A Gene For Longevity? Think Jaws Instead

July 4, 2010

Every time I see a study about longevity, I can't help but to chuckle inside. We've been searching forever for the fountain of youth, and characterizing genes that determine how long you'll live is just another high-tech version of our quest. The New York Times reported on a study out of Boston University that found a set of genes that can predict extreme longevity with 77% accuracy. I have to admit—I'm a bit skeptical about any study what promises potential cures or longer life based on genetic research.

Yes, there's been significant strides in our knowledge and understanding of our genes, but even the most experienced researchers admit that they've hit a wall in terms of actually making significant differences in improving people's lives using gene therapy. Sequencing the entire human genome was like going to the moon—it was an incredible accomplishment, but now what? The benefits of gene sequencing will probably show up indirectly, where the techniques that are learned will be incorporated into other scientific areas.

One thing that I've noticed whenever I see patients in their 90s or above is how wide their jaw are, with generally good dentition. Typically, these people grew up eating naturally, and in undeveloped parts of the world, where they didn't have access to modern, Western diets. It's amazing how many of these people are on minimal to no medications, and live healthy, vibrant, independent lives. I'm sure that if they can find a gene for large jaws, then that will be found to correlate with longevity even more significantly.

The next time you see a centenarian, take a look at his or her jaws. You'll see what I mean.

Written by Steven Park · Filed Under Blog | Leave a Comment

The Facts About Anti-Aging: Science or Scam?

September 16, 2009

September for those of you who weren’t aware is Healthy Aging Month. This brings to mind my father who just turned 77 this August even though my wife says that he looks like he’s 10 years younger. Everyone who knows him agrees. But the funny thing is my father is the antithesis of what most would consider “Anti-Aging”. He doesn’t take any supplements or vitamins, nor does he undergo cleanses or detox regimens. Yet he looks and acts like a man who’s in his 50s or 60s, and not someone who’s in his 70s.

So why doesn’t my father look and act more like his age? He’s living the life of his dreams.

Live, Not Strive

It’s widely known that the longest living people are in Japan, and I’m willing to bet that these 90 and 100 year olds aren’t taking multiple vitamins, detoxing, cleansing, or paying lots of money for the latest exercise trend.

Similarly, my father, as far as I can see, doesn’t do anything special to maintain his youthful exuberance. He simply eats a healthy diet (mostly vegetables), is physically active, and has a very health-promoting lifestyle.

Take for instance my father’s routine weekly schedule: He takes courses with undergraduates at Hunter college, plays tennis, performs in musicals and plays, sings in his church choir, hikes some very challenging trails in the Catskills, and regularly takes in the opera and the symphony on the weekends. He also jokes that when he wears his baseball cap on the subway or on the bus, no one offers him a seat. But when he takes off his hat, he’s offered a seat instantly. Much to the chagrin of his peers, who are confined to walkers, and need the aid of home health aids to get by, my father is one of the most active people I know even amongst my peers.

The only thing that my father has that would be considered “typical” for a man his age is that he has prostate cancer. Since 10 years ago when he was first diagnosed with the disease, he has had a persistently elevated PSA. And after multiple treatments for prostate cancer, for which no source can be found, he has received estrogen-like hormone treatments once in a while, but his youthful appearance is more pronounced now than when he was on a more intensive anti-testosterone regimens in the past.

Also, despite his cancer, his blood pressure and his glucose levels are better than most of his doctors and he doesn’t take any prescription medications.

Your Age Is A Matter of Chronology Not Biology

If you read the magazines or surf the internet, you’ll see various buzz words such as anti-aging, youth-promoting, regeneration, and age-reversal. It seems that the search for the fountain of youth is still alive and the secret is out. It’s not about how old you are that matters. It’s more a matter of how young you want to look and feel.

There’s even a medical specialty called Anti-Aging Medicine to assist people in their quest for agelessness. It’s almost as if we’re engaged in some sort of mythical battle for immortality. Yet unlike most battles of this sort, our enemies don’t have three heads, or turn you into stone. It just makes you look and feel that way.

Anti-Aging or Anti-Living?

The word Anti-aging to me is an oxymoron since you can’t literally change your chronological age. This also implies that the deterioration in the way you feel or the way you look can be slowed, or even sometimes reversed. There’s definitely value in looking and feeling younger (even for me), but what most of these programs tout is that one pill or supplement that can make you look and feel younger, without addressing the big picture. Yes, there are programs out there that are more “holistic,” but essentially, you’re told you have to replenish what your body is missing in order so that you don’t miss out on all that life has to offer.

The problem is, no one seems to have figured out what that missing ingredient is. Who do you believe if you want to stay healthy or maintain your vitality? Are you not drinking enough water, or are you eating nutritionally deficient foods, or is your water laced with toxins and chemicals? Is it a vitamin B12 deficiency or lack of calcium? Are you eating too many acidic foods or too much alkaline foods? How can you figure out if you’re allergic or sensitive to nuts, gluten, or milk?

Recent studies are now suggesting that vigorous exercise doesn’t really help you lose weight, since you’ll eat more. More confusion. Studies are published almost routinely giving conflicting results on any potential benefits of herbal or nutritional supplements, including valerian for sleep, echinacea for colds, and multi-vitamins for health in general.

With all the different opinions on how to stay young and healthy, it can be a maddening process that can actually make you age faster. Honestly, I don’t have a good answer for you. Even as a physician, I’m stuck in the same conundrum within the medical fields as well, with conflicting studies and vastly differing opinions.

But here’s my personal advice – do what feels right. If you truly believe in something, do it with all your might. Science actually invalidates one individual’s experiences and can only generalize based on large population studies. Since everyone responds differently, your only way to know whether or not it’s going to work is to try it (within reason, of course). Rather than trying to exclude the placebo effect that most studies try to do, take advantage of your body’s natural ability to heal itself, no matter which option you choose.

However, realize that that one pill, supplement or exercise regimen is not going to make you younger. Eventually, something will work for you, but without changing your mindset and daily habits, your health problems will return and you’ll be back to square one.

One plausible explanation to why people who take vitamins feel healthier is that they are naturally health conscious, eating the right foods and making healthy lifestyle choices. But when vitamins were tested in a prospective, randomized, placebo-controlled, double-blinded study, no benefit is found. Not too surprising. Rather than using the vitamin as the cure-all for all their ailments, healthy people use vitamins as part of a well-balanced, nutritionally smart, and stress free lifestyle, where youth and vitality is a state of mind as well as a continuing process, rather than an end point.

After all, you can draw infinite possibilities in the finite period of time that you have if you want it to. Take my 77 year old father as an example. Perhaps the best secret to living a long life is just this: Just live.

Written by Steven Park · Filed Under Articles | Leave a Comment

What’s Your Real Age?

March 29, 2009

A recent story in the New York Times describes Dr. Mehmet Oz’s online quiz that calculates your "real" age based on a series of health and lifestyle questions. The slant on the article was to bring up the fact that major pharmaceutical companies were using this data to market to people who use this service, but what I want to point out is that there’s another, simpler way of determining how quickly you’ll age: the size of your breathing passageways.

I’ve described in my book, Sleep, Interrupted, a concept called the sleep-breathing paradigm, which proposes that all modern humans are susceptible to breathing problems at night to various degrees. Our ability to talk caused anatomic changes that predisposes tongue collapse in deep sleep. Your genes determine the size of your jaws, and the smaller your jaws (with more dental crowding), the more susceptible you’ll be to breathing problems while sleeping. As one ages chronologically, our airways begin to narrow due to various factors, including obesity, inflammation, and gravity. The upper extreme end of this continuum is called obstructive sleep apnea, but even "normal" people are on this line.

Poor quality sleep due to multiple obstructions causes a myriad of physiological stresses, leading to everything from weight gain, hypertension, anxiety and depression to heart disease, heart attack and stroke. This process heightens your nervous system, making you edgy and hypersensitive. It also makes you more susceptible to external stresses.

So the next time you are brushing your teeth, take a look inside your mouth in the mirror. Is the space behind the tongue wide open? Can you see the back of your throat easily? Do doctors tend to cause you to gag using a tongue depressor to see the back of your throat? Is the roof of you mouth arching sharply upward, rather than a flat slope? Is there a family history of heart disease or early death in your family? Do you feel much older than your real age?

Post your answers below—I’d like to know. I promise, I won’t give your information to pharmaceutical companies.

Written by Steven Park · Filed Under Blog | Leave a Comment

New Age Dawning: Breathe Well, Sleep Well, Age Well

May 28, 2008

Sleep May Not Be the Number One Factor In staying Young and Healthy

“Early to bed, early to rise, makes a man healthy, wealthy and wise.”

This short proverb can be traced as far back as 1496, and even earlier if you count all its variations. It seems that people have always understood the necessity of a good night’s sleep, but these days quality sleep has become a luxury rather than a necessity. But going without sleep may not be so easy since it’s not something your body can easily do without.

The Growing Sleep Deficit
According to a recent Harvard Health Publications survey, “more people are sleeping less than six hours a night, and sleep difficulties confound 75% of us at least a few nights per week.” Most people are shown to be getting inadequate sleep, and as a result chronic fatigue is a major problem for millions of Americans.

But even with the sleep “catch up” on the weekends there are still those who are tired and listless no matter how many hours of sleep they get. In these circumstances, something else may be awry: the sleepiness patients feel is usually the end result and not the actual cause of their sleepiness. In fact, it may be their poor breathing at night and not the quantity of sleep they’re deprived of.

Breath Well To Sleep Well
Whenever you undergo any form of exercise training, you’re almost always reminded to take long deep breaths and to focus on your breathing. From Pilates, to yoga to running and Tai-Chi, exerting control over one’s breath, especially as it pertains to one’s stamina and endurance, is key to maintaining good form and gaining mastery.

But think what would happen if you couldn’t breathe well while you slept. You’d get more than a flabby body. You’d be headed for some serious health problems. But if you’re suffering from obstructive sleep apnea, or OSA for short, this is exactly what’s happening.

Having Trouble Breathing While Sleeping?
Although all humans have varying degrees of airway narrowing, those with sleep apnea, or its milder variant upper airway resistance syndrome (UARS) have anatomies that are more prone to collapse than others. If you have a triangular facial structure or if you have a long neck or if you have a thick, stocky neck, like a football player, or if your tongue happens to sit higher up on your arches (see diagram), all of these anatomical factors can predispose you to airway obstruction or breathing problems while you sleep. Obesity, or one’s weight is not the primary indicator as once believed for having sleep apnea.

This is why for some OSA and UARS patients, sleeping on their sides or stomaches is an important prerequisite for getting a good nights rest. The reason being that this position, as opposed to sleeping on their backs, gives the tissue around their airway a bit more openness, and their tongues don’t tend to collapse as easily if they were lying flat on their backs, especially in deep sleep when throat muscles tend to relax more.

Although many OSA and UARS patients think they prefer to sleep this way just because this is how they’ve always slept, they may very well have made a choice to sleep this way for very good reason. It’s almost like a reflexive survival mechanism, since these preferences to sleep on our sides or stomachs, may have been formed not by any conscious effort, but as a reflexive coping mechanism for something that’s ailing us. This is why oftentimes when patients come to me with sinus and or chronic fatigue issues, I always ask: “Which position do you prefer to sleep in?” It’s almost a given that if patients like to sleep on their sides or stomaches their airways will look like the opening of a coffee stirrer when I look at their airway with my video endoscope.

Breathing For Life
Although many of us intuitively know that breathing is necessary for life, those with sleep apnea and UARS aren’t breathing for their lives. Even though they’re sleeping and therefore should rest allowing time for their brain, muscles, and organs to reset and replenish, their apneas or frequent breathing cessations are constantly interrupting this process. It’s like their “fight or flight” response is on all the time, even though it needs some time off. Think what would happen to your car if the ignition was never turned off. Well, this is what’s happening with sleep apnea patients.

Problems with Sleep Apnea
There are many serious consequences to having sleep-breathing problems—many of which are preventable yet as I’d mentioned before, this is not very likely because so many people who have this condition are unaware.

For one thing, research has found that sleep apnea is inked with a higher incidence of high blood pressure and heart disease. Many patients that come to me already on high blood pressure medications or have a history of heart disease are found on examination to have some sort of a sleep-breathing disorder.

Some other chronic conditions related to sleep apnea are diabetes, depression and many anxiety issues. Many fatigue and attention deficit problems like ADHD (attention deficit hyperactivity disorder) in children have also been linked to sleep apnea. A recent study showed that some children having undergone tonsillectomies (where a high percentage of them present with obvious symptoms of OSA) showed significant improvement in their ability to focus and pay attention in schools if not a significantly noticeable decrease in their behavior problems as a result. As you can see, not breathing well while you sleep can have serious consequences for both the old and the young.

When Being Young Is Not Enough
Because sleeping well is almost synonymous in people’s minds with feeling well, looking young and healthy, many people neglect their breathing as a simple fact of life. Little do we realize that this is wherein life originates.

People don’t often ask themselves, “How well did I breathe last night” when they feel groggy and listless in the morning. Instead, most people fixate on the amount of sleep they got or not. This may be the reason why sleeping pills and anti-anxiety medications are so popular in America today.

Moreover, as everyone jumps on the latest new anti-aging rage, breathing is becoming not a secondary, but a tertiary issue in the medical community. In the scheme of holistic or preventative medicine, breathing is often taken as a matter of fact. Although many proponents of these therapies often tout breathing exercises as a means to reducing stress and improving mental wellness they nonetheless overlook this matter when they provide dietary regiments or herbal supplements as sleep aids with little or no regard to the fact that none of these regiments are all that effective unless the mechanism that allows for efficient sleep is working well too. It’s almost like an auto shop owner shoving premium gasoline at customers with cars with broken fuel lodges. Sooner or later, that car is either going to break down or stop dead in its tracks, or at the very least, waste the very good thing you put in to it to make it work better. Similarly, if your sleep problems originate from an anatomical issue, like your airway, no amount of pills or supplements, no matter how potent, can effectively cure your problems with sleep. These problems need to be addressed from the source where it originates—the airway.

Your Breathing Problems Solved
In lieu of giving out bottles of air to my OSA and UARS patients, there are simple measures you can take on your own to improve your breathing while you sleep if you suspect that this may be the source of your problems.

The first most obvious thing I recommend to all my patients who suffer from fatigue issues is to avoid sleeping on their backs. This is one of many reasons why snoring sometimes ceases when people turn over while they sleep. The next best thing to do, if you’re not able to change your sleep position in this way due to an injury or habit, is to lose any excess weight you’ve gained recently. Yet, if you’re still feeling tired or having trouble maintaining focus at work my recommendation will be to get a formal sleep study or polysomnography to determine the root cause of your day time fatigue or exhaustion.

You Want Me To Sleep Where?
A typical “sleep study” takes place in a sleep laboratory where a sleep technician can hook you up to a monitor while you sleep, and a “sleep doctor” can use the readings to objectively measure and quantify the real source of your sleep problems. (Watch meundergo a sleep study.)

Although you may or may not be officially diagnosed with OSA even after the sleep study, I’ve seen many if not a great majority of these patients gain useful information to address any other sleep problems they may be having. Yet, most if not in all cases, patients who I suspect have these conditions, are found to have some mild to moderate breathing component that goes along with their sleep problems. And for these patients, in lieu of treating the underlying breathing problem, no amount of sleeping pills will cure the airway blockage that’s at the root of their sleep problems.

Decelerating the Aging Process
To understand how essential it is to get the sleep you need, it’s equally if not more important to understand how you can get the restorative sleep you need as well.
Essentially, sound sleep offers vital services to your body. After spending a full day learning new skills and having new experiences, sleep allows your brain to shut down its learning mode and consolidate and commit the newly acquired information to memory. Adequate sleep also allows the body to produce the right balance of hormones to help stabilize weight and use carbohydrates efficiently (this may be why research studies show that inadequate sleep is often linked with weight gain). Getting enough sleep also helps to ensure your safety by keeping your brain more alert and in tune with your reflexes preventing injury, and keeping you happy and well adjusted.

Sleep also helps keep the body healthy by boosting your immune function, reducing your chances of getting certain cancers and lowering your blood pressure too. In a nutshell, if you’re not sleeping well, you’re missing out on one of the most valuable methods for keeping you young and healthy for a very long time.

However, ensuring that your good night’s sleep isn’t impaired by breathing problems like Obstructive Sleep Apnea may be more important than sleeping that extra hour of shut eye. As the new-age gurus of aging are telling us, it’s not how old you are chronologically as how old you are biologically. Similarly, if your breathing is impaired while you’re sleeping, your health may not depend so much on how much you sleep every night but how well you’re sleeping through the night, and moreover, how well you’re breathing while you’re asleep. In short, take a closer look at what’s happening on the inside and not on the outside for the answers to your sleep problems. You may be surprised by what you find.

Written by Steven Park · Filed Under Articles | Leave a Comment