IAS: Karen, can you please tell us about your credentials?
Karen: Certainly. I have a Master of Science degree from the University of New Haven in Connecticut. I have worked in the nutrition and antiaging field for the past 10 years and have had the privilege of working with James South and Ward Dean, both of whom I consider to be mentors.
IAS: Why did you choose this particular area of specialization?
Karen: I actually developed a serious chronic illness in 1991. Initially, I did not get a diagnosis, but from the start it was clear I had developed some sort of autoimmune, inflammatory, connective tissue disease. That disease was systemic lupus erythematosus (SLE). I was extremely debilitated by unremitting fatigue, severe pain in nearly every joint and intermittent ‘brain fog.’ I realized I could not continue in my career which required a lot of energy. I had always been interested in health and nutrition, so I went back to school to pursue a professional degree. In addition, at the time I was diagnosed with this autoimmune disease, the treatments that conventional medicine had to offer were in many cases worse than the disease itself! I was searching for novel and non-toxic ways to recover my health. This was how I became interested in innovative groups such as IAS, because it was clear the disease was attacking my central nervous system- so I needed to avail myself of every possible ‘smart drug’ and nutrient to preserve my brain function.
IAS: How did you go from that personal interest to the broader concerns you have today?
Karen: I began recovering my health through targeting the chronic inflammation in my body with diet, exercise, supplements and ‘smart drugs.’ Inflammation is at the root of so much ‘evil’ and we are now learning that many chronic illnesses and diseases of aging are caused by inflammation, i.e. heart disease, cancer and the complications of diabetes.
IAS: Tell us why do you want to speak out about the issue of obesity at this particular point in time?
Karen: It’s an interesting story. When I finished graduate school, I vowed to be a nutritionist that did not focus on weight loss, primarily because diets have a failure rate of 93% or more. Today I feel I no longer have that luxury because there is a pandemic of obesity. Diets may not work by themselves, but there are lifelong strategies people can adopt to preserve their health and quality of life while simultaneously extending their lifespan.
IAS: What prompted your change in focus?
Karen: The results of some provocative studies have recently made the headlines. They may seem quite opposite at first glance, but they are connected in some very important ways. The first involves the epidemic of obesity. The second involves some intriguing results from the first ever trials that have examined the affect of calorie restriction (CR) in humans.
IAS: Could you please give our readers some specifics?
Karen: The most astonishing headlines relate to the number of overweight individuals in the US, as well as the rapid rise in the prevalence of obesity. Today, two-thirds of adults in the US are overweight or obese. An individual who is overweight or obese is at risk for developing some diseases that may not necessarily shorten one’s lifespan, but these diseases certainly affect one’s quality of life. I am talking about diseases such as type-II diabetes, heart disease and cancer etc. Obesity is affecting children and adolescents as well. The increase in the number of overweight/ obese children and adolescents prompted the medical profession to rename diabetes. Type-I diabetes was previously known as juvenile onset diabetes. Type-II diabetes was known as adult onset diabetes since it previously affected people at mid-life or later. So many overweight children were developing ‘adult onset’ diabetes, which is really a disease of excess glucose and insulin, so the disease had to be renamed. I am extremely concerned about this.
IAS: What troubles you the most about this situation?
Karen: Basically an overweight child is much more likely to become an overweight adult. Some statistical algorithms suggest if we stay on this same path, one in two children alive today will develop type-II diabetes by the time they reach adulthood. It is not just the diabetes that is the problem. It is the micro and macro vascular complications that go along with it, things such as blindness, specifically retinopathy, peripheral neuropathy, limb amputations and heart disease. It’s well known that diabetes speeds up the aging process. It’s the excess glucose and excess insulin that really causes the body to breakdown from the inside out. The tragedy is that diabetes is a largely avoidable disease, but we must make some dramatic changes to our lifestyle.
IAS: You mentioned some recent studies were published that suggest there may be a way to truly extend life. Can you tell us more about that research?
Karen: Yes, although some say calorie restriction may not result in a longer life, but it will feel like it!
IAS: Ha ha!
Karen: No seriously, for the last six decades researchers have been extending the lives of laboratory rats, insects and worms by reducing their caloric intake. The person that is best known for asserting this hypothesis was a University of California Los Angeles School of Medicine professor of pathology, Roy L. Walford, M.D. He wrote Maximum Lifespan, Beyond the 120 Year Diet, and The Anti-Aging Plan. Many will remember him from the Biosphere experiment of the 1990s.
Today, many more physicians and scientists are asserting that calorie restriction (CR) might extend life in a laboratory setting in animals, but it is premature and possibly even dangerous to assume that CR can work in the real world amongst humans.
Before I get into the details, I must mention the obvious. It is very difficult to test this hypothesis in humans. It is impossible to do a ‘double blind placebo controlled trial’ when it comes to nutrition. The studies involve a small number of people. Non-believers would most certainly find hundreds of flaws in the research. But, personally I find the results very intriguing. I think the studies provide preliminary evidence that calorie restriction can extend life in humans as well.
IAS: I know you are excited about this new data. With the above caveat, are you ready to share the specifics with our readers?
Karen: Absolutely. The first study was published in January, 2006 in the Journal of the American College of Cardiology and was the result of research undertaken at the University of Washington in St. Louis by Luigi Fontana, M.D, PhD. There are a number of people around the USA who have been voluntarily practicing CR. While they do restrict their calories, they work hard to eat a nutrient dense diet. Their diet avoids empty calories, particularly calories from white flour and sugar. The researchers looked at 25 individuals between the ages of 41 to 65 who had been reducing their calories to 1,400-2,000 calories per day for six years, and compared them with individuals who consumed the average American diet which is about 2,000-3,000 calories per day. The study looked at heart function as a measure of ‘primary aging.’ Although people in the calorie restriction group had been eating a low calorie diet for only six years, their heart function, when compared to the control group, resembled the heart function of people 15 years younger. In the case of the group practicing calorie restriction, many of the subjects had parents, grandparents or siblings who suffered heart attacks or strokes. That makes it unlikely that the CR group had a more favorable genetic make up. Some subjects had actually been taking medication for high blood pressure before starting the CR plan. Other biomarkers for aging were lower in the members of the Caloric Restriction for Optimal Nutrition Society (CRONS). These markers included markers of inflammation such as C reactive protein (CRP) and tumor necrosis factor alpha (TNFa). Previously, these researchers had found that people on the very low calorie diet had low blood levels of cholesterol and triglycerides, blood pressure scores equivalent to much younger individuals, a lower risk of developing diabetes and reduced body fat. The findings taken together suggest that the people practicing calorie restriction have a longer life expectancy because they are more likely not going to die from a heart attack, stroke or diabetes. This suggests the quality of their life will also be better. Members of CRONS try to consume between 10% and 25% fewer calories than average Americans while maintaining proper nutrition. Accordingly, their diet resembles the Mediterranean diet. This published study was the first of many studies examining members of the CRONS. The research was supported by a number of organizations including the National Heart, Lung and Blood Institute and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health.
IAS: That sounds like extremely detailed and interesting research. You mentioned a different area of investigation. Can you tell us more about that?
Karen: Yes. The results of another investigation, called the Comprehensive Assessment of the Long Term Effects of Reducing Intake of Energy (CALERIE) study, were published in the April 5, 2006 issue of the Journal of the American Medical Association. This study recruited 48 middle aged overweight, non-obese men and women and randomly assigned them to one of four diets: control (weight maintenance diet); CR (calorie intake reduced by 25% of normal) CR with exercise (calorie intake by 12.5%, energy expenditure increased by 12.5%); very low calorie diet (890 calories per day until 15% weight loss, then weight maintenance diet). The study was conducted at Pennington Biomedical Research Center, Louisiana State University, Baton Rouge. After six months, the control group lost about 1% of their body weight. The three intervention groups all lost significantly more weight (as expected). The CR group and the CR plus energy expenditure group lost about 10% of their body weight. The very low calorie diet group lost 14% of their body weight. However, weight loss was not the primary focus of the study and positive results were observed for markers of aging. The lead author, Leonie Heilbronn, M.D. stated: Our results indicate that prolonged calorie restriction caused a reversal in two of three previously reported biomarkers of longevity, (fasting insulin levels and core body temperature)…and a reduction in DNA fragmentation, reflecting less DNA damage.
As one of the most widely held theories of aging is that free radicals AKA reactive oxygen species- assault DNA, which therefore affects normal cell function and potentially leads to cancer, this makes sense.
Another related theory of aging suggests the excess blood glucose causes the ‘sugaring or browning’ of all cells and all cellular function is compromised. This is one of the main reasons diabetes and metabolic syndrome causes so much morbidity and mortality. There have been extensive studies in animals, including mice. In 2004 researchers established that CR even when started in late middle age in mice, significantly extended life. So it may never be too late in life to begin CR and reap the health benefits. In 2005, a study in mice suggested one mechanism of the anti-aging affect of CR is the increase nitric oxide (NO). NO is so important in relaxing the walls of blood vessels and preventing that hardening of the arteries.
So here we are beginning to understand that CR works on several important mechanisms to improve both quality of life and longevity.
IAS: That’s all very interesting Karen, but what does that mean for the general population, and those of us who are interested in optimal health and longevity? Do we all have to be thinking about near starvation?
Karen: Don’t get me wrong, this is not a call for everyone to go on a very low calorie diet. Scientists would say the evidence is only preliminary and the studies were very small. Be aware that a very low calorie diet can lead to malnutrition. Those interested in this lifestyle change should make sure they do a lot of reading and get the advice of a qualified nutritional professional.
Let me read you part of an editorial that appeared in the New York Times on Sunday, April 9, 2006, Frank Bruni writes: If living to 99 means forever cutting the porterhouse into eighths, swearing off the baked potato and putting the martini shaker into storage, then 85 sounds a whole lot better, and I’d ratchet that down to 79 to hold onto the Haagen-Dazs, along with a few shreds of spontaneity. It’s all a matter of priorities.
IAS: So I guess the obvious question is: is there any way of having the cake and eating it too?
Karen: My answer is a resounding yes. But it takes some strategizing. CR prevents spikes in both glucose and insulin. Preventing those spikes in glucose and insulin is also the best way to prevent diabetes, metabolic syndrome, overweight/ obesity, heart disease, stroke and cancer.
The good news is that there are things known as calorie restriction mimetics; Metformin is the best known and it also has the longest history of success. Currently Metformin is prescribed (Ed.- off label) to help prevent diabetes in susceptible individuals. I see no reason why it shouldn’t be taken almost like a vitamin at this point.
Acarbose is also a drug being used to prevent type-II diabetes in the prediabetic population. Acarbose is a substance that blocks the absorption of refined carbohydrates thereby preventing the spike in glucose, which would then be followed by a spike in insulin.
In 2002, David Sinclair, M.D., professor of pathology at Harvard Medical School, claimed that he and a team of researchers discovered a way to genetically mimic the life-extending effects of CR, without the severe food deprivation. His studies were done in yeast and focused on the Sir2 protein. Later, he and his team asserted that the compound; resveratrol- a key antioxidant found in red wine and other substances, can slow the aging process without CR.
Of course, it is important not to overeat and maintain an active lifestyle. But there are other natural products that have shown the ability to regulate blood glucose and insulin. The best of these ‘weight loss’ products contain the important minerals chromium and vanadium. In addition, green and black tea extracts can help boost metabolism. Cinnamon extract, gymnema sylvetra extract, and bitter melon extract may have a certain synergy that can assist in weight loss.
IAS: Karen, you’ve discussed a lot of important and fascinating information here. Is there anything you’d like to conclude with?
Karen: Phil, I’d like to thank you for letting me present what I consider to be some critical health and longevity issues. The data at this point is suggesting that CR may indeed extend life while maintaining health and vibrancy. But that means one has to start thinking about eating to live, rather than living to eat. Eating after all, is one of life’s greatest pleasures. You know I am a huge believer in the health enhancing power of the right foods along with an active lifestyle. I am also a realist. My guess is many people are interested in reaping all the benefits of CR, but few will be interested in the arduous lifestyle changes required. I commend organizations such as IAS for making available some important pharmaceuticals and nutrients that may well mimic CR.
IAS: Thank you Karen, as always it’s a pleasure to talk with you.