April 2023 Newsletter | Outlive: The Science and Art of Longevity
My mission is to be the first woman in 4 generations to not develop Alzheimer’s Disease (AD). On my journey of discovering ways to mitigate my risk, I pass this information on to you in this Brain-Body-Health (BBH) Newsletter.
Since we know aging is the #1 risk of AD, I was excited to dig into Peter Attia’s new book, “Outlive, The Science and Art of Longevity”. In it, he sends a trumpet call to start taking health seriously, the sooner the better, challenging our binary thinking about health, illness, and aging. Utilizing batteries of tests to determine neurological, genetic, and physiological health, this is precision medicine at its best doing what it is supposed to do; zero in on what diseases we are the greatest risk for and develop an effective strategy to reduce them. According to Attia, most people think of themselves as healthy but are swimming deep in a river called de-Nile. He explains why your blood work and cholesterol might be “normal” but could be unhealthy because the average is not optimal. Relying on Penicillin-era acute treatments which he calls ‘2.0 Medicine’, the prevailing one size fits all, leaves us antiquated and ill-equipped to slow or delay aging. When is the last time your provider talked about slowing aging? It’s not even on the radar of possibilities for most. Precision ‘Medicine 3.0’ combines new technologies, and biomarkers with well-informed research that empower clients who are not passively waiting for a prescription, diagnosis, or pat on the back, but rather are involved, willing to work, learn, listen, and change habits to reduce the onslaught of chronic diseases, aka the 4 deadly Horsemen, Arteriosclerotic Cardiovascular Disease (ASCVD), Cancer, Neurodegenerative Diseases (NDD), and Type 2 Diabetes. Interestingly, these top causes of mortality all share underlying biological mechanisms, like chronic inflammation, oxidative stress, changes in the microbiome, telomeres, gene expression, and insulin resistance etc... Each one of these mechanisms is directly influenced by what we eat, sleep, how we respond to stress, how much exercise we get, and how much love and support we have. The chapters on the Horseman are informative especially the one on Neurodegenerative disorders. AD makes up the vast majority with new research pointing to Parkinson's’ Disease as the fastest-growing NDD. I was pleasantly surprised to learn the lab results Attia checks first. Yep, APOE4, Lp(a) genetic inflammatory factor, APOB inflammatory factor, and insulin resistance. These coincide with BBH recommendations because Attia believes like I do, that checking the APOE4 status in all of us is important since it predisposes us to chronic diseases that will reduce our health span. It is scary to know that you are at risk for a disease like AD, but the good news is the sooner you know the better equipped you will be in mitigating its effects as Chris Hemsworth discovered, as was discussed in the BBH December Newsletter.
“Outlive” debunks the myth that we will all grow old and feeble. Using studies on centenarians brings home the point that we don’t have to become old and frail. It is NOT a slam dunk. Breaking down specifically what kind of fitness you will need in order to accomplish certain daily living skills at age 80 or 90, like carrying two five-pound bags of groceries, tying your shoes, picking up your grandchild, having sex, and getting up off the floor, Attia encourages us to make our own list. This is part of the preparatory work and training for a healthy life span. There is a method to the ‘science and art of longevity’ and it involves new ‘eyes’ to see your vision of what health span means to you and how you plan to get there.
LESSONS ON COACHING
We APOE4's are the canaries in the mine when it comes to research in AD. Since the APOE4 gene runs in my family, I’m always on the lookout for studies that impact its expression. Recently, I was able to attend an international online symposium devoted to APOE4 gene research. My takeaway was having this gene creates more sensitive brains impacted by effects on cellular metabolism, glucose transport, inflammation pathways, and the blood-brain barrier. Some estimate 400+ reactions from this single amino acid substitution. Those of us who are APOE4 carriers need to focus on reducing or eliminating toxins (general anesthesia, household products, pollution, mercury, mold, viruses), alcohol, high glycemic foods, high saturated fat, and processed foods. There is mounting evidence that a modified ketogenic diet (low carb, healthy fat, moderate protein), physical exercise, Fish Oil, vitamins D and B, and HRT for women all improve cognition.
How much exercise should I have? Exercise physiologist's recommendation is 3 hours/week or 4 times for 45 minutes in zone 2, which improves cognition by increasing cerebral blood flow and BDNF (Brain Derived Neurotropic Factor). Zone 2, works on “slow-twitch” muscle fibers dense with mitochondria, maximizing cellular energy and reducing insulin resistance. Zone 2 is easy to moderate aerobic activity. There are lots of formulas for Zone 2 training. I use: 220 - 70 (age) = Maximum Heart Rate (MHR). For me: 220-70=150(MHR) X 65%= 97.5 bottom range; X 85% = 127 top range. Or you can use the “talk test”. If you are at the top of zone 2 you should be able to talk but not interested in holding a conversation.
Make sure to include strength training 2-3 times/week, with adequate protein.
STRATEGIES FROM “OUTLIVE” FOR ALZHEIMER-PREVENTION PROGRAM
What’s good for the heart is good for the brain.
What’s good for the liver and pancreas is good for the brain. Metabolic health is crucial to brain health.
Time is key. We need to think about prevention early, and the more the deck is stacked against you genetically, the harder you need to work and the sooner you need to start.
Our most powerful tool for preventing cognitive decline is exercise.
LESSONS FROM SCIENCE
This study shows slower cognitive decline in older adults adhering to six healthy lifestyle behaviors in a large population-based study (29,000 over 10 years) inclusive of APOE4’s; a healthy diet (adherence to the recommended intake of at least 7 of 12 eligible food items), regular physical exercise (≥150 min of moderate intensity or ≥75 min of vigorous intensity, per week), active social contact (≥twice per week), active cognitive activity (≥twice per week), never or previously smoked, and never drinking alcohol.
Just 2 patients and both APOE3/3 but nevertheless their cognition improved with vigorous, regular physical exercise slowing their Alzheimer's disease.
A new study shows HRT benefits in APOE4s. Discussed in February BBH Newsletter. There is an excellent section on this subject in “Outlive”.
To our optimized health!
Subscribe to the email list for news and updates on Body-Brain Health
“If you want to go FAST, go alone. If you want to go FAR, go together."
- African proverb
To our optimized health!