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Natural Foods Merchandiser

Triage theory offers a new look at aging

Half the population takes supplements regularly, hoping for a health dividend, according to The National Institutes of Health. But whether supplements will pay off in longevity has always been up in the air.

Finally, one of the world's most-cited scientists has proposed a "triage theory" that explains past observations of age-associated mitochondrial decay. And the theory implies that supplements can trigger an internal longevity switch.

In short, evolution has equipped us with a triage mechanism: When deficient, micronutrients are reserved for short-term health and reproduction—disabling DNA repair and longevity.

Bruce Ames, Ph.D., a biochemist with the University of California at Berkeley and Children's Hospital Oakland Research Institute, presented his theory in the Nov. 21, 2006 issue of the Proceedings of the National Academy of Sciences. Before publishing his new triage theory, he gave The Natural Foods Merchandiser some early details on its implications for micronutrient deficiencies and accelerated aging.

NFM: How did you develop the triage theory of aging?

Bruce Ames, Ph.D., professor of biochemistry and molecular biology at the University of California, Berkeley, and senior research scientist at Children's Hospital Oakland Research Institute.

Ames: It's less the triage theory of aging and more the triage theory of how people are accelerating their aging with deficient diets. We'd worked on DNA aging and how to reverse that, and made good progress feeding various metabolites that make mitochondria in old rats look more like mitochondria in young rats. Their brains got better and they were more energetic and other things.

And I'd long found that many kinds of vitamin or mineral deficiencies cause long-term DNA damage to human cells in culture, to mice or whatever.

I also found many instances in the literature of studies pointing to deficiencies causing cancer and other things—but only long-term—and I asked why would nature do it this way? Nobody had pulled it all together.

Then it hit me: Nature wants it this way. There must have been episodic shortages of different minerals throughout evolution. How would nature respond? Nature triages for survival: Survive short-term and you have a chance of reproducing. Whenever there's a tradeoff between short-term and long-term, short-term gets favored.

NFM: So triage reduces life span?

Ames: There's a known triage between organs. If you're short of iron, you take it out of the liver before you take it out of the heart because if you take it out of the heart, you're dead. And one of the things that's long-term is DNA damage, which doesn't show up as cancer for 20 years—so to hell with it if you're starving.

NFM: Triage works even for single-day deficiencies?

Ames: Sure. Nature doesn't want you to keel over and die because you're deficient in iron and your heart doesn't work. So it takes it out of nonvital organs. Obviously, if you're deficient for years, you pay a bigger long-term price in types of cancer that are impacted by this.

What level triggers all this, we don't know—we're trying to find out. If you want maximum life span, your micronutrient needs must be met throughout life. And you mustn't take too much—there's always an upper limit.

NFM: Doesn't following recommended daily allowances prevent deficiencies?

Ames: We've been looking at the wrong things for setting RDAs—amounts the population needs, but based only on acute effect. Someone might seem perfect, but their DNA is getting all damaged because they don't have enough iron or whatever. And that's exactly what we're finding.

People are eating horrible diets. I suspect deficiencies will be a major contributor to cancer, degenerative diseases—and aging. When you deprive cultured human cells of certain nutrients, they senesce earlier, essentially age faster.

We need to be "tuned up" with vitamins and minerals throughout life. Anytime we're not, we're paying a price in long-term DNA damage.

NFM: Eliminating deficiencies retards aging rather than reversing it?

Ames: Right. But if half the population's aging is due to deficiencies, this could really have a big impact.

NFM: You recommend multivitamins for the elderly. Why not everyone?

Ames: Well, you can't just take pills. You need a good diet. But we need to focus more on micronutrient deficiencies. I have an Italian wife and get a wonderful Mediterranean diet, but I still take multivitamin-minerals as insurance. I think everybody should. And those who need it most are teenagers, the obese—those on bad diets. The elderly may be eating enough vitamin B-12, but if they're not absorbing it, they may need bigger doses.

NFM: Is there proof micronutrients will greatly reduce cancer and aging in humans?

Ames: There are a lot of suggestive epidemiological studies and rodent studies, and I don't see much downside.

NFM: Experts say if you get a balanced diet, you don't need supplements. Do you agree?

Ames: People in nutrition say, "Just tell people to get a good diet." And they've been doing that for a long time with little success. I'm getting a good diet—but I still take a multi as insurance. A lot of evidence out there links deficiencies to long-term DNA damage and faster aging, and I see no reason to think any diet can be optimum in everything.

NFM: How do we know supplements are metabolized when not ingested as food?

Ames: People have done lots of studies. In general, there's not much difference. I'm not too worried about that.

NFM: If one antioxidant is deficient won't other antioxidants take over?

Ames: To some extent. But vitamin E, for instance, is in the membrane whereas vitamin C is in the cell's soluble part. And it's not just antioxidants. If you're not getting enough iron and zinc, your mitochondria just pour out oxygen radicals. It's like you've aged instantly. What you need to get back to normal is not more vitamin C or E—you need to get that missing iron and zinc because deficiency is a powerful oxidant.

Editor's note:
It happens every day: A customer comes in and wants to know why this or that supplement works. You become a de facto science teacher, educating all of your shoppers on the science of supplements. The triage theory put forth by Bruce Ames, Ph.D., begs a related—and equally important—question: "How do we interpret and judge the science behind our products—if it exists at all." Educating yourself on this important aspect of naturals sales is the first step in getting your "teaching" degree. In a series of three articles, beginning with this Q&A with Ames, NFM will explore the science, how to understand this potentially confusing element and then how to pass it on.


NFM: You've rejuvenated older rats with alpha lipoic acid and acetyl-L-carnitine. Are these nutrients more aging-related?

Ames: You need all micronutrients, but some work indirectly. I think ALA turns on the entire antioxidant defense system. ALCAR—it works only in old animals—may overcome age-related deterioration. Should everyone take ALCAR and ALA? Everything looks very good, but it's too early to tell.

NFM: The body makes ALCAR. Why would it be deficient?

Ames: Well, you get old and all sorts of things start going downhill. If the elderly make less of a nutrient or absorb less, they may need to get more.

NFM: Calorie restriction promotes longevity. Where does CR fit in?

Ames: CR itself does seem to increase longevity and health. But in CR, they maintain micronutrients by giving the animals lots of vitamins and minerals. They're saturated in all those things.

NFM: So what supplements does Dr. Ames take?

Ames: A multivitamin-mineral, magnesium-calcium, fish oil and a combination of ALCAR and ALA. I also get a good diet and exercise. But I always say I get my exercise by running experiments, skipping the controls and jumping to conclusions.

Michael Downey is a Toronto-based freelance writer.

The first in a series of three articles.
Click here for part II.
Click here for part III.


Studies suggest triage may react to various micronutrient deficiencies, including:
alpha lipoic acid
cobalamin (B-12)
omega-3 fatty acids
pyridoxine (B-6)
riboflavin (B-2)
thiamine (B-1)
vitamin D

Natural Foods Merchandiser volume XXVIII/number 1/p. 56

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