on your own personal balance of genetics, activity and dietary intake, including supplementation. A study from the University of Minnesota, my old alma mater, is one of the first prospective studies showing a link between vegetable and fruit consumption and lung cancer risk. A questionnaire was sent to 41,837 Iowa women, age 55 to 69. After 4 years there were 179 cases of lung cancer and when diet intakes were compared with 138 randomly selected non-cancer patients it was found that high intake of all vegetables, fruits or of green leafy vegetables were each associated with a reduction in cancer cases by half, ie.half the risk of lung cancer if you eat your veggies!

Continuing on that theme, a headline appeared in the American Medical Association News (4/26/93): "Veggies beat popping pills" The article was reporting a study released by the American Heart Association in which the health of 87,245 nurses correlated with their intake of carrots and spinach, rich in beta carotene. Those who ate 5 or more servings of carrots per week had 68 percent less risk of stroke than women who ate one serving per month or less. Those who ate spinach every day had a 43 percent lower risk.

This study by Drs. Manson, Stampfer and Willett concluded that beta carotene provided the greatest protection against stroke, though vitamins C and E also provided additional protection.[1] Vitamin A also provides protection against stroke. Patients with higher than normal serum vitamin A (over 65 mcg/dl) had reduced mortality, higher rate of recovery and better outcome from stroke.[2]

Of course, it is better to protect against stroke in the first place. Research evidence finds potassium and vitamin B12 of particular value in this regard. The risk of stroke decreases as the dietary potassium intake increases.[3] The mechanism behind this is not yet known, but it is known that high potassium diets also prevent damage to the cells lining blood vessel walls. Atherosclerosis and cholesterol deposition are markedly reduced with a high potassium diet. Vegetables, particularly melons, squashes, seeds, nuts and fruits are the richest dietary sources.

Deficiency of vitamin B12, found only in red meat, often leads to dangerously increased amounts of homocysteine and MMA (methyl malonic acid), by-products of protein metabolism. Homocysteine is specifically toxic to the endothelial cells, the lining of blood vessels, and causes platelet clumps and clots. In a recent study at the Veterans Administration Medical Center in Denver[4], 152 patients were screened by measuring serum levels of B12 as well as homocysteine. Deficiency of B12 was identified in 22 of these patients when homocysteine and MMA were measured along with B12. The blood test of vitamin B12 alone is likely to miss the diagnosis; therefore researchers recommend that all three be measured when B12 is in question. The extra tests cost $125 and insurance may not always cover the expense but is that not cheaper than a wrong diagnosis and inadequate treatment? By treating the B12 deficiency, heart attacks, strokes and peripheral vascular diseases are prevented.

Other nutrient deficiencies are common causes of illness in the elderly: for example, folic acid deficiency in post-menopausal women is known to contribute to osteoporosis, B6 deficiency interferes with immune and nervous system function. How about vitamin C? A recent study in Holland compared women living at home versus those in nursing homes.[5] The dietary vitamin C intake was observed to decrease as dependency on institutional care increased. Thus women at home selected diets with over 130 mg of vitamin C on average. Nursing homes provided only 54 mg of vitamin C daily and clinical signs of scurvy were identified in over a third of these women!

Even in France with its tradition of good foods and wines and minimum of food additives, research finds that the elderly are often selenium deficient[6]. There is more to it than diet because it is known that plasma selenium decreases with age. The lower selenium status correlates with reduced activity of the antioxidant enzyme, glutathione peroxidase. Other nutrients that decline with age are chromium and coenzyme Q. Chromium deficiency aggravates diabetes and promotes atherosclerosis. Supplementation can improve the diabetes and actually reverses atherosclerotic plaque[7]. Coenzyme Q is a natural catalyst for energy production within cells; it also protects the mitochondria from oxidation. The net result is both a significant increase in energy and protection of the cells, a combination of effects that preserves our youthful qualities.

Energy is not enough to assure healthy aging, however, for one also must remain free of acute illness so as to enjoy life. The power of nutrient supplements against infection is well documented by professor Ranjit Chandra, a world leader in research defining the nutrition-immune relationship. A control group of about 50 healthy seniors, all over age 65, was observed over the course of a year. On average they reported 48 days of infection-related illness in that time. This was more than twice the amount of illness, only 23 days, reported by a similar group who were treated with a special multivitamin mineral supplement.

In this case, research demonstrated a 50% reduction in illness for those taking a properly engineered nutrient supplement! Such research is helpful because there are still many people who just can't believe that a "simple" vitamin pill can be of value. And research is indispensable in persuading the largely skeptical medical profession, who have been brainwashed by the institutional bias of their medical education against diet and vitamin therapy. Can 150 million Americans (who take vitamins) be wrong? Only the AMA, FDA and the surgeon general seem to think so.

On the other hand, excess calories, overeating, particularly foods that lack nutrients or are polluted with toxic chemicals, including excessive sugar, salt, phosphates, rancid unsaturated fats, trans fats (as in margarines), denatured proteins (due to heat or processing in the presence of sugar) and the now ubiquitous fluorides--all these and more predispose us to degenerative disease. The key is to find the optimum intake for each individual, relative to motivation, and lifestyle. There is no single set of recommendations that works for everyone alike, but physical and laboratory examination with a focus on nutrients is the most rational medical method to assure ongoing health and well-being. This is Nutri-Molecular Medicine©, putting nutrition first for long life and a healthy old age.

© 2011 Richard A. Kunin, M.D.

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