Monthly Archives: December 2014

Age Gracefully with Nutrition

Turning 30 is a big deal. Some of us dread it, some of us embrace it. I can’t speak for all you fellas out there, but a lady’s 30th birthday is a major milestone. We women deal with the pretty intense pressure of Who We Should Be By 30. Our careers Should be in full swing, we Should be seriously dating someone, engaged, or better yet, married with at least 2 kids. We Should own a house and we Should be contributing 10% of our income to our 401k.

I’m playing a little devil’s advocate here, because, on my 30th birthday I was nowhere near Should. In fact, Should and I were on completely different continents.  And I was totally content with that. I turned 30 happily single, surrounded by great friends, working toward a career I was in love with. I didn’t feel like less of woman because I wasn’t fitting perfectly into society’s mold for me. Plus, I got carded all the time.

And then, a year later, I turned 31. That’s right, there’s a 31. Who knew? I mean, who turns 31? It sounded so weird to me that I decided to call it my 2nd annual 30th birthday instead.  There’s no glamour in 31. No special celebration. I was old news (literally), and even though my friends insisted I didn’t look a day over 25, I felt a sudden urge to run to the cosmetics counter for $200 anti-wrinkle cream (what 401k?).

Of course I know the difference between 30 and 31 is minimal, but it did get me thinking a lot more about the future of my health than I ever had in my 20s. Gray hairs and wrinkles aside, preventing age-related chronic disease is the ultimate goal, and working in a hospital, caring for patients with diabetes, heart disease, and kidney failure, means I’m faced daily with motivation to reach that goal. I feel great now, and I want to stay healthy as long as possible – physically and mentally.

Ladies and gents, I mean this in a purely biological science-y way – the physical aging process is unstoppable and you ain’t getting any younger. But you can make some lifestyle decisions now to slow the process, like exercising, minimizing the psychological stress in your life, and eating a well-balanced, nutritious diet. So put down that expensive anti-aging serum, sign up for spin classes, and read the following about the importance of nutrition in aging gracefully.


Have you heard of telomeres?

There are many theories of aging, but it’s generally accepted in the scientific community that most of the body’s cells have a finite lifespan, or a set number of times they’ll replicate. As we age, more and more of our cells reach this point and our cells cease to divide or die. The biological term for this stoppage of cell division is “senescence”. It sounds so peaceful, doesn’t it?

Your chromosomes are capped with little structural components called telomeres. They function by preventing damage to your DNA and the potential fusing with other chromosomes during replication.

Telomere research is all the rage right now. Typically, telomere length shortens with each chromosomal replication, so as we age, and our cells keep dividing, telomeres shorten to what’s known as “critical length”, inducing senescence or apoptosis (programmed cell death). Thus, telomere length is currently being studied as a potential biomarker for aging (1), and some research has shown an association between short telomeres and certain age-related conditions such as cardiovascular disease and diabetes (2, 3).  It’s not as neat and tidy as it sounds, however, and the relationship between telomere length and age-related disease is not completely understood (it’s kind of a “chicken or the egg “thing).

Telomere shortening can be exacerbated by inflammation and oxidative damage. There is limited evidence that telomere shortening can be slowed, halted, or even reversed in response to certain environmental and lifestyle interventions that would theoretically reduce or repair oxidative damage.  Exercise, meditation, and nutrition have all been studied in relation to their respective effects on telomere length. The research is HARDLY unequivocal, though, so beware of the Dr. Oz episode that tells you what anti-aging foods to eat for long telomeres. There are a lot of limitations with telomere research as it pertains to dietary interventions. For example, not all studies are measuring length the same way, because there isn’t one single gold standard. Plus, a lot of diet intervention studies use food diaries and questionnaires to estimate their participants’ intake, which are subject to over- and underreporting.


If aging is associated with oxidative damage in our cells, then antioxidants are literally the enemy of aging. They prevent damage that leads to the death of cells by neutralizing the reactive oxygen species (ROS, also commonly known as “free radicals”) that cause the damage. Most antioxidants are substances produced by plants as protection against harmful oxidation reactions that occur during photosynthesis. It just so happens that humans eating those plants reap the benefits, too! Ah, the beautiful chaos that is evolution.

Examples of antioxidants are vitamins A, C, and E, beta carotene, glutathione, and ubiquinol (coenzyme Q10). The goal is to get a hefty combination of all of them, so don’t get wrapped up in which foods have which antioxidants. Following a Mediterranean-style diet is a great way to get antioxidants from food. The diet (yes, I hate that word too) features fruits, vegetables, nuts, seeds, legumes, whole grains, fish, olive oil, and red wine in moderation, and limits red meat, saturated fats, and refined grains. The health benefits of the Mediterranean style of eating are well documented in the literature, especially in regards to cardiovascular disease (8, 9).

medi pyramid

(Mediterranean diet pyramid – find it here)

Antioxidants and telomeres

Antioxidants have been studied in relation to telomere length, and the data suggests that higher intakes of vitamins C and E from food are associated with longer telomere length. Studies that compared a Mediterranean-style diet with telomere length found that adherence to the diet (again, measured with subjective food diaries, so we’ve got some issues) was associated with longer telomeres (4, 5, 6, 7).

It might seem tempting to pop a couple antioxidant supplements from your neighborhood health food store, but I’d advise against this. Research has shown that while eating a diet containing foods high in antioxidants is beneficial to health, taking the stuff in supplement form shows no benefit (10, 11) and in some cases may actually do harm (12).*  A massive and well-respected review of the literature on antioxidant supplementation and risk of death from any cause (13) showed no benefit of supplementation, and increased mortality with some Vitamin A studies. We eat food, not isolated nutrients. Antioxidants are part of the complex, organic matrix of deliciousness that is food. The nutrients and substances present in fruits and veggies work symbiotically to confer health benefits to us.

Bottom Line

Aging and telomere research is evolving and more randomized, controlled trials (the gold standard in medical research) are needed to find out if longer telomeres delay aging and prevent age-related disease, and if so, whether or not there are specific foods that will lengthen telomeres. It’s a pretty fascinating area of research. For now, I feel pretty safe recommending a Mediterranean diet to the general population as well as my patients with heart disease and diabetes.

Here’s a (by no means comprehensive) list of foods that contain antioxidants:

Beverages: Coffee, green tea (go easy on the sugar), red wine (in moderation – which means 1 glass with dinner)

Nuts/seeds/legumes: Walnuts, almonds (look for raw or roasted, unsalted and un-sugared!)

Spices/herbs: Mint, cloves, allspice (sprinkle allspice in coffee, toss chopped mint leaves with fruit salad)

Fruits & Veggies: ANY! Seriously – I wouldn’t want to insult my little fruit and veggie friends by highlighting a select few. They all contain antioxidants and should really comprise at least half of the total food you eat in a day. But, if you’re going to twist my arm, I will point out that antioxidants are what give fruits and vegetables their diverse colors, so the deeper-hued, more vibrant your produce, the more antioxidant-rich (read: less iceberg lettuce and more kale and spinach).

Proteins: Seafood, kidney beans

For fun on a rainy Sunday…

… rent the movie Death Becomes Her.  Released in 1992, it’s a tale of two women (Goldie Hawn and Meryl Streep) so desperate to stay young they’ll try anything. It won an Oscar for visual effects. Instead of buttery popcorn, snack on yummy roasted veggies:

1 head fresh cauliflower, chopped into bite-sized pieces

2 large or 3 small sweet potatoes, skin on, and cut into bite sized pieces

1 Tbsp olive oil

1 Tbsp dried rosemary

2 tsp garlic powder

Salt and pepper to taste

Mix all ingredients in a large bowl till veggies are evenly coated. Spread onto a sheet pan (I line with foil to avoid having to clean the pan) and roast at 425 degrees for approximately 25 minutes (roast longer if you want crispy edges). Makes 4 servings.

Nutrition information per serving:  195 calories, 4 gm fat, 0.5 gm saturated fat, 0 mg cholesterol, 41 mg sodium, 1244 mg potassium, 38 gm carbohydrate, 8 gm fiber, 3 gm sugar, 4 gm protein, 158% vitamin C, 12 % vitamin A. Also high in iron, manganese, copper, vitamin K, folate, and B vitamins.

*Mega-dose (also known as “pharmacologic”) vitamin C administration has been studied in the treatment of cancer. That’s because at super high levels in the blood, vitamin C actually acts as a pro-oxidant, causing cell death the way chemotherapy drugs do. Don’t worry though, you can’t attain these levels with over the counter oral supplements– it has to be administered intravenously to have this potential effect.


  7. (Note: Yes, this is a study looking at multivitamin supplements and telomere length, BUT they separate out a group of supplement non-users and measured their telomere length and intake of micronutrients from food only and still found an association)

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