"Quality of life (Q. of L.) is the contemporary goal of Gerontology. Until now, this concept (Q. of L.) seems to form a Gordian knot that nobody is prepared to untie at the present time period. My opinion is to use a Global Vision to recognize individual and cultural variations.
A global vision conceptualizes Q. of L. as a ontogenetic process that is produced by a complex of individual, social and environmental factors.
In this vision the individual is the cornerstone and is directly influenced by many factors. Each factor can be changed throughout life.
This dynamic vision may be used to clarify the complex relationship between positive, negative, subjective and objective indicators, and in each case to take practical measures to enhance the Q. of L.
I believe that in the next century, Western high tech and Eastern ancient art and medicine will merge to create a holistic health care in order to promote the Q. of L.
Aslan's 10 commandments synthesize the importance of general and particular recommendations to delay the aging process and to maintain a healthy and active body."
Professor Aslan proved that it is possible to fight aging. Everything she thought of, and carried out was like declaring war on old age. Her war was equivalent to those against cancer and smoking. Her wish to find the most adequate way of fighting made her affirm many times that "old age is a parasite of life."
Initially, the firm, prophetic convictions and attitude she adopted made some gerontologists regard her attempts with skepticism. Their distrust was motivated by the complex determinism of aging and by the insufficiency of some biological arguments. However, time has rendered more justice. In hundreds of laboratories, scientists are now concerned by new theories on the way people grow old. They are trying to find out the secret of youth and the mysteries of longevity. In the near future it will be the possible to double, or even triple the life span of the human being.
The first time Aslan introduced her concept of Gerontoprophylaxis was at the International Conference of Gerontology in 1956, at Merano, Italy. This synthesized the importance of her treatment and included general recommendations to delay aging and maintain a healthy and active body. Since then, health literature and the mass media have saturated the public with such advice. Let me tell you about what Aslan named "Decalogue", which after some time I referred to as "Aslan's Ten Commandments".
1. FOOD-A SECRET TO AN EXTENDED LIFE
It is said of the appetite what "Leonard da Vinci" affirmed about painting: "Es una cosa mentale" [it is a mental cause].
In French culture there are many references on the noxious role of abundant meals, being mentioned that "lunch kills half of mankind, and dinner the other half."
Centuries ago, it was noticed that a diet reduced in calories and rich in vegetables and fruits represented an important factor of longevity. Meals eaten together with beloved persons maintain physical tonus and delay aging.
Research workers in gerontology identified "Isles of longevity", and connected this fact with nourishment rich in milk products and fish. Some of them even affirm that "Numerous biological sings of aging are valid only if they are considered markers of nourishment, of inactivity". They are inclined to answer affirmatively to the question, if the genes which protect youth are possibly influenced by what we eat. Food provides not only proteins and energy, they also have an important role in genes and good functioning which influences longevity. It has been discussed, and an effort has been made to isolate certain revitalized nourishment principles, more efficient than vitamins, which are found in lemons, garlic and liquorice root.
If, in the past decades chronic diseases were considered as a prerogative of advanced age, in the last few years they are more and more related to nourishment type, personal habits, and inadequate mental stereotype. There are known food stuffs with a strong anticancerous effect, and there are prospects to isolate these food principles with a rejuvenating effect, and which are found in infinitesimal quantities in common nourishment. The basic compounds of sulfur present in garlic prevent esophageal, colon, and rectal cancer, and strengthen the liver detoxification function. By these results, indirectly, we extend the life span, knowing that the tumor incidence increases with the advancing age. Food fortifying by natural protective products is an interesting and important way to prolong the life span. In food stuffs there are chemical compounds with antioxidative qualities, which neutralize the free radicals, and which appear when the cells use oxygen to generate energy.
In Latin America, Asia, there are groups of the population without colon, or breast cancer. They eat fresh vegetables and fruits, wheat, whole meal, and milk products.
The most important nourishment benefit for good health proved to be food reduced in fats. After such a diet, the vascular cerebral, and coronary diseases decreased up to 40-45%.
Everyday the human body needs a certain quantity of vitamin "E, B1, B6, A, D, Zinc, Iron, Folic Acid, Calcium", for certain specific functions and optimum functioning of the immune system.
In elderly people we should take into consideration the fact that they eat less, are sedentary persons, and maybe ill, (possibly taking drugs), factors which may interfere with the absorption in essential food principles. In this conditions, additional quantities of nutritive factors are required.
IT IS A SCIENCE AND AN ART TO EAT ADEQUATELY, SO THAT IN THE LATER YEARS, YOU WILL BE ACTIVE AND HEALTHY.
The secret consists of a diet rich in essential food principles, and with a lower number of calories. An adequate nourishment supposes quality, rhythm, a certain value, all are attributes designed to prevent diseases frequently met in the elderly: diseases such as; diabetes, obesity, arteriosclerosis, arterial hypertension, poliartritis, food, and vitamin deficiency.
Among the elderly's disturbances of nourishment related to food quantity and quality, I note the following nutrition, and mal nutrition. DENUTRITION of the elderly has a multiple causality. At this age we meet denutrition states by:
Loneliness is associated with depression and a low interest in cooking food which are elements which generate a lack of appetite.
If a common cold occurs, a trauma, a cardiovascular suffering, "Syndrome of sliding," a lack of appetite occurs immediately. The rapid and severe degradation of the elderly's general conditions appears first caused by poor appetite, and then by the disease itself.
MALNUTRITION is determined by a deficient food balance. The energetic requirements should be individualized according to sex, nutrition state and degree of activity. After the age of 50, it is recommended to reduce caloric supply by 7-10% every ten years.
After the age of 65, it is necessary to have an average of 2200 calories in 24 hours, but for those with obesity it is recommended an energetic supply not surpassing 1800 calories in 24 hours.
Proteins, specially those of animal origin, in quantities of 1-1.5 g/kg. (1kg = 2.2pounds) body-weight/24h., are essential in the period of growth and in old age. The minimum is of 100g/24h., and for weak people, or after surgical interventions, when the supply may reach to 150-200g. proteins in 24hr.
Those who have lost their teeth should eat finely cut meat. Fowl is indicated, a quantity of 150g providing 25.6g. proteins.
Fish, 150-200g in 24 hr., as well as fresh eggs, 1-2 a day, twice a week may replace meet. Milk, and milk products are useful (a jar of yogurt contains 4.2g. proteins), but for an older person it is not recommended a strictly milky nourishment.
Rice, semolina, pastes, bread provide 50% of the necessary proteins. Dry vegetables, which are difficult to digest as well as fat, salty, smoked sausages should be avoided.
A diet low in protein (25-30g/24h.) is indicated in renal diseases. The hyperproteic diets (200g/24h.) is recommended for states of denutrition.
The needs for Lipids (fats) for the old man raise to 40-50g/24h., and they are obtained from: lean meat and butter, 10-15g; oil-20g., milk and cheeses 25g.
The obsession with an increased cholesterol of dislipidemias is not justified after the age of 70 years old.
The critical period is situated in the decade 5 and 6 (40-60 years of age). The suffering which appears after the age of 70 is the result of dietetically errors accumulated during the life time.
The ratio of Carbohydrates (including sweets) should not surpass 50% of the total calories in 24 hours, so that 150g. bread, or 200g. potatoes, or 150g. pastas, 100g. rice, 250g. grapes are enough. It is advisable to avoid confectionery such as cakes, or candy.
The hydride supply, as well as mineral salts is indispensable. In a 24 hours period one should drink at list 1 liter of water, to which should be added soup, tea, coffee and a little wine. In the evening it is better to avoid ingestion of liquids because the need to urinate causes insomnia. The infusion of lime-blossom, thyme are useful due to their physiotherapeutic qualities.
In osteoporosis it is recommended to undertake a nourishment rich in calcium (milk, cheese, eggs) which represented in a minimum of 800 mg/dairy produce.
A glass of milk contains 0.295g. calcium, and 8g. lipids.
Magnesium has an important role for the elderly, the minimum need being 6mg/daily. It is found specially in uncooked vegetables.
Spinach, stinging nettle, liver, apricots and lentils contain the iron element, and should not be removed from the elderly's diet. A daily supply of 12-15mg is necessary (100g. of liver contain 11.3mg. iron).
In regard to mineral salts supply, I should emphasize the role played by sodium and potassium. Sodium is very necessary for the elderly; a sodium free diet causes inappetence, even neuropsychical disturbances. The diet free of salt is recommended for a short period of time only, and it has special indications, such as when hypertension onsets, or a period of acuteness in cardiac failure. In 24h., 3g of sodium is necessary (1 liter of milk = 1.5g of sodium).
The potassium need is 3-4g. daily. Here are some examples of vegetables and fruits rich in potassium (the content is calculated/ 100g).
Dry apricots = 1600mg.
Carrots = 300mg.
Dry plums = 950mg.
Figs = 983mg.
Bananas = 300mg.
FOR PEOPLE FOLLOWING A TREATMENT WITH DIURETICS A SUPPLEMENT OF POTASSIUM IS RECOMMENDED.
Fruit juices complete the need of vitamins.
The elderly menu should be varied and individualized. The rich and unique meals should be avoided. Four meals a day are desirable. Breakfast and a snack in the afternoon are important for the psycho-physiological point of view. Selective and restrictive diets should be avoided.
Following a nourishment program on a group of elderly persons, I noticed: among those over 85-90 years of age that 56% had a mixed diet, 27% ingested predominantly milk products, vegetables and fruits, and 17% ate mainly meat.
I discovered that the mixed diet is prevalent in longevous people who live in rural areas. I also noticed a decrease of pork intake with advancing age. In exchange, fish intake was increased. What should be emphasized is the elimination of culinary refinement; boiling was the prefaced way of preparation and fresh green vegetables have been used also.
The intake of alcoholic drinks in both sexes was more in the rural areas. The percentage of longevous people who have not regularly ingested alcoholic drinks were men in urban areas 60.2%, and in rural areas 47.9%; in women the rate is respectively 82% and 73%.
It is an aspect not without importance: the alcoholic drinks used by the elderly, especially those living in rural areas were prepared on their own farms, and had a reduced content of alcohol.
The nourishment peculiarities of longevous people show the habits of the last 90-100 years. In the last two three decades, in parallel with the general change that occurred in people's life, there were also changed in their diet habits.
Since the years of the "60's", "70's" and "80's", especially in the developed countries, a hypercaloric food prevailed due to the increased intake, more over, the organisms energetic need for fats and sweets. The hypercaloric food predominantly glucidic and lipidic, generates metabolic lack of balance, and increases the frequency of chronic degenerative diseases.
The care we take for a nourishing diet is determined by preventing metabolic lack of balance, and represents a first rank security for the maintenance of a healthy condition over the age of 70 and 80's.
Recommendations for preparing the foodstuff
By a correct preparation of foodstuff the entire nutritive value is guaranteed, and the possibility for them to become toxic is avoided. At 65°C the proteins begin to coagulate, and at 100°C they change into soluble substances (a process similar to digestion). Through boiling the purinic bases pass into water, and give taste to soup, and in the body change to uric acid.
Boiling is still the best way to prepare meat, as long as the meat is not inserted until the water has reach the boiling point, a proceeding by which the extractive substances remain in the meat.
It is recommended for the elderly to eat only boiled meat, baked, or grilled under a lid. The meat when it is prepared in the oven should be covered first in a sheet of parchment which absorbs the grease and prevents the formation of a crust.
Elderly people are forbidden to eat roasted flour, this being replaced by a browning without grease, in the dry stewpot after which is added vegetable soup or meat soup.
You do not add oil and butter until this mixture is boiling. The taste of roasted flour is similar to roasting, and in addition it has many advantages.
The SCIENCE and ART to NOURISH ourselves, by balance, moderation, and knowledge of the secrets of preparation, plays a major role in giving YEARS to LIFE and LIFE to YEARS, in the conditions of the elimination of physical and emotional sufferings. With a good nourishment and Aslan's treatment, you will maintain your vitality and a normal rhythm of aging.
To lose weight you have to reduce your consumption of high-fat, high-calorie foods and increase physical activity. You must to personalize your plan to fit your own needs.
2.- TRAINING FOR AGING
Research about the lifestyles of long-lived people reveals that good physical, psychological, and social condition depends on certain behavior. In fact, the behavior conducive to a long, healthy life, which leads to an active and dignified old age, begins in early childhood. This optimum lifestyle decisively influences health in later life. Training for aging should be started in the first years of life, as any disease or bad habits may adversely affect the aging rate. Delayed psycho-motor development, or a glandular imbalance, should encourage parents to make an in-depth check-up of their children.
In the first part of life, preventive measures are the responsibility of the parents. Afterwards, adolescents and young people should themselves be conscious of the late consequences of diseases, of the deviations from a balanced way of life and of harmful influences of the environment. From this point of view, we should know that healthy aging is affected not only by genetic factors, but also by environmental factors: climate, air purity and geographical conditions.
Aging is highly individualized. Training for long life depends mostly on the social and cultural level of the group to which we belong. The way we live our lives is learned first in the family, and later in school and society. I emphasize all these because habits are hard to change especially in old people. We can make things worse when we try to change some habits which have lasted for more than 20 years. For example, many of us know how difficult it is to give up coffee or tobacco. (Ed. My father said it was easy, he did it twelve times!)
Parents shouldn't be concerned about obesity in children until they are at least 2 years of age. Putting an infant on a diet at this age is more harmful than good. After that time, children in families with a history of cardiovascular disease, who have increased levels of blood lipids should be evaluated. Overweight children whose cholesterol is over 180 mg % should be placed on a diet. During childhood and adolescence, the child should be encouraged to participate in vigorous physical activity. A high level of physical activity and lower levels of cholesterol in the first part of life will have a tremendously beneficially effect on later health. The child should also acquire good eating habits. Discipline in school, exercise, and learning of foreign languages, are all helpful to form strong characters and healthy habits.
Whenever preventive gerontologic examinations are performed, the physician individualizes advice according to the GERIATRIC CODE: to maintain health, an optimum balance should have between work and recreation, and a profession should be pursued which gives one satisfaction. A person who has more than one profession has an advantage over a person who concentrates on only one.
The lifestyle most likely to result in good health and long life is one which minimizes the stress of our high-tech, bad environment, actively uses leisure, avoids toxins, maintains a high level of intellectual and physical activity and a balanced diet. These factors have a major role in training for old age an extending the active life span.
"PEOPLE WHO ARE PHYSICALLY AND INTELLECTUALLY ACTIVE HAVE NO TIME TO GROW OLD".
Work is a fundamental requirement of human life. Its beneficial effect on body functions and the major role it has in maintaining physical and mental health are well known. Throughout the entire cycle of life, starting with the period of education and learning, continuing into the period of maturity and productive contributions to society - man participates in a permanent process of working and self-fulfillment.
In training for aging, the time of retirement is a milestone. The "third age" corresponds to the period when this permanent activity ceases, and there is a change in the occupational and social status. At present, the social age of retirement has a tendency to increase, and the concerns related to this period have not been missed from the sociological, economic and psychological investigations.
At a meeting in Vienna in 1982, the concept of "active elderly" was promoted. This concept proposed that training for retirement has to be incorporated within the complex program of training for aging, an evident option for employing the elderly in accordance with their level of education, functional capacity, and the struggle of the elderly themselves for a new status and social role.
Retirement is an important moment in an individual's life and it is differently regarded - not only according to the type of retirement (i.e., due to age or illness), but also to many other factors: temperament, sex, and previous extra-professional concerns. For those who are unprepared, retirement may represent a major stress, causing a real moral crisis - "crisis of retirement", "drama of retirement", or, as the German authors call it, "Pensionkrankheit" (pension sickness). The crisis of retirement is evident most frequently in those who had no previous hobbies to occupy their time.
Until a certain point, it is natural for us to think that the human being develops under the influence of labor, which formed his/ her personality and character, which imposed rigor, order and rhythm. Retirement disturbs this human necessity, and breaks this natural link which severely upsets the somato - physical balance. If "pre-retirement" training has not been accomplished, retirement brings about inertness, lack of initiative, loss of social relationships, and increases the tendency to physical and psychical immobility. There is an increased preoccupation about health, resulting in anxiety, depression, ending in isolation and solitude.
The maintenance of intellectual aptitudes and creativity, a certain spiritual rejuvenation by the association of wisdom, experience and a wish to be useful - even if the passing of years were merciless - are part of the remedy for the "retiring disease" and aging.
Another aspect of great importance after the age of 65 is represented by "The Elderly's Leisure", which should be understood in accordance with the major needs of this age. If good health is maintained, the elderly may remain socially active. The elderly like to be recognized as individuals, and to express their personalities. Far from being only consumers, the elderly may participate in many activities within the limits of their functional capacities. Creativity is frequently present in the advanced ages to a surprisingly high degree, and lasting pieces of work are often produced during these years. At this age, as a result of their relativity long life and experience in all fields (arts, literature, philosophy, music etc.), history knows of personalities which otherwise nobody would have heard about. In human, ethical and moral terms, the elderly represent a treasure of wisdom and history, and may be of great use for society and family. By their presence, we all are much more wealthy.
Education is another indicator of old people experience. The elderly can tell us how we reached our present standard of civilization, because they were witnesses and creators of past events. Therefore, the time of aging belongs not only to the elderly, but also to society, to all of us. If they do not have a second occupation or a hobby once they have reached the age of retirement, some old people only then realize that they have no choices.
Geriatric physicians have a duty to "sound the alarm bell" and to train the population, (beginning in youth), about what they should do after retirement. Elderly people need an occupation, above all, to maintain their physical health. Labor represents a basic requirement of human existence, and in this respect, an experiment performed in Montreal by Prof. Hebb is very interesting. He looked for and found volunteers for...laziness! In addition to paying them, he provided them with comfortable accommodations. From the 46 persons selected for the study, only one was willing to not work for more than 5 days, one for 117 hours, another for 114 hours, and the others gave up after only 70 hours.
Work has also been used as a treatment for some diseases, so called occupational therapy. The Greeks and the Egyptians practiced occupational therapy for mental disturbances. "Philippe Pinnel", even in 1909, found out that labor rigorously carried out represented the best way to maintain the health and high spirits of retirees in a home. The wish for activity is also experienced in advanced ages. Prohlic, in his paper "How should the retired organize their life?", shows us that the elderly, like the young, are in need of affection, the freedom to choose their friends and to be useful in the community.
Leisure is known by different names: "loisir" in France, "leisure" in England, "non-working time" or "free time" in the United States, "Freizeit" in German. In ancient times, the Greek word for "school" had multiple meanings, i.e.: repose, leisure, lack of activity, occupation during the free hours - after work, or after business, study, conversation. School also meant the place where this time was spent. Leisure activity should be outside all basic obligations, and have no utilitarian purpose. We should seek satisfaction, relaxation, entertainment, or education. Leisure should be a time of absolute individual liberty. Unlike the adult's leisure, the elderly's leisure should be a continuous time of doing as they wish.
Cessation of many formerly pleasurable social and professional activities after retirement often produces a great deal of anxiety. In order to compensate for the loss of socio-cultural, socio-economical or political activities and responsibilities, I recommended the following activities substitutes:
Victor Hugo wrote a volume of poetry titled "The art of being a Grandparent". An American author wrote, "Life Begins at 40." Michelangelo began to learn Greek at the age of 80. Margaret Murray wrote "My First 100 Years." Cicero, Seneca, Shopenhauer, meditated upon age, and training for old age.
Let's plan and train with wisdom (attributes of aging itself) for a long healthy life!
3.- PHYSICAL MOVEMENT
In the context of the present decade, the third age (people over 65) is considered as the period of life in which experience, knowledge, capacity of creation can, and should be fully used.<