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NUTRITIONAL SUPPORT FOR
ANTI-AGING AND AESTHETICMEDICINE
STEPHEN HOLT, MD, LLD(Hon.) ChB., PhD,
ND, FRCP(C) MRCP (UK), FACP, FACG,FACN, FACAM, OSJ
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CONCEPT:INNER BEAUTY
Physical appearance is a function of
general body health.
Beauty lies within the body.
All cosmetic interventions have short
to intermediate term benefits only.
Longevity is a legacy of positive
lifestyle, resulting in youthful looks.
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ANTI-AGING METHODS
Natural medicine is favored byclients in medical spas and anti-aging or recuperative clinics.
Natural medicine is combined withadvanced preventive medicinestrategies in the practice of anti-
aging or recuperative medicine. Recuperative medicine integrates
allopathic and natural approaches.
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LONGEVITY
Longevity implies health retention in the
elderly. Elite age with ill health is bad.
First-line anti-aging strategies are theprevention of diseases that cause
premature disability or death.
Important public health initiatives to
promote longevity involve strategies for:Metabolic Syndrome X, obesity, diabetes
mellitus, cancer and osteoporosis etc.
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LIFESTYLE MEDICINE
Several domains of lifestyle exist.
Attention to each domain is the basisof holistic healthcare.
Psycho-social wellbeing
Avoidance of substance abuse
Optimum nutrition
Exercise Sexual Health
Biorhythms (Sleep)
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THE SPA OR ELDERLY CLIENT
These clients often have occult
nutritional deficiencies (e.g. fad diets).
These deficiencies impair recuperativeprocesses or healing from invasive
cosmetic treatments.
All clients may benefit frommultivitamins combined with
phytochemicals and active omega-3.
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THEORIES OF AGING
Free radical
theories
Cross-linktheories
Immunologic
theories
Mutation and
Error Theories
In-built
Programs of
Tissue Aging
Stress
Theories
Repair budget
Theories
Miscellaneous
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DIET SELECTIONS
The anti-aging diet should be low incalories but nutrient dense (Walford).
Reduced in simple sugars andsaturated fats, enriched with omega 3.
High in dietary fiber, >25g/day
Modest in mixed protein intake
Rich in mineral and antioxidant intake
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OXIDATIVE TISSUE DAMAGE
Free radical damage is the most tenabletheory of aging OXIDATIVE STRESS.
Environmental toxins are pro-oxidants. Multifunctional antioxidants are found in
fruits, vegetables and berries.
Antioxidant support must be given withantioxidants of different REDOXpotential, with wide tissue distribution.
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CUTANEOUS OXIDATIVE DAMAGE
The fundamental basis of skin aginginvolves sunlight, toxins etc.
Topical antioxidants are limited intheir value for skin rejuvenation.
Oral antioxidants in mixed formshave greater therapeutic potential for
the reversal of skin aging.
A combined approach is ideal.
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SUNLIGHT
A double-edged sword, vitamin D
Protection from UVA and B radiation
Polypodium leucotomos diminisheschanges associated with photo-aging.
Reduces dermal elastosis, mast cell
infiltration and skin fold thickness (UVB). Oral photo protection: A new concept
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ANTI-AGING ANTIOXIDANTS
Certain antioxidants have tissue ororgan specific effects, EXAMPLES:
Ellagic acid prevents breast cancer. Turmeric supports cognition.
Lycopene supports the prostate.
Alpha-lipoic acid (protean benefits)
Polyphenols regulate glucosemetabolism (green tea and coffee).
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TISSUE GLYCATION
Undesirable cross-linking of sugar
or aldehydes with protein.
Results in AGES with loss offunctional integrity of proteins.
Carnosine and antioxidants may
inhibit tissue glycation(glycosylation).
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METHYL DONATION
Methyl donation maintains structural andfunctional integrity of key compounds,e.g. DNA, HDL, serotonin.
Characterized by elevated bloodhomocysteine.
Part of body inflammation (bodyitis):
obesitis, diabetitis, Syndrome X-itis.
Curb inflammation e.g. fish oil (EPA)
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THE OMEGA STORY
A widespread deficiency of omega-3
Active moieties are EPA and DHA
Omega-6 to 3 dietary ratio up to 20:1
EPA is anti-inflammatory. DHA is not.
Plant LNA precursors are not reliable
sources of EPA or DHA.
Enteric coated fish oil capsules arethe optimal way of taking fish oil.
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THE VALUE OF ENTERIC COATING,
TARGETED DELIVERY FISH OIL
Better tolerated, absorbed withhigher bioavailability to meetrecognition of high dosage
therapeutic benefit. Regular fish oil capsules and liquids
are obsolete in professional
practice. Belluzzi et al, NEJMed, 24, 334,
1557-8, 1996.
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VALUE OF ENTERIC COAT, NEJMed, 1996
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HORMONE REPLACEMENT
The notion that hormone deficienciesexplain aging in a comprehensive
manner is quite nave. GH, Bio-HRT etc. must be monitored.
GH releasing hormones should be tried
before GH injections e.g. GHRP-2
Need for staged anti-aging strategies.
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THALASSOTHERAPY
Topical for detox and dermabrasion
Oral for weight control, iodine, fucoids,
minerals, vitamins and gels.
Fucoxanthin promotes fat oxidation by
increasing Uncoupling Protein-1. Synergy
with fish oil.
Increase in transporter 4mRNA
expression of L-6 myotubes, glucose
uptake.
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AESTHETIC PROCEDURES
Increase in trauma from semi-invasive
cosmetic procedures e.g. lip-puffing,
liposuction, nips and tucks etc.
Trauma and Procedure Recovery is
required in spa and anti-aging practice.
Evidence-base for homeopathic Arnica
montana, bromelain and bioflavonoids.
Start supplements on day of surgery or
intervention, continue for 5-7 days.
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SKIN, HAIR AND NAILS
Skin, hair and nail beauty areparamount in aesthetic practice.
Several natural substances optimize
skin regeneration or repair andsupport sub-dermal structures.
Evidence-based ingredients can be
used in synergistic formulations:eggshell Ca, horsetail, olive leaf,antioxidants, DMAE, hyaluronate,MSM, collagen, Aloe etc.
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WEIGHT MANAGEMENT
Obesity and Metabolic Syndrome Xare the number one preventablecause of premature death anddisability.
Overweight status is not a simplecosmetic issue.
Weight gain is of multi-factorial cause,requiring multi-pronged interventions.
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LINKED TO OVERWEIGHT STATUS
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REDEFINING SYNDROME X
Classic Definition: Obesity,Hypercholesterolemia, High
Blood Pressure, Linked by
Insulin Resistance.
Syndrome X, Y and Z.., an
expanded definitionincorporating a novel unifying
concept of common diseases
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SYN X, Y, Z(Expanded Definition)
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THE PUBLIC HEALTH RISK
Syndrome X increases risk
for :
Type II Diabetes MellitusCardiovascular Disease
Cardiovascular Deaths
Deaths from ALL CAUSES
Am.J.Epidemiol, 148, 958, 1998.
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FACTS
Obese people die young
Obese people develop
premature disability Obese people are modern,
metabolic dinosaurs
Obese people are generallymismanaged in clinical practice.
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OBESITIS Epidemiological links between obesity and
inflammation have been proposed for >40y.
Glucose and fat intake induce inflammation byoxidative stress or the activation of transcription
factors.
Reductions in macronutrient intake in obesesubjects reduces oxidative stress and theproduction of inflammatory mediators
(1000kcal/day, 4 weeks or 48 hr fast).
Managing weight control without managinginflammation may be malpractice?
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: Fat tissue, normal weight mouse
:Fat tissue, from fat mouse (ob/ob)
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POTENTIAL MECHANISMS OF OBESITIS
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OBESITIS
Obesity is an inflammatory disorder
30% of blood cytokine IL-6 fromadipose tissue, decrease CRP and IL-
18 with weight loss
Nave Zones, but EPA valuable
Adipocytokines [leptin, adiponectin and
visfatin], adiponectin lowers TNF-alpha
Final common pathway oxidative stress
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OBESITIS
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DRUGS AND NUTRACEUTICALS
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UNREALISTIC
WEIGHT LOSS
EXPECTATOIN
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THE POT BELLY:USELESS AND
DANGEROUS ENDOCRINE ORGAN
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POT-BELLIED DINOSAURS
Fat tissue stores fat soluble chemicals,synthesizes inflammatory mediators andelaborates sex hormones.
Toxicants e.g. PCBs, pesticides etc.concentrate in fat deposits and alter fatmetabolism.
This is the concept of TOXIN INDUCED
LIPOGENESIS and it provides good reasonsfor body detoxification with weight control.
Pot bellies and insulin resistance go hand inhand, especially in Syndrome X.
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WHICH ARE QUICK FIX PROMISES
FORWEIGHT CONTROL?
DRUGS: Phentermine, Sibutramine,Orlisat, Phenylpropanolamine etc.
DIETARY SUPPLEMENTS: Pyruvate,Chromium, Hydroxycritic Acid,Omega-3 Fatty Acids, GLA, HoodiaGordonii, Caralluma, Fucoxanthin etc?
[SYNERGY IS IMPORTANT!]
ALL OF THE ABOVE!
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COMMON CAUSES OF
OBESITY The Double Whopper Brain
Sedentary Lifestyle Genetic Tendency
Social Gluttony (Appetite) Sleeplessness
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THE GLYCEMIC INDEX
Calculations of the glycemic index offood is probably a waste of time.
Understanding factors that controlgastric emptying rate can result ininference about the glycemic index.
Slowing gastric emptying slows glucoseabsorption relevance in acute dosing
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GLUCOSE TOLERANCE WITH
SOLUBLE FIBER
Holt S, et al
Effect of
Gel Fiber
Lancet,
March 24th,
1979.
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DIETARY PRINCIPALS
Calories Count
Watch Macronutrients CHO, Fat
Protein
Healthy Fat (EPA)
Salt Restriction Fiber Intake
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DIETARY SUPPLEMENTS
FORWEIGHT CONTROL
Modern concepts use synergy informulation for weight control.
Appetite suppression (Hoodia),thermogenesis (Fucoxanthin andHydroxycitrate), sugar regulation
(Polyphenols, Cinnamon), antioxidants,soluble fiber (oat beta glucan).
Example: Clinical Fucoxanthin Complex
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SYNDROME X NUTRITIONAL FACTORS
OBESITY: Hoodia, fiber, green coffee beanextract, starch blocker, chromium, fat blockers
HYPERTENSION: fiber, botanicals unpredictable
OXIDATIVE STRESS: alpha lipoic acid, AGES,
redox balanced, hydrophilic and lipophilic
HOMOCYSTEINE: B6, B12, folate, TMG
INSULIN RESISTANCE: fish oil(EPA), alpha
lipoic acid, vitamin and mineral supportBLOOD LIPID: soy, fish oil, guggul, garlic etc.
INFLAMMATION: EPA, curcumin, C etc.
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SYNDROME X NUTRITIONAL FACTORS
A healthy blood glucose level
A healthy blood cholesterol level
A healthy blood homocysteine level
Healthy immune function
Healthy digestive function
Antioxidant functionCalorie control by induction of satiety
Inhibition of fat and sugar absorption
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SYNDROME X NUTRITIONAL FACTORS
Soluble fiber e.g. oat beta glucan
Soy Protein 25 g/day Omega 3 fatty acids (EPA)
Chromium
Alpha lipoic acid
Vanadium Antioxidants e.g. ellagic acid, bioflavonoids
Starch blockers
Cinnamon
Maitake Green coffee bean extract
Hoodia gordonii
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THE SLEEPLESS NATION
About 100 million Americans do notsleep well. Sleeping pill poppers
Sleeplessness causes obtrusive and
unobtrusive problems. Sleep deprivation promotes weight
gain and it is diabetogenic.
Restoration of the biorhythm of sleepis pivotal in beauty and anti-aging.The nation should Sleep Naturally.
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ADAPTOGENS
Stress causes disease andaccelerates aging.
Adaptogens are underestimated
nutraceuticals in anti-aging medicine(concept of genomeceuticals).
Anti-aging adaptogens include:
Ginseng, Ashwagandha, Dandelion,Ganoderma, Schisandra, Rhodiola,Bacopia monnieri and Resveratrol.
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CONCLUSION
Dietary supplements remain the mainstay
of natural approaches for anti-aging.
Longevity is a legacy of lifestyle.
Synergistic formulations address the
complex cascade of harmonious
biochemical events in the body.
The therapeutic use of dietarysupplements has emerged into main-line
medical practice, despite the rhetoric.
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