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SPRING M THE OFFICIAL MAGAZINE OF THE AMERICAN ACADEMY OF ANTI-AGING MEDICINE A R 2007 G O AAAAnnnnttttiiii----AAAAggggiiiinnnngggg R P W O H S L A CI FI F O MMMMeeeeddddiiiiccccaaaallll NNNNeeeewwwwssss IN THIS ISSUE: A4M 2007-2008 Worldwide Official Educational Programs 2 Report from the Medical Committee for Aging Research & Education (Issue 1, 2007): Lifespan Literature Scan 4 Obesity and Longevity 6 Research Recaps: Dementia and Alzheimerʼs Disease: A Scientific Literature Review 12 Program of the 15th Annual Congress on Anti-Aging Medicine & Regenerative Biomedical Technologies, Spring 2007 Session: Schedule at a Glance 16 Educational Affiliates 26 Board Certification 28 Faculty Biographies 29 Faculty Disclosures 51 Abstracts 53 PRSRT STD U.S. POSTAGE PAID Milwaukee, WI PERMIT NO. 1353 THE INTERNET’S LEADING ANTI-AGING PORTAL Anti-Aging Medical News : Winner - APEX Award THE A4M SPECIAL INFORMATION CENTER WWW.WORLDHEALTH.NET 2003 & 2004: Excellence in Health and Medical Content PUBLISHING & MEDIA SHOWCASE 2005 & 2006: Excellence in Conference & Meeting Materials WWW.A4MINFO.NET Welcome Dear Attendee: The American Academy of Anti-Aging Medicine (A4M) welcomes you to Florida for the 15th Annual International Congress on Anti-Aging Medicine and Regenerative Biomedical Technologies, Spring 2007 Session. The American Academy of Anti-Aging Medicine (A4M) is among the fastest growing medical societies in the world today, growing from twelve doctors in 1993 to a current membership of 20,000-plus. The A4M conferences have grown to become the largest worldwide in the area of preventative medicine. A4M conferences have achieved what to our knowledge no other medical group in history in any specialty has accomplished, growing in three years from just two international conferences to more than 30 annual international conferences around the world on all continents in 2007, many with the support of governments, ministries of health and international sports federation organizations. The worth and value of A4M and its scientifi c conferences has been decided and validated by the practicing physicians around the world, who elect to attend its worldwide co-supported/co-sponsored academic events. The A4M has on-site trained 100,000 physicians and health professionals to date and provides online continuing medical education to more 500,000 physicians and health professionals annually. We commend you for attending this premier educational event in the anti-aging medical specialty, where more than 60 of the worldʼs most recognized clinicians and researchers in anti-aging and regenerative medicine present the very latest data and fi ndings that advance a new paradigm of innovations in advanced preventive medicine. With warm regards, Dr. Ronald Klatz, MD, DO Dr. Robert Goldman, MD, PhD, DO, FAASP President, A4M Chairman, A4M IMPORTANT NOTICE: PLEASE READ The Exhibition Hall is a separate commercial exposition, held in conjunction with but distinct from the medical education presentation coordinated by the American Academy of Anti-Aging Medicine (A4M). Exhibitors are invited to participate on a fi rst-come, fi rst-serve basis. Neither the A4M nor Medical Conferences International Inc. has conducted an evalua- tion of exhibitors, their products, their labels or labeling, or their representations. A4M and Medical Conferences International Inc. do not vouch for the relative worth, safety or effi cacy of products or services displayed. A4M and Medical Conferences International Inc. encourage all attendees to conduct their own independent and diligent evaluations. Be mindful that anti-aging medicine delivers an innovative model for healthcare in which the sanctity of personal freedoms of choice is upheld. It is with a reverence for freedom of thought, ideas and practice in healthcare that A4M refrains from limiting, censoring, or discriminating against those who wish to pres- ent their products or ideas in an open forum of medical professionals. With this open marketplace, however, it is incumbent that you, the Exposition visitor, is aware that participants at this commercial venue are not endorsed and have not been evaluated or approved by A4M. The A4M encourages you to exercise your personal scrutiny, educated and demanding scientifi c evaluation in assessing the ideas and products presented. To restrict this free exchange of thought, both conventional and unconventional, would eliminate true opportunities for breakthrough and discovery vital to our new science. Indeed, freedom of thought is the essential foundation upon which the advancement of health care itself is based. Spring(cid:3)2007(cid:3) Anti-Aging(cid:3)Medical(cid:3)News(cid:3)•(cid:3)1 A4M Co-Sponsored/ Anti-Aging / Regenerative April 16-17, 2007 London, England September 14-16, 2007 London, England*,† 15th Annual 16th Annual International Congress International Congress September 12-14, 2008 Summer 2007 Session Summer 2008 Session London, England*,† August 2-4, 2007 August 7-9, 2008 Chicago, ILUSA*,**, † Chicago, ILUSA*,**, † Anti-Aging World Congress March 22-24, 2007 15th Annual International 16th Annual International Monaco*,† Congress Congress Anti-Aging Winter 2007 Session Winter 2008 Session World Congress December 12-15, 2007 December 3-6, 2008 March 27-29, 2008 Las Vegas, NVUSA*,**, † Las Vegas, NVUSA*,**, † Monaco*,† October 5-7, 2007 Madrid, Spain October 3-5, 2008 Madrid, Spain Sept. 19-22, 2007 Estoril, Portugal Sept. 17-20, 2008 Estoril, Portugal October 27-29, 2007 15th Annual Guadalajara, Mexico International Congress Spring 2007 Session October 25-27, 2008 April 26-28, 2007 Guadalajara, Mexico Orlando, FLUSA*,† October 5-7, 2007 Cancun, Mexico 16th Annual October 3-5, 2008 International Congress Cancun, Mexico Spring 2008 Session April 24-26, 2008 Orlando, FLUSA*,† August 2007§ Sao Paulo, Brazil Information on upcoming August 2008§ Sao Paulo, Brazil conferences at: www.worldhealth.net Co-Supported Events in Medicine ~ 2007-2008 Calendar February 15-17, 2007 Moscow, Russia September 15, 2007 June 1-3, 2007 Zurich, Switzerland Munich, Germany April 20-22, 2007 September 7-9, 2007 Moscow, Russia Seoul, Korea September 20, 2008 June 6-8, 2008 February 14-16, 2008 September 5-7, 2008 Zurich, Switzerland Munich, Germany Moscow,Russia Seoul, Korea April 18-20, 2008 August 16-19, 2007 Moscow,Russia Beijing, China June 15-17, 2007 October 17-19, 2007 August 14-17, 2008 Tokyo, Japan*,† Vienna, Austria Beijing, China June 20-22, 2008 October 15-17, 2008 Vienna, Austria Tokyo, Japan*,† May 4-6, 2007 Bucharest, Romania November 1-4, 2007 May 2-4, 2008 Shanghai, China Bucharest, Romania November 6-9, 2008 February 16-17, 2007 Shanghai, China Bangkok, Thailand May 18-20, 2007 June 8-10, 2007 Guangzhou, China Bangkok, Thailand April 20-22, 2007 May 16-18, 2008 November 9-11, 2007 Catania, Italy Istanbul, Turkey Guangzhou, China February 15-16, 2008 Bangkok, Thailand April 18-20, 2008 November 7-9, 2008 November 17-19, 2007 Catania, Italy June 13-15, 2008 Istanbul, Turkey Bombay, India* Bangkok, Thailand November 15-17, 2008 * Bombay, India April 29-May 1, 2007 September 6-9, 2007 October 19-21, 2007 Kuala Lumpur, Malaysia*,† Bali, Indonesia*,† Dubai, UAE April 27-29, 2008 September 4-7, 2008 October 17-19, 2008 Kuala Lumpur, Malaysia*,† Bali, Indonesia*,† Dubai, UAE May 11-13, 2007 Melbourne, Australia*,† January 26-28, 2007 Cape Town, SouthAfrica* May 9-11, 2008 Melbourne, Australia*,† January 25-27, 2008 Cape Town, SouthAfrica* * Written examination of the American Board of Anti-Aging / Regenerative Medicine (ABAARM)and the American Board of Anti-Aging Health Practitioners (ABAAHP)to be administered at this venue. ** Oral examination of the American Board of Anti-Aging / Regenerative Medicine (ABAARM) to be administered at this venue. †Written examination of the American College of Anti-Aging Sports Medicine Professionals (ACASP)to be administered at this venue. § Pending. ISSUE 1, 2007 M C A R E A REPORT FROM THE EDICAL OMMITTEE FOR GING ESEARCH AND DUCATION SCIENTIFIC EDITORIAL BOARD Executive Editor Ronald Klatz, M.D., D.O. (USA) President-American Academy of Anti-Aging Medicine Lifespan Literature Scan Managing Editor Robert Goldman, M.D., Ph.D., D.O., FAASP (USA) President-National Academy of Sports Medicine Chairman- American Academy of Anti-Aging Medicine Associate Editor Catherine Cebula (USA) Administrator, The London School of Postgraduate Medical Education Scientific Editorial Advisory Board Over 5 Million Rising Cost of Juan Marcos Becerro, M.D., Ph.D. (Spain) Olympic Medical Committee Spain (Ret.) Americans Afflicted with Living Affects Seniors Heather Bird-Tchenguiz, M.B.A. (U.K.) Director, World Academy of Anti-Aging Medicine Alzheimer’s In the United Kingdom, the Consumer Denise Bruner, M.D. (USA) Former President, American Society of Bariatric Physicians Credit Counseling service (CCCS) has Anongnuth Chiangpradit, M.D. (Thailand) The Alzheimer’s Association reports that Bumrungrad Hospital more than 5 million Americans are living found that the number of people age 60- Brian Corrigan, M.D., Ph.D. (Australia) plus experiencing money concerns is grow- Australian Olympic Committee (Ret.) with Alzheimer’s Disease (AD), a 10% in- Eduardo De Rose, M.D., Ph.D. (Brazil) ing faster than any other age group. Pen- crease since the last estimates issued by the President, International Federation of Sports Medicine sioners are being forced into debt because Rafael Santonja Gomez, PharmD (Spain) organization five years ago. The Associa- Olympic Committee, Spain of the rising cost of living. Recent reports Dato Harnam, M.D., Ph.D. (Malaysia) tion projects that, unless scientists discover President, Society for Anti-Aging & Aesthetic Medicine Malaysia a way to delay AD, the condition could af- have shown that the personal inflation rate Thierry Hertoghe, M.D. (Belgium) for those age 60-plus is near 10%. Accord- European Academy of Longevity Medicine flict 7.7 million Americans by 2030, and 16 Vernon Howard, Ph.D. (USA) ing to the Office for National Statistics, million by 2050. Alzheimer’s Association Harvard University (Ret.) food prices were up 4.9%, electricity 27%, Michael Klentze, M.D., Ph.D. (Germany) vice-president Steve McConnell observed President, European Center for Aging Research & Education and gas 39.9%. Stanley Kornhauser, Ph.D. (USA) that: “[in fighting heart disease, cancer, and Director, National Institute for Electromedical Information other diseases, ironically] we’re keeping The Telegraph UK, 20 March 2007. Seung-Yup Ku, M.D., Ph.D. (Korea) Seoul National University people alive so they can live long enough Edward Lichten, M.D. (USA) to get Alzheimer’s disease.” US government Wayne State College of Medicine Jun Matusama, M.D. (Japan) figures released in 2006 show small declines Japanese Society of Clinical Anti-Aging Medicine (JSCAM) João Francisco Marques Neto, M.D., Ph.D. (Brazil) from most of the nation’s leading killers be- President, SOBRAO tween 2000 and 2004, but deaths attributed Wimpie Pangkahila, M.D. (Indonesia) Udayana Medical University to AD rose by 33%. Steve Sinatra, M.D. (USA) University of Connecticut School of Medicine Associated Press, 20 March 2007. Robert Tan, M.D. (USA) University of Texas/Houston Robert Tien, M.D., M.P.H. (Taiwan) Duke University School of Medicine (Tenured) Fredrick Vagnini, M.D. (USA) continued on page 5 Cornell University School of Medicine ISSUE 1 2007 4(cid:3)•(cid:3)Anti-Aging(cid:3)Medical(cid:3)News(cid:3) Spring(cid:3)2007 M C A R E A REPORT FROM THE EDICAL OMMITTEE FOR GING ESEARCH AND DUCATION continued from page 4 Consequences of An Aging Spending Habits of Population Singapore’s Seniors The proportion of elderly people is growing faster in Singapore seeks to establish itself as a center of excel- China than in any major country, with the number of lence for the elderly, where Asians fl ock to for goods retirees set to double between 2005 and 2015, when and services to enhance their golden years. The na- it will reach 200 million. By midcentury, 430 million tion’s Social Enterprise Committee aims to grow a vi- Chinese – about a third of the nation’s population – will brant social entrepreneurship culture by 2010, which be retirees. The nations’ one-child policy, along with a ultimately is hoped to spinoff economic independence decline in the numbers of younger workers, will cause to Singapore’s elderly citizens. It is estimated that in the ratio of workers to retired people to decline, from 2007, senior Singaporeans spent US$ 1.2 billion on 6 to 1 now to 2 to 1 by 2040. All of these demographic dining, entertaining, and shopping, as well as US$ 300 shifts are expected to place enormous demands on the million on travel and leisure. Experts predict that in country’s finances. As a result, China is considering the next decade, elderly Singaporeans will outspend raising the retirement age, from the current 50 to 55 their younger counterparts by three-fold. for women and 55 to 60 for men. While raising the Channel NewsAsia, 16 March 2007. retirement age may alleviate pressures on the pension system, some experts are fearful that it would spur prolonged unemployment among younger workers. In 2006, 4.13 million young Chinese graduated from universities, yet 30% of them are still unemployed. Prolonged employment of older workers is feared to worsen the unemployment of the nation’s youth. International Herald Tribune, 20 March 2007. India Raises Retirement Age for Teachers Americans Easing into India’s Central government has increased the retire- Retirement ment age for teachers in centrally-aided educational institutions from 62 to 65 years. In addition, they can A study by The Vanguard Group, a mutual funds be re-employed beyond 65 years and up to 70 years company, found that many Americans are easing into against sanctioned vacancies if they are not fi lled by retirement via a gradual transition phase. The study regular candidates. The increase in retirement age has of 2,500 adults age 40 to 60 found that “a common been necessitated to meet the growing demand for ex- strategy for making the transition from work to re- perienced teachers both in technical and non-technical tirement is downshifting,” where workers shift to less fi elds, explained Union Information and Broadcasting stressful or simpler jobs before stopping work entirely. Minister Priya Ranjan Dasmunsi. Nearly 25% of those age 55-plus who were surveyed have downshifted at least once, and 40% expected to IndiaEduNews.net, 16 March 2007. do so in the future. As a result, about 6 in 10 Ameri- cans will include part- or full-time work in their re- tirement plans. Associated Press, 18 March 2007. continued on page 72 ISSUE 1 2007 Spring(cid:3)2007(cid:3) Anti-Aging(cid:3)Medical(cid:3)News(cid:3)•(cid:3)5 OObbeessiittyy aanndd LLoonnggeevviittyy SStteepphheenn HHoolltt MMDD,, LLLLDD ((HHoonn..)),, PPhhDD,, DDNNMM,, FFRRCCPP ((CC)),, MMRRCCPP ((UUKK)),, FFAACCPP,, FFAACCGG,, FFAACCNN,, FFAACCAAMM,, DDiissttiinngguuiisshheedd PPrrooffeessssoorr ooff MMeeddiicciinnee,, OOSSJJ,, CChhaaiirrmmaann,, DDeeppaarrttmmeenntt ooff IInntteeggrraattiivvee MMeeddiicciinnee,, NNYYCCPPMM,, NNYY Introduction countered in Syndrome X have been cise and controlled calorie diets. The associated with many other diseases many causes of weight gain require a The global epidemic of obesity (Syndrome X, Y, Z…) 3 multi-pronged clinical approach. Bar- threatens longevity. Considerable evi- iatric medicine has not addressed con- dence supports the notion that a phys- Obesity is caused by an interaction sistently the management of obesity ically active person of normal body of complex factors, including: genetic related disease or Metabolic Syndrome weight lives longer than the over- predispositions, poor lifestyle, normal X in weight control tactics. weight, inactive individual.1, 2 Obesity reductions in lean body mass with age causes premature morbidity and mor- and diet. Pivotal observations of the Obesity has a series of “ugly disease tality as a consequence of obesity re- effect of diet on aging are provided by companions” and it has emerged as lated diseases are often associated met- many animal studies which show a re- the nation’s number one cause of pre- abolic problems, such as the Metabolic lationship between retention of body mature death, at least indirectly. This Syndrome X. Among the commonest functions or survival and partial food means that weight control initiatives causes of premature death and disabil- restriction.1, 4 must address the primary objective of ity are heart disease, cancer, stroke, This article is designed to reinforce overall health and well being.3 Excess lung disease, diabetes mellitus, organic the importance of the management of dietary intake of simple sugars, com- brain disease, accidents, infections and an overweight status with appropriate pounded by other factors, drives the side effects of drugs. These diseases consideration of obesity related dis- disordered regulation of the functions or disorders are often associated with ease, most notably Syndrome X. The of insulin (metabolic dysglycemia). In- obesity or the Metabolic Syndrome X. approach described is a strategy for sulin resistance leads to excess insulin The many obesity related diseases and “anti-aging” given the characterization secretion which has many negative ef- diseases associated with Syndrome X of obesity and Metabolic Syndrome X fects on the body. In addition to the in- mirror common causes of premature as disorders of premature aging. effi cient “handling” of blood glucose, morbidity and mortality.2, 3 insulin excess in the presence of insu- Weight Management Principles lin resistance can promote cholesterol The association between being synthesis in liver, raise blood pressure, overweight and the occurrence of the Simple or single interventions for cause other hormonal aberrations and Metabolic Syndrome X presents a weight control are universally unsuc- result in cell proliferation.3 unifying concept of premature aging, cessful. There is not a documented, with its attendant morbidity and mor- “stand-alone” use of a diet, drug or The legacy of Metabolic Syndrome tality.3 Metabolic Syndrome X is char- dietary supplement that has resulted X has not been fully experienced. acterized by the variable continuation consistently in sustained weight loss Some credible opinions imply that of obesity, hypertension and hyper- or weight control. A combat against we may have a current generation of cholesterolemia, linked by resistance obesity must involve a multi-factorial adults who may variably outlive their to the hormone insulin. This variable approach including: positive lifestyle children. Syndrome X may be pre- constellation of problems that are en- change, behavior modifi cation, exer- cipitating a “human dinosaur” phe- Stephen Holt, MD is a pioneer of integrative medicine, best-selling author and he holds the academic rank of distinguished professor of medicine. Dr. Holt is a frequent guest lecturer at scientifi c meetings and he is a Knight of the Order of St. John. 6(cid:3)•(cid:3)Anti-Aging(cid:3)Medical(cid:3)News(cid:3) Spring(cid:3)2007 Obesity and Longevity nomenon as the metabolic evolution disease, gestational diabetes, changes a “back up plan” for management.3, 11, of humankind cannot keep pace with in eicosanoid status and cancer. The 12 In contrast, natural approaches with “advancing lifestyles”. Such lifestyles pathophysiology of Metabolic Syn- lifestyle modifi cation and nutritional are characterized often by excess calo- drome X creates a platform for the de- and/or nutraceutical interventions rie intake combined with inactivity. velopment of many disease.3, 5, 6 This may provide versatile and powerful, is why I coined the terms Syndrome fi rst-line management options.3 Metabolic Syndrome X, X, Y, and Z…3 Syndrome X is caused The use of dietary supplements in Syndrome X, Y, and Z.., by a combination of adverse lifestyle the adjunctive management of the Insulin Resistance Syndrome and genetic predispositions; and it has metabolic syndrome in the overweight variable manifestations are apparent in The phrase “Syndrome X” had been individual has led to the suggestion proposed diagnostic criteria for meta- used to describe the combination of that there is an array of nutraceuti- bolic syndrome or the newly proposed obesity, hypertension and hypercho- cals that can be defi ned as syndrome “Syndrome X Clinical Index”.3 lesterolemia, linked by underlying in- X nutritional factors. (Table 1.) These sulin resistance.3, 5 Approximately 70 Effective prevention and treatment nutritional factors include a variety of million Americans have Syndrome X of Syndrome X involves a multifac- nutrients or botanicals or herbs that which is causally linked with the de- eted approach to impact all cardinal may be used variably in a synergistic velopment of cardiovascular disease components of the disorder. Current manner to correct underlying meta- (Metabolic Syndrome X), female en- allopathic treatments may have been bolic problems in Syndrome X. (Table docrine disorders, polycystic ovaries too focused on individual components 1.) (PCOS), non-alcoholic fatty liver of Syndrome X and they tend to form continued on page 8 TABLE 1. Syndrome X Nutritional Factors Syndrome X nutritional factors are composed of nutrients, botanicals, herbs and extracts that are of potential value in the nutritional management of Metabolic Syndrome X, associated with obesity. Some listed substances may provide nutritional support for diets used in the management of diabetes mellitus. FACTOR THERAPEUTIC EFFECTS Soluble fi ber e.g. oat beta glucan Soluble fi ber reduces post-prandial blood glucose, reduces blood cholesterol, improves glucose tolerance, regulates bowel function, primes the immune system, probably by a prebiotic effect. In addition, soluble fi ber promotes satiety and it has other intrinsic metabolic effects. Plays a pivotal role in nutritional management of syndrome X and weight control, especially in children. Soy Protein Soy protein reduces blood cholesterol and its isofl avone content may reduce platelet “stickiness” and exert valuable (25 g/day) antioxidant functions. Value of vegetable protein rotation in diets. Soy has many other health benefi ts and it is an ideal dietary substrate for use in diabetes mellitus and syndrome X. Soy is not toxic. Omega 3 fatty acids (EPA) Omega 3 fatty acids are best taken in fi sh oil concentrates, high in EPA, presented in enteric coated capsules for greater compliance and bioavailability. Plant precursors of omega 3 fatty acids (e.g. fl axseed oils, walnut oils, macadamia etc. are not reliable sources of active fatty acids). Fish oil sensitizes insulin by acting on PPAR receptors and it has multiple health benefi ts including: cardiovascular benefi ts, anti-infl ammatory actions etc. Chromium Several studies imply that chromium in various forms may assist in blood cholesterol reduction, weight control and they may sensitize the actions of insulin. Alpha lipoic acid A powerful anti-oxidant which plays a specifi c role in combat against advanced glycation end-products (AGES), with possible reduction in tissue complications in states of dysglycemia. Has a specifi c insulin sensitizing role, but should not be given by parenteral administration. Vanadium An insulin sensitizer of variable value. Antioxidants Including but not limited to anthocyanadins, ellagic acid, turmeric, biofl avonoids, direct or indirect anti-oxidant vitamins or minerals e.g. Vitamin E, C, A, selenium, zinc etc. Anti-oxidants are often misused and mis-formulated. Anti-oxidants should be given with REDOX balance to access all body tissues, hydrophilic and lipophillic properties. Single high dose antioxidants are best avoided, especially by unopposed intravenous administration. Starch blockers and fat blockers White kidney bean extract, soluble fi ber, chitin of variable value. Cinnamon An insulin mimetic. Maitake Weak insulin sensitizing effect with both whole mushroom powder and fractions. Not a stand-alone weight control or syndrome X nutritional factor. Green coffee bean extract Polyphenols e.g. chlorogenic acid assists in correction of dysglycemia, with specifi c effects on hepatic glucose synthesis. Green tea Very potent antioxidant with widespread health benefi ts, including effects on glucose metabolism. Distinguished content of catechins, especially EGCG. Hoodia gordonii Proposed as a non-stimulant appetite suppressant due to its content of steroidal glycosides. Spring(cid:3)2007(cid:3) Anti-Aging(cid:3)Medical(cid:3)News(cid:3)•(cid:3)7 Obesity and Longevity continued from page 7 These natural substances may help While the underlying biochemi- the complications of obesity and dia- reverse pathophysiology encountered cal basis of the relationships between betes mellitus is related to oxidated in the overweight person by address- obesity or Metabolic Syndrome X and tissue stress with the development ing: abnormal glucose metabolism, in- infl ammatory disease remains under- of advanced glycation end products sulin resistance, body status of infl am- explored, these circumstances permit (AGES).3 Therefore, the treatment of mation, diminished immune function, me to coin the term “obesitis” and obesity related disease seems quite in- blood lipid abnormalities, hyperten- propose that “anti-infl ammatory” ap- complete without supporting antioxi- sion and other issues that precipitate proaches shouldn’t be overlooked as dant activity in the obese clinical man- or contribute to obesity related dis- an important part of obesity manage- agement of the obese or overweight ease. (Table 1.) However, one has to ment. person. (Tables 1 and 2.) be reminded that dietary supplements Up to one third of blood levels of Circadian Biorhythms, Sleep, are not to used prevent or treat dis- the infl ammatory cytokine, IL-6, Obesity and Metabolic ease: an enigma created by the law in may emanate from adipose tissue and many countries. Syndrome X weight loss is often associated with Obesitis: A Concept that reduction in blood markers of infl am- Sleep deprivation, overweight status Further Unifi es Modern mation e.g. C-reactive protein (CRP), and Metabolic Syndrome X appear to IL-18.17 Popular healthcare authors be inextricably linked in many people. Disease Theories? have attempted to link infl ammation The mechanisms of this association Obesity and excess body fat can be with many common diseases, but their are not fully understood. Reduction in classifi ed as infl ammatory conditions interpretation of this important as- sleep duration in healthy young men is and infl ammation is a key factor in the sociation is limited or naive because associated with major changes in hor- pathophysiology of Metabolic Syn- only changes in eicosanoid status are monal levels of substances (ghrelin and drome X. 6, 7, 13, 14 Not only does obesi- emphasized (e.g. The Zone).18 While leptin) that increase hunger and appe- ty raise the level of pro-infl ammatory correcting eicosanoid precursor path- tite, thereby promoting weight gain.27 messenger molecules in the body, it ways with Omega 3 fatty acids is an An established association between precipitates or contributes to several important anti-infl ammatory and in- short sleep duration and obesity has disorders of infl ammation, including sulin sensitizing maneuver, it is not the led to the proposition that more sleep cardiovascular disease, cancer, arthri- whole story.3, 6-12 is necessary to prevent obesity.27-29 tis, liver disease and asthma.6 This in- Recent studies have confi rmed the Chronic lack of sleep may increase fl ammatory disease “link” compounds anti-infl ammatory actions of certain susceptibility to the Metabolic Syn- the undesirable effects of insulin resis- substances that are found in fat tis- drome X and it is known that forced tance. sue.16 These substances have been sleep deprivation in healthy young The hallmarks of Metabolic Syn- referred to as adipocytokines which adults appears to be “diabetogenic”, drome X and many cases of pre-Type include leptin, adiponectin, and visfa- as evidenced by detectible alterations II, or early Type II diabetes mellitus tin.16 Adiponectin is manufactured by of glucose metabolism.27 The diabe- involves the presence of insulin resis- fat cells and blood levels of this protein togenic effects of sleep deprivation tance.7 Insulin acts by specifi c recep- are reduced in states of obesity, insulin may be hormonally mediated. Sleep- tor binding which precipitates many resistance, type II diabetes mellitus lessness has been associated with de- intra-cellular events.7 Current evi- and atheroma.8, 12 Adiponectin exhib- creases in the normal nocturnal surge dence suggests that insulin resistance its potent anti-infl ammatory effects of thyrotropin or growth hormone is determined partially by chemical by suppressing TNF-alpha synthesis and increases in corticosteroid secre- mediators that are released from im- and promoting the availability of anti- tion. These hormonal changes are of- mune competent cells or fat cells.7, 15 infl ammatory cytokines, e.g. inter- ten present in the elderly, reinforcing For example, elevated levels of the in- leukin-10 or interleukin-1- receptor the notion of a potential causal rela- fl ammatory cytokine, tumor necrosis antagonist.13, 19 The “plot” thickens in tionship between sleeplessness and/or factor-alpha (TNF-alpha) are associ- “obesitis” where imbalances of pro- obesity and premature aging. 27-31 ated with overnutrition and reduction infl ammatory and anti-infl ammatory The relationship between obesity of TNF-alpha activity is associated cytokines exist. and insomnia may be linked to the ex- with weight loss improvements in in- The fi nal common pathway of tis- citability of brain cells, most notably sulin resistance.16 Many factors that sue damage often involves oxidated the stress-responsive hypocretin/orex- link infl ammation and tissue damage damage due to the generation of free in cells in the hypothalamus.30 Daily have come from recent studies of non- radicals, perhaps exacerbated by a re- stresses may act on the hypothalamus, alcoholic, fatty liver disease which is duction in antioxidant defenses in the resulting in sustained stimulation of a common component of Metabolic body.13 Of course, the progression of hypocretin/orexin cells which could Syndrome X.3, 9 8(cid:3)•(cid:3)Anti-Aging(cid:3)Medical(cid:3)News(cid:3) Spring(cid:3)2007

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Apr 23, 2007 Bumrungrad Hospital . allopathic treatments may have been and its isoflavone content may reduce platelet “stickiness” and exert valuable .. Flavanol-rich chocolate may boost blood flow in the brain and ers reported that cognitive decline was associated with decreases of plasma
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