James A Golczewski, Ph.D.


Health & Life-Extension News


The material in this Web site may be reproduced with appropriate citation. Corrections or suggestions may be sent to JGolczewski@Yahoo.com.  Please be specific and include citations where appropriate.



B.A. in physics, with honors, Rutgers University

M.S. in physics, with honors, Fairleigh Dickinson University

Ph.D. in biophysics, 1980, Stevens Institute of Technology

Postdoctoral Fellow, 1980-1982 University of Alabama in Birmingham.

Postdoctoral Fellow, 1982-1983 Wistar Institute, University of Pennsylvania.


Aging, cardiovascular disease, cancer, diabetes, psychiatry, neurology, nutrition, cell biology, biophysics, infectious diseases, asthma, immunology, urology, pain, gastroenterology, and electronics, including writing, editing, research, development, production, and teaching. Major concentration in aging and age-related diseases.




Golczewski JA. Aging: Strategies for Maintaining Good Health and Extending Life. Jefferson, NC: McFarland & Co Publishers; 1998. ISBN 0-7864-0412-4

Golczewski JA. Life Extension: Current and Future Possibilities, Camp Hill, PA, Sunbury Press; 2012.ISBN 978-1-62006-082-7



Golczewski JA, Hiramoto RN, Ghanta VK. Antigenic determinants on lymphocytes from young and old C57BL/6 mice. Experimental Gerontology. 1982;17:375-381.

Golczewski JA, Hiramoto RN, Ghanta VK. Enhancement of maze learning in old C57BL/6 mice by dietary lecithin. Neurobiology of Aging. 1982;3:223-226.

Golczewski JA, Ng TC, Hiramoto RN. In vivo measurement of 31P nuclear magnetic resonance spectrum of aging mouse brain. Physiological Chemistry and Physics. 1983;15:13-18.

Golczewski JA. Comparison of EGF receptors from young and old WI-38 cells. Physiological Chemistry and Physics. 1983;15:115-120.

Golczewski JA. Effect of 2-mercaptoethylamine on proliferation and lifespan of WI-38 cells. Experimental Gerontology. 1984;19:7-11.

Golczewski JA, Frenkel GD. Cellular selenoproteins and the effects of selenite on cell proliferation. Biological Trace Element Research. 1989;20:115-126.


Golczewski JA, Hiramoto RN, Ghanta VK. Interactions between lymphocytes from young and old mice. Federation Proceedings. 1982;41:297.

Golczewski JA, Hiramoto RN. Effect of old mouse serum on learning. The Gerontologist. 1982;22:234.

Golczewski JA, Ng TC. NMR study of brain energy metabolism as a function of age. Bulletin of the American Physical Society. 1982;27:883.

Golczewski JA, et al. The human epidermal growth factor receptor-kinase complex during in vitro aging. In: Altered Endocrine Status During Aging. New York, NY: Alan Liss Inc; 1984.

Golczewski JA. Loss of mitogenic response and diminished receptor phosphorylation in old cells. Bulletin of the American Physical Society. 1984;29:117.

Golczewski JA. MEA extends in vitro lifespan. Presented at the Annual Meeting of the American Association for the Advancement of Science; 1984; New York, NY.

Zirvi KA, Golczewski JA, Hill GJ. Continuous culture of A549 human lung carcinoma cells in serum-free medium. Proceedings of the American Association for Cancer Research. 1986;27:28.

Golczewski JA, Frenkel GD. Effects of selenium compounds on human cell proliferation and the formation of intracellular selenoproteins. Federation Proceedings. 1987;46:907.

Frenkel GD, Falvey D, Golczewski JA. Formation of selenium-protein adducts upon exposure of DNA and RNA polymerases to selenotrisulfides and cells to selenite. Presented at the International Conference on Trace Elements in Human Health and Disease; 1987; Copenhagen, Denmark.

Leibovich SJ, Golczewski JA. Expression of inducible nitric oxide synthase (iNOS) is required for production of angiogenic activity by murine macrophages and IC-21 cells. Molecular Biology of the Cell. 1994;5(Suppl):373a.


Fatty Acids in Fish May Protect Against Alzheimer's Disease 

Consumption of fish once a week or more decreased the risk of developing Alzheimer's disease by more than 60% after adjusting for confounding risk factors.  Researchers in this study questioned 800 elderly people about their dietary habits and examined how many had developed Alzheimer's disease 4 years later.  Total omega-3 fatty acid consumption and docosahexaenoic acid (22:6n-3, DHA) were associated with lower risk, but eicosapentaenoic acid (20:5n-3, EPA) and alpha-linolenic acid consumption were not. DHA and EPA are often found in fish.

Morris MC, Evans DA, Bienias JL, et al. Consumption of fish and n-3 fatty acids and risk of incident Alzheimer disease. Arch Neurol 2003 Jul; 60:940-946.

Chemicals Found in Red Wine May Mimic Life-Extension Effect of Caloric Restriction

Resveratrol is a substance found in red wines, particularly wines made in cooler climates.  A study reported by Dr. David A. Sinclair of Harvard Medical School and published in Nature reported that resveratrol had an effect on yeast similar to calorie restriction, extending lifespan by 70%.  Dr. Mark Tatar of Brown University found the same effect in fruit flies.  It has not yet been tested in mammals. [See update below]

It has long been known that reducing calories prolongs life span; in fact, it is the only known method of increasing maximum life span in mammals.  However, since such severe restriction is difficult in practice, a chemical mimic would represent a major breakthrough.

Elixir Pharmaceuticals of Cambridge, MA, has found a different set of chemicals that mimic caloric restriction.  But Ed Cannon, Elixir's CEO, noted that his company is "8 to 10 years away from having an approved drug."

Howitz KT, Bitterman KJ, Cohen HY, et al. Small molecule activators of sirtuins extend Saccharomyces cerevisiae lifespan. Nature 2003 Aug 24.
http://www.nytimes.com/2003/08/25/science/25LIFE.html?ex=1062827457&ei=1&en=bee8 960c050e5802

Animal Fat in Diet Increases Risk of Breast Cancer

The relationship of dietary fat intake to the risk of breast cancer has been controversial.  Although many studies in animals have found that higher fat intakes significantly increase the risk of breast cancer, human studies have not confirmed this.

Now the Nurses Health Study II, which studied 90 000 women over 8 years, reports that the risk of breast cancer increased with increasing consumption of animal fat.  A significant relationship was only found for animal fat, not total fat or other types of fat.  Red meat and high-fat dairy foods were individually associated with a higher risk.

Cho E, Spiegelman D, Hunter DJ, et al. Premenopausal fat intake and risk of breast cancer. J Natl Cancer Inst 2003 Jul 16; 95:1079-1085.

Fruit Consumption Linked to Lower Risk of Lung Cancer

The relationship between fruit and vegetable intake and the risk of developing lung cancer was studied among 478 021 persons from 10 European countries, followed for up to 10 years.  After adjustment for possible confounding variables, higher fruit consumption was significantly linked to lower risk of lung cancer.  The risk among those in the highest quintile of consumption was 60% of the risk in the lowest quintile (P = .0099 for trend).  No association between vegetable consumption or vegetable subtypes and lung cancer risk was detected.

Miller AB et al. Fruits and vegetables and lung cancer: Findings from the European prospective investigation into cancer and nutrition. Int J Cancer. 2004 Jan 10; 108:269-276.

Meta-analysis Confirms Link Between Fat Intake and Risk of Breast Cancer

Although laboratory experiments and population studies have suggested that dietary fat increases the risk of breast cancer, the findings have not always been consistent.  A meta-analysis of all published scientific studies on this question found that women with the highest consumption of dietary fat had a 11% to 13% higher risk of developing breast cancer compared to women with the lowest intake.  High consumption of saturated fat was associated with a 19% higher risk, and high meat consumption with a 17% higher risk.

Boyd NF et al. Dietary fat and breast cancer risk revisited: A meta-analysis of the published literature. British Journal of Cancer. 2003;89:1672-1685.

Low Fiber/High Fat Diet Increases Risk of Breast Cancer in Postmenopausal Women

Another large study confirmed the link between risk of breast cancer and low fiber/high fat diets.  It followed nearly 12 000 postmenopausal women over a number of years.  Even after accounting for potential confounding factors, women with the highest fiber/lowest fat diets had a 42% lower risk of developing breast cancer compared to women with the lowest fiber/highest fat diet.

Mattisson I et al: Intakes of plant foods, fibre and fat and risk of breast cancer - a prospective study in the Malmö Diet and Cancer cohort. British Journal of Cancer. 2004;90:122-127.

Fiber in Grains and Fruits Linked to Decreased Risk of Heart Disease 

A meta-analysis of 10 large studies has linked the total amount of fiber in the diet as well as fiber from cereals and fruits with decreased risk of coronary heart disease.  The studies included 91 058 men and 245 186 women followed for 6 to 10 years.  After taking into account body mass index, lifestyle factors, and demographic factors, for each additional 10 grams (about 1/3 ounce) of total fiber in the diet, the relative risk of having a coronary event (like a heart attack) decreased by 14%, and the risk of death from coronary events decreased by 27%.  When analyzed by fiber from types of food, fibers from cereals and fruit were associated with decreased risk, but fiber from vegetables was not.  This study is especially interesting because of the large number of subjects and the length of the followup.

Pereira MA, et al. Dietary fiber and risk of coronary heart disease: A pooled analysis of cohort studies. Arch Intern Med. 2004;164:370-376.

Drinking Coffee Linked to Decreased Risk of Diabetes 

Drinking coffee may significantly reduce your risk of developing type 2 diabetes.  Type 2, the most common form of diabetes, usually develops later in life.  The study followed 6974 men and 7655 women aged 35 to 64 years for an average 12 years.  After accounting for possible confounding factors (age, body mass index, systolic blood pressure, education, occupation, physical activity, alcohol and tea consumption, smoking), men who consumed 3-4, 5-6, 7-9, and 10 or more cups of coffee a day had 73%, 70%, 67%, and 45% the risk of developing diabetes, respectively, compared to those who drank only 0 to 2 cups.  Among women, the reduction in risk was even greater, with a risk of 71%, 39%, 39%, and 21% for those who consumed 3-4, 5-6, 7-9, and 10 or more cups a day, respectively, compared to 0-2 cups.  The lower risk was seen in all subgroups stratified by age, smoker or not, weight, alcohol drinkers or not, and filtered vs. unfiltered coffee.

Tuomilehto J, Hu G, Bidel S, et al. Coffee consumption and risk of type 2 diabetes mellitus among middle-aged Finnish men and women. JAMA.  2004(Mar 10);291(10):1213-1219.
PMID: 15010442

Roy Walford, Leading Researcher in Aging, Dies at 79 

Roy Walford, one of the leading lights in aging research, died on 27 April 2004 from complications of amyotrophic lateral sclerosis.  He was born in San Diego, California, on June 29, 1924, did his undergraduate work at the California Institute of Technology, and received his M.D. from the University of Chicago.

Although Dr. Walford worked in immunology and other areas of aging research, he is best known for his work on the effect of caloric restriction in extending life span.  This effect had first been noted in the 1930s, but Dr. Walford investigated it more thoroughly and was the first to show that the extension of maximum life span still occurs if restriction is begun in mid-life.  He also showed that a low-calorie diet could result in beneficial changes in blood pressure, blood sugar, and cholesterol.  He himself began the practice of caloric restriction in middle age, although he stressed that one man is not an experiment.

Dr. Walford published numerous scientific papers and several books, including Maximum Life Span and The 120-Year Diet.  Both remain excellent surveys of the field of aging and possible life-extension strategies.

Although I met Dr. Walford only once, he left a lasting impression of wisdom and courtesy.  He was one of the few aging researchers who had the courage to speak out about applying the research in everyday life at a time when this was not fashionable in the scientific community.  He will be missed.


Selenium Reduces Risk of Cancer 

Previous studies have reported that selenium supplements reduce the risk of cancer.  Among 1312 patients randomly assigned to 200 micrograms of selenium per day or placebo, those who received selenium had a lower overall death rate from cancer and lower rates of lung, colorectal, and prostate cancer.
Combs GF Jr, Clark LC, Turnbull BW. Reduction of cancer mortality and incidence by selenium supplementation. Med Klin. 92(Suppl 3):42-45, 1997.

Further evidence that selenium helps reduce the risk of cancer, especially prostate cancer, comes from a study that followed over 1000 men for 13 years.  The results of the Nutritional Prevention of Cancer Trial confirmed that low selenium levels were associated with increased cancer risk and that selenium supplementation was associated with marked reduction in the overall cancer risk and risk of cancers of the prostate and colon/rectum.  Selenium supplementation reduced the risk of cancer most strongly among men who initially had the lowest blood levels of selenium.  It is thought that selenium promotes the death of cancer cells and inhibits their growth and proliferation.

Li H et al. A prospective study of plasma selenium levels and prostate cancer risk. J Natl Cancer Inst. May 5; 96:696-703, 2004.
Combs GF. Status of selenium in prostate cancer prevention. Br J Cancer. 2004 Jun 22.

Selenium May Decrease Risk of Colorectal Cancer 

A combined analysis of data from three randomized trials evaluated the relationship between selenium and colorectal cancer risk.  Higher blood levels of selenium at the outset of the study period were significantly linked to lower risk of developing colorectal cancer.  Persons with blood selenium levels in the highest 25% had a 34% lower risk of colorectal cancer compared to persons with the lowest selenium levels.

Jacobs ET et al: Selenium and colorectal adenoma: results of a pooled analysis. J Natl Cancer Inst 2004 Nov 17;96:1669-1675.

Diet High in Fruits and Vegetables Decreases Risk of Diabetes 

A diet with a higher intake of fruits, vegetables, legumes, fish, and whole grains reduces the risk of developing diabetes, compared to the typical Western diet that includes more red and processed meats, desserts, french fries, and refined grains.  That is the finding of a study of 69,554 women aged 38 to 63 years without a history of diabetes or cardiovascular disease that began in 1984.  After accounting for possible confounding factors, women who consumed the typical Western diet had a significantly greater risk of developing diabetes, which reached as much as 50% greater than women with a "prudent" diet.

Fung TT et al. Dietary patterns, meat intake, and the risk of type 2 diabetes in women. Arch Intern Med. 2004 Nov 8;164(20):2235-2240.


Vitamin B6 Consumption and Lower Risk of Colorectal Cancer 

Women who consume the most vitamin B6 have a significantly lower risk of developing colon or rectal cancer. Alcohol consumption does not affect the risk. However, the protective effect of vitamin B6 was most pronounced among women who consumed the most alcohol. Those are the findings of a study of 61 433 women in Sweden aged 40 to 76 and followed for an average of 15 years. After accounting for possible confounding factors, women who consumed the most vitamin B6 had a 44% lower risk of colorectal cancer. The risk was 25% lower for colon cancer and 50% lower for rectal cancer. Vitamin B6 affects the body in a number of ways and may therefore influence the risk of cancer through several mechanisms.


Larsson SC, Giovannucci E, Wolk A: Vitamin B6 intake, alcohol consumption, and colorectal cancer: A longitudinal population-based cohort of women. Gastroenterology 2005;128:1830-1837.



Alcohol and Caffeine Consumption Seem to Reduce Risk of Developing Dementia

Light-to-moderate alcohol consumption was associated with a lower risk of dementia in persons aged 55 years or older. The effect did not seem to depend on the type of alcoholic beverage.  In a study of 7983 persons initially without dementia, over a 6-year period those who had one to three drinks per day had a 42% lower risk of developing dementia of all types and a 71% lower rate of vascular dementia (dementia due to disorders of the blood vessels).  This relationship was seen even after adjusting for age, sex, systolic blood pressure, education, smoking, and body-mass index.

Ruitenberg A, van Swieten JC, Witteman JC, Mehta KM, van Duijn CM, Hofman A, Breteler MM. Alcohol consumption and risk of dementia: the Rotterdam Study. Lancet. 2002 Jan 26;359(9303):281-286.


Persons who regularly consumed more caffeine in the preceding 20 years had a lower rate of Alzheimer’s disease after accounting for possible confounding factors.  In a study of 54 persons with and 54 without Alzheimer’s disease, those with Alzheimer’s disease had consumed an average of 73.9 mg of caffeine a day, whereas those without Alzheimer’s disease had an average daily caffeine intake of 198.7 mg.

Maia L, de Mendonca A. Does caffeine intake protect from Alzheimer's disease? Eur J Neurol. 2002 Jul;9:377-382.

Are Omega-3 Fatty Acids Beneficial?


A number of beneficial effects have been reported for omega-3 fatty acids.  Common sources of these fats are cold-water fish and flax.  A meta-analysis (mathematical analysis of previously published studies) of 97 studies and several hundred thousand subjects compared the effects of omega-3 fats as well as diet, statins (e.g., Lipitor, Zocor), and other medications on blood lipids and mortality.  Omega-3 fats were the most effective intervention.  Statins reduced overall mortality by 13%, whereas omega-3 fatty acids reduced it by 23%.  Statins reduced cardiac mortality by 22%; omega-3 fatty acids reduced it by 32%.  The benefits of the other methods were significantly less and questionable.


Marco Studer, MD; Matthias Briel, MD; Bernd Leimenstoll, MD; Tracy R. Glass, MSc; Heiner C. Bucher, MD, MPH. Effect of different antilipidemic agents and diets on mortality. A systematic review. Arch Intern Med. 2005;165:725-730.


However, a more recent meta-analysis, published in the British Medical Journal, of 89 previous studies reported no "strong evidence" of an effect on total mortality or combined cardiovascular events.


Hooper L et al. Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review.

BMJ, doi:10.1136/bmj.38755.366331.2F (24 March 2006)




More Benefits of Coffee


A previous study reported that drinking coffee was associated with a decreased risk of developing type 2 diabetes (Tuomilehto J, Hu G, Bidel S, et al. Coffee consumption and risk of type 2 diabetes mellitus among middle-aged Finnish men and women. JAMA.  2004(Mar 10);291:1213-1219).  More recent studies have reported other benefits of coffee.


Persons who drank one or more cups of coffee a day had half the risk of death due to liver cancer (hepatocellular carcinoma) compared to non-coffee drinkers in a study of over 100,000 persons in Japan.  This effect was present after accounting for possible confounding factors such as age, smoking, and alcohol consumption.  Drinking less than one cup a day was associated with a 17% lower risk.

Kurozawa Y, JACC Study Group. Coffee and risk of death from hepatocellular carcinoma in a large cohort study in Japan. Br J Cancer. 2005 Sep 5;93:607-10.


Among 27,000 postmenopausal women, those who drank coffee had a lower rate of mortality due to cardiovascular disease.  The reduction was up to 24% after accounting for possible confounding factors.  Coffee also reduced the total mortality rate and the rate due to other inflammatory diseases.

Andersen LF, Jacobs DR Jr, Carlsen MH, Blomhoff R. Consumption of coffee is associated with reduced risk of death attributed to inflammatory and cardiovascular diseases in the Iowa Women's Health Study. Am J Clin Nutr. 2006;83:1039-46



Update on Resveratrol


Resveratrol has extended the lifespan of yeast, roundworms (nematodes), and fruit flies.  Now a study published by researchers at Harvard University reports that it increased the survival of middle-aged mice fed a high-calorie diet.  This is significant because it is the first evidence that resveratrol works in mammals.  Resveratrol increased insulin sensitivity and counteracted the effects of the high-calorie diet in 144 biochemical pathways.


Many beneficial effects have been reported for resveratrol, including antioxidant activity, anticarcinogenic effects, inhibition of tumor invasion, anti-inflammatory effects, inhibition of atherosclerosis, and inhibition of platelet coagulation.  Resveratrol is found in grapes, wine (especially red wine), grape juice, and berries such as blueberries, bilberries, and cranberries.  It is found only in the skins of grapes.  However, it is doubtful whether the amounts in most foods are high enough to exert the effects seen in laboratory experiments.


Baur JA et al. Resveratrol improves health and survival of mice on a high-calorie diet. Nature. 2006 Nov 16;444(7117):337-342. Epub 2006 Nov 1.



Lower Cholesterol Level Linked to Lower Risk of High-Grade Prostate Cancer


A lower cholesterol level is associated with a decreased risk of developing high-grade prostate cancer.  This relationship was found in a study of over 18,000 men, including 698 who developed the disease.  The relationship remained significant after adjusting for possible confounding variables, including statin use.  However, cholesterol was not associated with overall risk of developing prostate cancer or low-grade disease.  For men with blood cholesterol level in the lowest quartile, risk of high-grade disease was 39% lower.  Previous studies have found that persons taking statins, drugs that lower cholesterol level by inhibiting its synthesis, had a lower risk of advanced and possibly high-grade prostate cancer.


Platz EA, Clinton SK, Giovannucci E. Association between plasma cholesterol and prostate cancer in the PSA era. Int J Cancer. 2008 Oct 1;123(7):1693-1698.



Resveratrol may not mimic effects of caloric restriction


The SIRT1 gene is thought to mediate the effects of caloric restriction, which has extended life in many species, including mammals.  However, although resveratrol produces many of the changes to SIRT1 that resemble caloric restriction, it has extended the life of obese mice but not lean mice.  Researchers are investigating other mechanisms through which resveratrol may produce its beneficial effects.


Agarwal B, Baur JA. Resveratrol and life extension. Ann N Y Acad Sci. 2011 Jan;1215:138-43.



Evidence that SIRT1 is associated with aging in the brain


University of Pennsylvania researchers recently presented data showing that certain neurons (nerve cells) are vulnerable to a variety of metabolic changes and that the SIRT1 gene helps protect them from oxidative damage.  These included loss of dendrites (the projections of nerve cells), accumulation of lipofuscin (a substance that accumulates in cells in Alzheimer’s disease), and changes in neurotransmitter enzymes.  These findings provide further evidence that SIRT1 plays an important role in aging.  Our increased understanding of the aging process may lead to means of intervening to slow it.


Panossian L et al. SIRT1 regulation of wakefulness and senescence-like phenotype in wake neurons. J Neurosci. 2011 Mar 16;31(11):4025-36.


Selenium compounds linked to many functions but role in cancer prevention and other disorders still unclear


Selenium has been known to have a role  in human health for several decades, and may protect against some cancers.   More than 25 selenoproteins have been identified but the function of most is unclear.  Selenium compounds and selenoproteins have been linked to the prevention of some forms of cancer, Alzheimer's disease, cardiovascular disease, and life span. This paper reviews what is known about selenium and the prospects for its clinical use.

PMID:19905883[PubMed - indexed for MEDLINE]


Papp LV, Holmgren A, Khanna KK. Selenium and selenoproteins in health and disease. Antioxid Redox Signal. 2010 Apr 1;12(7):793-5.


Robert Ettinger, founder of cryonics, dies at 92 


Robert Ettinger founded the cryonics movement in the U.S. in the 1970s.  Cryonics preserves people who have died by immersing them in liquid nitrogen, which has a temperature of minus 320 degrees Fahrenheit (minus 196 Celsius). Before freezing, a cryprotectant is infused into the person to prevent the formation of ice crystals that would damage the cells.  The hope is that future technology will be able to repair any damage.  The chances of this happening are unknown, but some scientists have argued that it is a worthwhile chance compared to death.  Ettinger will be housed at the Cryonics Institute in Clinton Township, Michigan, which was founded in 1976 and is where Ettinger first froze his dead mother, followed by his first wife.  Cryonics is only peripherally related to aging and life extension, but it is of interest to many of the same people.


Rapamycin as an antiaging agent


Rapamycin acts as an energy, nutrient, growth factor, stress, and oxidation sensor to increase protein synthesis and decrease macroautophagy, a process involving the degradation of a cell's own components through the lysosomal system.  This is a highly regulated process that plays a normal part in cell growth, development, and homeostasis (the maintenance of a normal physiologic state), helping to maintain a balance between the synthesis, degradation, and subsequent recycling of cellular products.  This process is thought to play a major role in homeostasis,  its deterioration in aging, and the suppression of  the immune system.  Rapamycin has extended the life of old mice but has not been well tested in humans.  Furthermore, it has a number of adverse effects.


Mendelsohn AR, Larrick JW. Rapamycin as an antiaging therapeutic?: targeting mammalian target of rapamycin to treat Hutchinson-Gilford progeria and neurodegenerative diseases. Rejuvenation Res. 2011 Aug;14(4):437-41.



Evidence that drinking coffee reduces risk of basal cell skin cancer


Using data from the Nurses' Health Study, which followed 72,921 persons between 1984 and 2008, and the Health Professionals Follow-Up Study, which followed 39,976 people between 1986 and 2008, researchers at Brigham and Women's Hospital and Harvard Medical School found that women who drank more than three cups of caffeinated coffee a day had a 20% reduction in the incidence of basal cell carcinoma and men who drank three cups a day had a 9% reduction.  Basal cell carcinoma is a common and slow-growing form of skin cancer and nowhere near as deadly as the less common form, melanoma.  Previous population studies found that  women who drank coffee had a 10.8% lower rate of nonmelanoma skin cancer and, after adjusting for other variables, those consuming six or more cups had a 30% reduced risk.


Data presented at American Assn. for Cancer Research International Conference on Frontiers in Cancer Prevention Research, 2011
Abel EL et al. Daily coffee consumption and prevalence of nonmelanoma skin cancer in Caucasian women. Eur J Cancer Prev. 2007 Oct;16(5):446-52.


Although some studies have found that selenium supplementation reduces the risk of cancer, especially prostate cancer, others have reported no effect.  It has long been known that low levels of selenium intake are beneficial, regardless of the chemical form, while higher levels can be toxic.    Selenium protects cells in at least two ways--by increasing certain antioxidant enzymes and by protecting DNA against the formation of adducts and breakage.  One problem with studies on selenium is that they have not distinguished the chemical form.  The same is true in studies combining selenium and vitamin E.


Ferguson LR et al. Selenium and its role in the maintenance of genomic stability. Mutat Res. 2012 Jan 5.


Life-extending befefits of resveratrol remain uncertain


Although resveratrol has extended the life of obese mice, studies in several species have been contadictory.  One reported an extension of life in Drosophila (fruit flies) while another found no effect.  A recent study in Wistar rats found that resveratrol preserved vascular function in normal rats but did not extend lifespan.  It may be that resveratrol blocks the effects of life-shortening characteristics but does not increase lifespan in "normal" organisms.  On the other hand, a large percentage of the population have charateristic that may shorten their life expectancy, making resveratrol a worthwhile supplement.


da Luz PL et al. Red wine and equivalent oral pharmacological doses of resveratrol delay vascular aging but do not extend life span in rats. Atherosclerosis. 2012 Jun 26. [Epub ahead of print]


Resveratrol may help relieve pain


Although the evidence that resveratrol can extend life is still equivocal, several other beneficial effects have been found to be associated with this compound.  Experiments in animals have found that it has an anti-inflammatory effect that would counteract the pain caused by such disorders.  Resveratrol also reduced levels of proinflammatory cytokines (small molecules released by cells to perform many functions) in vitro and showed analgesic potential in vivo.  However, these effects have not been confirmed in humans.


Pham-Marcou TA et al. Antinociceptive effect of resveratrol in carrageenan-evoked hyperalgesia in rats: prolonged effect related to COX-2 expression impairment. Pain. 2008 Nov 30;140(2):274-83. Epub 2008 Sep 23

Beloeil H et al. Antinociceptive effect of resveratrol in carrageenan-evoked hyperalgesia in rats: prolonged effect related to COX-2 expression impairment. Pain. 2008 Nov 30;140(2):274-83. Epub 2008 Sep 23.


Combination of supplements extends lifespan and youthful part in mice


Although most attempts to extend life-span by supplements have been disappointing, several recent studies found that a "cocktail" of a number of supplements can extend life and maintain animals longer in the youthful phase.  Dr. Rollo of McMaster University studied the effect of substances that affect what he considers the five major processes involved in aging: oxidative stress, inflammation, mitochondrial dysfunction, insulin resistance, and membrane integrity.  One group of mice received the 30 supplements the B vitamins B1 (thiamin), B3 (niacin), B6 (pyridoxine), B12(coalmine) and folate, vitamin C, vitamin D, acetyl-l-carnitine, alpha-lipoic acid, acetylsalicylic acid (aspirin,) beta-carotene, bioflavonoids, chromium picolinate, garlic, ginger root extract, ginkgo biloba, ginseng, green tea extract, l-glutathione, magnesium, manganese, melatonin, n-acetyl cysteine, potassium, rutin, selenium, vitamin E, omega-3 fatty acids in the form of cod liver oil, coenzyme q10, and flax seed oil.  Mobility, cognitive function, and longevity were compared to a control group. Compared to control animals, the supplemented mice of the accelerated aging strain lived 28% longer, and supplemented normal mice survived 11% longer than their controls.  By 24 months of age (the normal life span of mice), supplemented normal mice were moving roughly three hours more per day than controls.  Other studies of one or more of these supplements have reported similar results.  These studies are very important because they provide evidence that the right combination of supplements can extend life, and they also help elucidate the mechanisms of aging.


Long J, Aksenov V, Rollo CD, Liu J. A complex dietary supplement modulates nitrative stress in normal mice and in a new mouse model of nitrative stress and cognitive aging. Mech Ageing Dev. 2012 Apr 13. [Epub ahead of print]

Lemon JA, Boreham DR, Rollo CD. A complex dietary supplement extends longevity of mice. J Gerontol A Biol Sci Med Sci. 2005 Mar;60(3):275-9.2.

Aksenov V, Long J, Liu J, et al. A complex dietary supplement augments spatial learning, brain mass, and mitochondrial electron transport chain activity in aging mice. Age (Dordr). 2011 Nov 27.3.

Aksenov V, Long J, Lokuge S, Foster JA, Liu J, Rollo CD. Dietary amelioration of locomotor, neurotransmitter and mitochondrial aging. Exp Biol Med (Maywood). 2010 Jan;235(1):66-76.4. Barzilai N, Atzmon G, Derby CA, Bauman JM, Lipton RB. A genotype of exceptional longevity is associated with preservation of cognitive function. Neurology. 2006 Dec 26;67(12):2170-5.

Dkhar P, Sharma R. Amelioration of age-dependent increase in protein carbonyls of cerebral hemispheres of mice by melatonin and ascorbic acid. Neurochem Int. 2011 Dec;59(7):996-1002.

Son EW, Lee SR, Choi HS, et al. Effects of supplementation with higher levels of manganese and magnesium on immune function. Arch Pharm Res. 2007 Jun;30(6):743-9.

Prasad K. Flaxseed and cardiovascular health. J Cardiovasc Pharmacol. 2009 Nov;54(5):369-77.



Study of caloric restriction on lifespan in monkeys raises questionable findings


A study reported in Nature examined whether reducing calories in the diet of monkeys extends lifespan.  Monkeys that were calorically restricted had many improved physiologic parameters but not increased life span.  This finding is in contrast to previous reports from the Wisconsin National Primate Research Center and previous reports from the U.S. National Institute on Aging that reported a significant increase in the lifespan of calorie-restricted monkeys. Calorie restriction has extended lifespan in many species, from rodents to fruit flies, so the expectation was that it would work in monkeys and humans also. However, the results cannot be considered conclusive at this time since studies have reported conflicting findings.  This study was quite different form the design of previous studies of this issue.  The control group was not under a strict 'ad libitum' diet, but only on the diet needed for their age and weight. Therefore, this study does not examine caloric restriction in a rigorous manner. It confirms that excess of caloric energy causes disease and shortens life, but showing that eating a near starvation diet increases lifespan does not really address the issue of caloric restriction. Only more research, difficult to do because of the relatively long lifespan of monkeys, will settle the issue, but the weight of the evidence that caloric restriction, done properly, extends the average and maximum lifespan of animals in general, including mammals.


Mattison JA et al. Impact of caloric restriction on health and survival in rhesus monkeys from the NIA study. Nature, Published online doi:10.1038/nature11432 29 August 2012


Possible beneficial effects of curcumin


The decrease in endothelial function during aging is known to be associated with higher risk of cardiovascular disease.  Aerobic exercise and diet can have a positive effect by inhibiting vascular aging.  Curcumin, a major component of turmeric, has anti-inflammatory and anti-oxidative properties.  These are associated with a number of effects, possibly including analgesia.  Curcumin is therefore being investigated as a potential inhibitor of pain and disorders associated with inflammation and similar problems.  Three groups of postmenopausal women were studied to help clarify the effect of curcumin and aerobic exercise on flow-mediated dilation as an indicator of endothelial function.  Flow-mediated dilation increased significantly and equally in the groups on curcumin and exercise but not in the control group.  Supplements of turmeric and high-curcumin turmeric extract are now available and are worthy of study as potential analgesics, cardiovascular disease inhibitors, as well as other possible beneficial effects.


Akazawa N et al. Curcumin ingestion and exercise training improve vascular endothelial function in postmenopausal women. Nutr Res. 2012 Oct;32(10):795-9. doi: 10.1016/j.nutres.2012.09.002. Epub 2012 Oct 15.


Resveratrol extends life of honey bee


The effects of resveratrol and their mechanism still need much investigation.  But a recently published study reported that it extends the median and maximum lifespan of the honey bee, typically by about one-third.

Bees with a resveratrol-supplemented diet significantly reduced their food consumption under ad libitum conditions.  Reservatrol has been shown to activate sirtuins and some members of the targets affected by rapamycin, which has previously been found to slow aging in yeast, worms, fruit flies, and mice.


Rascón B et al. The lifespan extension effects of resveratrol are conserved in the honey bee and may be driven by a mechanism related to caloric restriction. Aging (Albany NY). 2012 Jul;4(7):499-508.



This book (Aging: Strategies for Maintaining Good Health and Extending Life)  is getting a little out of date. Although most of the information in it is still correct, and it does contain some data not readily available elsewhere. I would recommend my later book. Golczewski JA. Life Extension: Current and Future Possibilities, Sunbury Press (2012) to anyone seeking to learn about aging and life-extension.

Aging: Strategies for Maintaining Good Health and Extending Life [excerpts and updates; note changes in supplement recommendations]
James A Golczewski, Ph.D.
Jefferson, NC: McFarland & Co Publishers; 1998.
Copyright 1998 James A. Golczewski



    In this chapter we will look at various foods and other substances that should or should not be included in putting together a healthy diet.
     Fat is probably the single major dietary component most closely linked to disease.  Fats and oils are essentially the same thing, by the way; they are both in the class of chemicals called triglycerides.  Each molecule of fat contains three fatty acids which can be saturated, unsaturated, or polyunsaturated.  (A more detailed discussion of fats and fatty acids is provided in Appendix 1.)  An oil is just a fat that is liquid at room temperature.  Generally speaking, the more unsaturated the fat and the shorter its fatty acids are, the more liquid it will be.  For some time it was thought that saturated fats (as in butter and beef) led to increased blood cholesterol and incidence of heart disease, that polyunsaturated fats (as in soybean oil and margarine) decreased blood cholesterol and consequently the incidence of heart disease, and monounsaturated fats (as in olive oil) were neutral in this respect.  It is now known that the effects of dietary fat are not as simple as this and there are in fact different types of cholesterol.  One type, the high-density lipoprotein, or HDL, is associated with lower risk of disease; low-density lipoprotein, or LDL, is associated with higher risk.  LDL is thought to transport cholesterol to the sites of disease in the arteries; HDL is thought to help clear cholesterol from such sites by transporting it to the liver where it is broken down for excretion.  It is the ratio of HDL to LDL (or, what is similar, the ratio of HDL to total cholesterol) that is the best predictor of cardiovascular disease (1).  In a detailed, well-designed study that measured total cholesterol, LDL, triglycerides, and HDL, along with the actual narrowing of the coronary arteries in men and women "HDL cholesterol was the most powerful independent variable associated with the presence and severity of [coronary artery disease]" (2) after age and gender.  That is, the risk and severity of heart disease increased with the person's age, or if the person was male (factors obviously beyond our control) but after that, the person's HDL level was the best indicator of whether disease was present, and the extent of the disease, higher HDL being associated with decreased risk.  The study also found that in patients with total cholesterol less than 200mg/dL, i.e., normal levels, 79 percent had some degree of coronary artery disease.  Therefore, blood cholesterol can be, and frequently is, in the normal range when a person has heart disease.  Other recent studies have reported similar findings--it is the level of blood HDL, or the ratio of HDL to LDL (or HDL to total cholesterol) that is most closely associated with (decreased) risk of cardiovascular disease.  Or put the other way, low HDL and high cholesterol to HDL ratios are associated with increased risk.  While different studies have come up with somewhat different numbers, a HDL less than 25mg/dL would certainly be considered dangerous; below 35 a risk factor; 40 to 45 about normal, and above 45 associated with increasingly below-average risk of coronary disease.  A total cholesterol to HDL ratio above 5.5 is a serious warning sign, 4.5 to 5.5 within the range of normal values, and below 4.5 good.
     The ratio HDL/LDL is not as easy to change as total cholesterol; diet and other lifestyle changes (exercise, smoking) don't seem to increase it in every person.  In a practical sense, then, to reduce our risk of heart disease, we must undertake a strategy of adopting lifestyle changes which increase HDL and/or the HDL/total cholesterol ratio, while monitoring both.  This last is not difficult, by the way; HDL and the ratio HDL/cholesterol are now routinely measured in a standard complete blood test.
     It has long been known that diet has a considerable influence on blood cholesterol and triglycerides.  (The latter is also related to heart disease in ways not well understood.)  While dietary cholesterol, common in animal products like meat, eggs and whole milk, has a moderate effect, dietary fats can raise or lower cholesterol levels considerably (3). The old rule that saturated fats increase blood cholesterol and polyunsaturated fats decrease it has some validity, but is not always true.  The effect (raising, lowering, or neutral) depends to a large extent on the specific fatty acids in the fat consumed.  Dietary fats typically contain a number of different fatty acids.  The fat is labeled saturated, monounsaturated, or polyunsaturated depending on which types of fatty acids predominate.  For example, butterfat has mostly saturated fatty acids and few polyunsaturated fatty acids, so we say it is saturated.  Some saturated fatty acids (e.g. stearic acid, found in cocoa butter and beef) don't seem to raise cholesterol.  There is evidence that some kinds of polyunsaturated fatty acids, such as are found in fish, have an especially beneficial effect on cholesterol and other blood lipids.  This has less practical significance than you might think.  As I mentioned, the fatty acids found in common foods are almost always mixtures of various types of fatty acids, so we usually cannot eat only beneficial or neutral ones in choosing a particular food.  For example, the stearic acid in beef might be neutral, but beef still contains lots of palmitic acid, which strongly raises cholesterol.
     Polyunsaturated fats have their own potential for harm.  Such fats easily react chemically with oxygen; indeed, antioxidants such as BHT (butylated hydroxytoluene) are frequently added to them to prevent this oxidation.  There is considerable evidence linking such oxidized fats to increased incidence of cancer and possibly other diseases.  This type of chemical reaction, which is the common way fats go rancid, can occur whenever the fat is exposed to air, and even after it is eaten.  It becomes more likely, however, as the temperature increases.  Therefore, cooking, especially frying polyunsaturated fat, can result in the formation of potentially dangerous compounds.  Oxidation also occurs with monounsaturated and saturated fats, but to a lesser extent because of their chemical nature.  One could address this problem (as many people have) by taking large quantities of various antioxidants, i.e., substances which prevent the fat from reacting with oxygen.  These include BHT and BHA (butylated hydroxyanisole), both of which are commonly added to commercial foods such as soybean oil and cereals for this purpose, and a number of naturally occurring antioxidants.  Among these are vitamin E, which functions in the body as an antioxidant, selenium, an essential component of the glutathione peroxidase system (an intracellular antioxidant and protective system), and beta-carotene (a precursor of vitamin A and also a potent antioxidant).  There is evidence that the incidence of cancer and possibly other diseases can be reduced by such antioxidants (4,5,6).  But antioxidants probably cannot provide complete protection against the oxidation of polyunsaturated fats.  However, substituting monounsaturated fatty acids for dietary saturated fatty acids reduces cholesterol while maintaining a very favorable ratio of HDL to LDL (1,3,7,8,9).  Table 4.1 lists the fatty acid composition of a number of common fats.  Olive oil is one of the most common sources of monounsaturated fatty acids.  It is rather unique in being composed overwhelmingly of monounsaturated fatty acids, with only small amounts of saturated and polyunsaturated ones.  You therefore avoid the cholesterol-raising effects of saturated fats and the high susceptibility to oxidation of polyunsaturated fats.  Olive oil consumption may well be at least partially responsible for the low incidence of heart disease and certain cancers in southern Italy and other Mediterranean countries (10,11).  Since it has a long tradition in cooking, it is already included in many recipes and can easily be made part of almost anyone's diet.  Canola oil (rapeseed oil) is another monounsaturated fat which has become quite common in recent years.  It is somewhat blander and less expensive than olive oil, and seems to have similar effects, but has been studied less.
     Other dietary factors possibly affecting cardiovascular disease include omega-3 fatty acids.  These are polyunsaturated fatty acids found in many fish and marine animals.  (Chemically, they differ from the omega-6 fatty acids common in vegetable oils in that the first unsaturated bond is the third from the end of the fatty acid chain instead of the sixth.  Again, interested readers can find further details in Appendix 1.)  A number of fish, especially cold-water fish like salmon, mackerel, and herring are rich in them.  It was first noticed that Eskimos had low rates of coronary disease despite a high-fat diet.  Subsequent epidemiologic studies generally (but not always) confirmed the finding that fish-eating populations had less coronary disease compared to non-fish-eating populations.  A fair amount of evidence has now accumulated linking omega-3 fatty acids to a decreased risk of heart attack (12).  The two main omega-3 fatty acids found in fish are called eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).  It is thought that EPA and DHA play a role in atherosclerosis (hardening of the arteries), inflammation, immunity, high blood pressure, and the formation of blood clots, through several of the body's metabolic pathways.  The actual composition of the fat in your body, including that in the membranes surrounding each of your body's cells, depends to a large extent on the kind of fat you eat.  Several studies have shown that omega-3 fatty acids influence this composition in a favorable manner.  However, you may have to eat a substantial amount of omega-3 fatty acids daily to obtain effective long-term benefits.  In laboratory studies, fairly high intakes of fish oil (around 100 grams, or 3.5 oz. a day) were needed to significantly reduce blood cholesterol.  The most consistent effect of dietary fish oil is a lowering of blood triglycerides.  Other researchers have reported that small to moderate amounts of omega-3 fatty acids had no significant effects on cholesterol even when administered as concentrated capsules of several hundred milligrams (13,14).  These studies suggest that high intakes, approaching the 5 to 10 grams of omega-3 fatty acids consumed daily by Eskimos, are required for any significant beneficial effects.


Table 4.1 Saturation of fatty acids in common fats and oils

Data from U.S. Dept. of Agriculture Nutrient Database

All values are grams of fatty acids per 100 grams of fat or oil, rounded to nearest whole number.






almond oil




avocado oil




beef tallow








canola oil




chicken fat




cocoa oil




coconut oil




corn oil




cottonseed oil




fish oil, cod liver




fish oil, herring




fish oil, salmon




lard, pork




linseed oil




oat oil




olive oil




palm oil




palm kernel oil




peanut oil




poppyseed oil




safflower oil, regular




sesame oil




soybean oil




soybean lecithin oil




sunflower oil, regular




turkey fat




walnut oil




wheat germ oil





     Alternative sources of omega-3 fatty acids include linseed oil (flaxseed oil), walnut oil, canola oil, wheat germ oil, and soybean oil.  The main omega-3 fatty acid in such plant sources is alpha-linolenic acid (LNA), not the DHA and EPA found in fish oils.  LNA can be converted into DHA and EPA by the body after ingestion.  Linseed oil in particular has also been suggested as an important source of omega-3 fatty acids (15).  It is rather special in this respect, as you can see from Table 4.2, which lists amounts of the major omega-3 fatty acids in a number of common fats and foods containing significant amounts.  Cholesterol content is also listed; it's instructive to see how much dietary cholesterol would be consumed along with substantial quantities of any fish oil. (As with Table 4.1, these are average figures.)  Being of plant origin, linseed oil also does not contain the cholesterol associated with all fish oils.


Table 4.2 Omega-3 Fatty Acids and Other Fat Components in Some Common Foods and Oils.
All values are grams per 100 grams edible portion except for cholesterol, which is in milligrams.
Data from U.S. Dept. of Agriculture Nutrient Database. A dash indicates data not available.
Food                  total fat  LNA  EPA  DHA cholesterol
herring, Atlantic     9.0     0.1     0.7     0.9     60
herring oil             100.0  0.6     7.1     4.3     570
mackerel, Atlantic  13.9   0.1     0.9     1.6     80
salmon, Atlantic       5.4   0.2     0.3     0.9     63
salmon oil             100.0  1.0     8.8    11.1   485
chicken fat              99.8  1.0     0         0       85
canola oil              100.0  9.3      -         -         0
linseed oil             100.0  53.3    -         -         0
olive oil                100.0   0.6     0         0        0
soybean oil           100.0  6.8     0         0        0
walnut oil              100.0  10.4   0         0        0
wheat germ oil      100.0   6.9    0         0        0


    These fatty acids share the same problem as other polyunsaturated fats: they are subject to degradation by oxidation.  It is even more of a problem with fish oils than vegetable oils because they are generally composed of long, highly unsaturated fatty acids, and therefore have more chemical bonds which are susceptible to oxidation (16).  Note also the relatively small amounts of omega-3 fatty acids even in oily fish; this is one reason why some researchers question whether it is feasible to consume sufficient quantities of fish to have significant health benefits.  Substantial amounts are present in purified fish oils, along with very substantial levels of cholesterol and calories.
     Fat has also been linked to cancer.  In particular, there is evidence that cancers of the prostate, colon, rectum, and possibly the breast are related to dietary fat (6,17,18).  The link to breast cancer is more controversial; while some studies have reported a definite relation, others have not (19).  Cancer of the prostate may be associated with dietary animal fat and protein (20).  The causal relation of fat to cancer does not appear to be as strong as its relation to cardiovascular disease, but it's more than enough to be concerned about.  It's particularly difficult in the epidemiologic studies to disentangle the differential effect of low to high fat diets from those due to a diet low or high in fruits and vegetables, which seem to protect against cancer, or other dietary factors.  Low-fat diets are usually low in animal products and frequently high in fruits and vegetables.  The protective effect of green or yellow-green vegetables against many common cancers, including stomach, esophageal, oral, lung, and bladder, has been established; a similar, smaller effect seems to exist for fruits (6,21).  The mechanism behind this effect is not known but it is thought that carotenoids, a large group of substances common in plants, may be responsible (22-27).  These include the well-known beta-carotene as well as the lesser known but still common alpha-carotene, canthaxanthin, xanthophyll, lutein, and lycopene.  This will be discussed further in the next chapter on dietary supplements.
     Fats have something of a double negative effect.  There is a good correlation between number of calories consumed and the incidence of many diseases (28,29).  This might be expected from the data on caloric restriction and life span, but has been seen in experiments quite independent of such severe caloric restriction studies.  Fat has over twice the calorie density of protein and carbohydrates.  There are 4 calories per gram of protein or carbohydrate, but 9 calories per gram of fat.  Alcohol, the only other common source of calories, has 7 per gram.  (A calorie is a unit of energy, and the units by which the energy extractable from food is usually measured.  In the strict scientific use of the term, a calorie is the amount of energy needed to raise the temperature of one gram of water one degree C.  What is commonly called a calorie in talking about food (on food package labels, in recipes, etc.), is actually a thousand calories, or a kilocalorie (kcal).  This is the unit you will see used in scientific discussions of nutrition.  Since this book is intended for a general audience and most people already have a rough idea of how much a calorie is, I will follow the common usage of the term calorie.)  So it becomes harder to keep your total calorie intake within proper limits as fat constitutes a greater percentage of your diet.  It also becomes harder to maintain proper body weight, and there seems to be negative health effects of overweight independent of excessive calorie consumption, although these two factors are of course usually closely related in any practical sense.
      It has been suggested that animal protein, or animal product consumption in general, is related to cardiovascular disease, cancer, and other diseases.  In an extensive study of over 27,000 Seventh-day Adventists over a twenty-year period (30), Snowdon reported that "meat consumption was positively associated with mortality because of all causes of death combined (in males), coronary heart disease (in males and females), and diabetes (in males).  Egg consumption was positively associated with mortality because of all causes combined (in females), coronary heart disease (in females), and cancers of the colon (in males and females combined) and ovary."  This study also found a correlation between milk consumption and prostate cancer mortality, while cheese consumption did not have a clear relationship with any cause of death.  Breast cancer and stroke were not related to these products in this study.  Consumption of meat, milk, eggs, and cheese was never associated with lower mortality from any cause of death.  Evidence from animal studies also suggests that animal products are not conducive to long life.  In a life span experiment with rats (31), animals fed soy protein lived significantly longer (average, or median, life span 844 days) than those fed the same amount of the animal protein casein (average life span 730 days).
     There is considerable evidence that dietary fiber helps to prevent several serious diseases, including cancer and heart disease.  By definition, fiber is the indigestible part of food.  It is common in grains, vegetables and fruits, and essentially absent in meats and animal products.  There are several major types of common fibers--cellulose, hemicellulose, lignin, pectins and gums.  Fibers can also be divided into two major groups both by their physical properties and reputed health benefits: insoluble fibers and soluble fibers.  The "soluble" here refers to their solubility in water.  Insoluble fibers include cellulose, lignin, most types of hemicellulose, and some kinds of pectin.  Soluble fibers include most forms of pectin and gums, and some hemicellulose.  With the exception of lignin, fibers are carbohydrates, but they cannot be significantly broken down by the body's digestive secretions, as nutritional carbohydrates like starch are.  Cellulose is the main structural material of plant cell walls and is therefore present in almost all foods derived from plants.  There are significant amounts in many vegetables and most brans.  Bran refers to the covering or shell on grains such as wheat, oats, and rye.  It is removed along with the germ when whole grains are processed into white flour.  Lignin is a woody substance which becomes more abundant in vegetables as they age; it is the only noncarbohydrate fiber.  Insoluble fiber, as is found in wheat bran, increases stool bulk and decreases the time it takes for food to move through the digestive tract, thereby exerting a significant natural laxative effect.  Table 4.3 lists the different fibers present in a number of common foods.  There is considerable evidence that insoluble fibers afford some protection against cancer, primarily colon cancer.  This would be no trivial protection: colorectal cancer is one of the major causes of death in the developed countries.  It is the third leading cause of cancer death in both men and women in the U.S., ranking behind lung and prostate cancer in men, and lung and breast cancer in women (32).  The mechanism behind this is unknown; it may just be due to the diluting effect fiber has on any carcinogens, or the reduction in the length of time they are in contact with the intestine's cells.  It has also been suggested that fiber binds to carcinogens, thereby inactivating them or pulling them out of the body before they can do any harm.

     The soluble fibers, as are found in oats and beans, lower total cholesterol and LDL and thereby afford some protection against cardiovascular disease (33-36).  Substantial reductions in blood cholesterol have been obtained by the addition of oats or beans to the diet.  In one study (37), 100 grams of oat bran or 115 grams of beans daily (dry weight of each) lowered cholesterol by 19 percent in men with initial levels of 260mg/dL or above.  LDL was reduced by a somewhat greater percentage.  Note, however, that this is a substantial dietary intake; it would amount to nearly 20 percent dry weight of an average diet.  When dietary intakes have been closer to practical levels, consisting of a bowl of oat-based cereal per day, small but significant decreases were obtained in cholesterol (2.2 percent) and LDL (4.6 percent) even in people with normal initial cholesterol readings (38).

Table 4.3 Percentage of Various Fibers in Some Common Foods
These percentages apply to the edible portion of the foods, as noted, and were calculated and adapted from USDA data and JA Marlett: Content and composition of dietary fiber in 117 frequently consumed foods.  J Am Diet Assoc 92:175-186, 1992.
                                                                                   _______Insoluble fiber_______
Food                      Total Fiber        Soluble Fiber     Total         Cellulose           Lignin
Wheat bran, raw         42.5                         3.3             39.2             5.3                 5.6
Oat bran, raw             17.0                         6.5             10.5             1.0                 3.5
Oatmeal, uncooked     10.6                         3.9              6.7              0.6                 1.0
Oatmeal, cooked          1.9                         0.7              1.2              0.1                 0.5
Bread, Italian                3.8                         0.9              2.9              0.9                 0.7
Apple, unpeeled            2.4                         0.3              2.1              0.8                 0.2
Banana                         1.7                         0.5              1.2               0.3                0.6
Blueberries                   2.7                         0.3              2.4               0.4                 0.9
Pear, unpeeled              2.8                         0.4              2.4               0.7                 0.4
Strawberries, fresh        1.8                         0.4              1.4               0.4                 0.5
Asparagus, canned        1.6                         0.4              1.2               0.4                 0.2
Broccoli, raw                3.3                         0.3               3.0               1.1                 0.3
Carrots, raw                  2.5                        0.2               2.3               0.8                 0.1
Corn, canned                 1.9                        0.1               1.8               0.7                 0.5
Green beans, canned     1.9                         0.5               1.4               0.5                0.2
Kidney beans, canned    5.2                        1.1               4.1               2.2                0.3
Peas, canned                  4.3                        0.3               4.0               2.8                0.1


     A study supposedly showing that oat bran did not in itself lower blood cholesterol received considerable attention in the general news media a few years ago (39).  This was a very small study, involving only 20 people, 16 of whom were women.  It compared the effect of adding a small amount of fiber (as oat bran) with the effect of simply replacing dietary fat with a low-fat, low-fiber food like farina.  The study reported no significant differences in blood cholesterol in people on these two diets.  But oat fiber did lower cholesterol and the changes involved in this experiment were very small.  This was because the subjects had normal cholesterol levels to begin with and the amount of fiber or low-fat food added was small.  There were other differences between the two groups, namely higher fat and calorie intake in the oat-bran group, that could explain the results, but all the numbers involved, including the size of the study, make it almost totally meaningless.  As I have mentioned, other, better-designed studies have shown a cholesterol lowering effect due to oat bran even when the amount added was small (38), but you have to be careful in the design of the experiment to make it clear in such a case.
     Many of the soluble fibers form a gel which inhibits absorption of digested food from the intestine.  Guar gum appears particularly effective at this.  This property may make these fibers useful in regulating the blood sugar response of diabetics or others with impaired insulin response, or of just normal people seeking to control their appetite.  Such fibers bind to bile in the intestine.  The bile is then excreted along with the fiber instead of being reabsorbed, as it normally would.  Significant amounts of fat may also be excreted in this way.  This process depletes the body's supply of sterol, the molecule used by the liver to make both bile and cholesterol, which may be the reason that soluble fibers decrease blood cholesterol.
     But the evidence for protective effects of fiber is not as clear as is sometimes claimed.  Some studies have reported no effects; some have reported that fiber increased cancer incidence (29).  Most studies have demonstrated that wheat bran and cellulose exert a protective effect against cancer, whereas some have reported that pectin, corn bran, alfalfa, and a few other fibers enhance cancer.  Usually this enhancement was observed with soluble fibers.  It is interesting that it is usually the soluble fibers that are fermented most by bacteria in the large intestine.  Pectin, which also lowers blood cholesterol and is common in fruits, is fermented almost completely in the colon.  In contrast, cellulose is fermented little and lignin not at all.  This fermentation can produce considerable intestinal gas and an uncomfortable bloated feeling.  It also produces a more acid environment in the colon, which is associated with pre-cancerous conditions (40).  Similar pre-cancerous changes have been reported for tissue in the stomach (41).  There is also some epidemiologic evidence of a correlation between high-fiber diets and the incidence of stomach cancer (42).  The incidence of stomach cancer has undergone a dramatic decrease in the U.S. and many countries during the past century, but it is still a major cause of death in many parts of the world.  In Japan, it is five times as common as in the United States and causes more deaths than all other types of cancer.
     In the face of the uncertainty about the effects of various fibers, some best judgments are called for.  My own feeling is that the data are clear enough with regard to the beneficial effects of the insoluble, non-fermentable fibers like cellulose and lignin.  Wheat bran is one of the most useful sources of these.  It is now available in many packaged cereals, or, in lesser amounts, in whole wheat cereals and breads.  I have serious reservations about adding large amounts of soluble fiber to a diet.  Moderate amounts, however, are probably beneficial, especially when combined with insoluble fiber which speeds their passage through the digestive tract.  By moderate amounts I mean up to roughly 15 grams per day.  This is probably as much as most people would care to add in any case.  Oat bran, while usually considered a source of soluble fiber, actually has a nice balance between soluble and insoluble (Table 4.3).
     Happily, the recommendations from the several dietary practices we have just discussed point in the same direction.  Increasing the fiber content of your diet is likely to decrease your consumption of total fats and your total calories.  Fruits and vegetables have relatively few calories, contain substantial quantities of fiber, and probably contain inherent protective substances.  Whole grains have similar beneficial qualities.  The conclusions in terms of practical changes to make in your diet would be similar: replace the high fat foods with lots of grains, especially whole grains, fruits and vegetables.  Appendix 2 lists the nutritional content of most of the best foods in terms of the criteria we have just discussed.  While whole grains are preferable, because of their additional fiber and other nutrients, there is nothing actually wrong with products made from refined white flour.  White bread, spaghetti, farina, bagels, and similar products are usually very low in fat, since they are made almost entirely from white flour, which has a negligible fat content.  Occasionally you will see these products made with added fat and cholesterol (fresh spaghetti is sometimes made with eggs, and there are egg bagels), but these are the exception and are easily avoided.  One also has to be careful of high-fat additions to these foods, such as meat sauces to spaghetti, and butter or margarine to bread.  Low-fat alternatives are almost always available.
     Nuts are sometimes suggested as a significant source of nutrients.  Nuts do contain considerable amounts of fiber, protein, and other nutrients.  But they are murderously high in fat and calories (with the exception of chestnuts; water chestnuts, by the way, are not a nut but a vegetable).  They therefore can be included in a healthy diet to a minor extent, but not as a staple.
     It's probably best to reduce fat to as low a percentage of the diet as possible, and to use monounsaturated fat like olive oil whenever possible.  Humans do have a requirement for unsaturated fatty acids (linoleic, linolenic, arachidonic), but, except for a very small need for linolenic, only linoleic is truly essential, since the body can synthesize the others from it (43).  The adult RDA is estimated to be about 3 to 6 grams a day (44).  Fortunately, linoleic acid is one of the most common fatty acids in plants.  It constitutes 58 percent of corn oil, 55 percent of wheat germ oil, 51 percent of soybean oil, 20 percent of canola oil, and 8 percent of olive oil (USDA Nutrient Database).  Even oats have a significant amount.  One tablespoon (15ml) of soybean oil contains 7 grams, which exceeds the RDA.  You can also easily exceed the RDA just from eating a reasonable amount of whole grains like wheat.
     The question is sometimes asked: If we replace meat, eggs, cheese and the like with vegetables, fruits and grains, will we get enough protein?  Won't we be overloading with carbohydrates?  The U.S. Recommended Dietary Allowance for protein is 0.8 grams of protein per kilogram of body weight per day (44).  This amounts to 56g for a 154 lb (70kg) adult.  These guidelines recommend that 15 to 20 percent of the calories in your diet come from protein, but they further state that, since there are no benefits and possibly some risks in consuming more protein than needed, no more than twice that amount (i.e., 1.6g per kg of body weight) be consumed.  These recommendations are not the minimum requirement for protein but allow for a significant safety margin.  But would additional protein above the minimum be beneficial?  To the contrary, there are good theoretical and experimental reasons for thinking it would be harmful.  Protein, or actually the amino acid components of protein, must be metabolized in the liver and excreted by the kidneys.  Normally, there is no problem with this.  However, it has been suggested that over longer periods of time a protein intake significantly higher than normal or needed could strain and gradually damage these organs (45,46).  Animals fed high-protein diets have undergone this overload effect, seen in enlargement of their livers and kidneys.  There is also actual life span evidence from a study of rats which compared the effects of caloric restriction, protein restriction without caloric restriction, and normal feeding (47).  Animals fed the same number of calories but only 60 percent of the protein of controls lived about 13 percent longer.  (This was still less than rats which consumed 60 percent of the calories of the control group.)  This, and similar studies, suggest that there is certainly nothing beneficial in eating more protein than necessary, and it is probably even harmful.
      Table 4.4 lists the percent calories from protein in a number of common vegetables, grains and fruits.  You can see that while fruits are rather low in protein, many vegetables and grains have a percentage within and even above the 15 to 20 percent guideline.  The items in this table were just chosen as typical examples, but if you calculate an average including most common vegetables, you still get about 27 percent calories from protein.  A rough average for the common grains is 15 percent.  The point is that protein malnutrition is just not going to be a serious problem on any kind of reasonable diet.


Table 4.4  Percentage of calories from protein in selected vegetables, grains, and fruits
Data from US Dept. of Agriculture Nutrient Database
                                            Percent Calories
Food                                       From Protein
asparagus                                      40.0
broccoli                                         42.6
corn                                               12.2
lettuce, romaine                              40.5
peas                                               26.7
potato                                            10.5
squash, zucchini                              33.1
oats,rolled                                      16.7
spaghetti, cooked                           19.8
wheat, whole, flour                         16.2
wheat, white, flour                          11.3
apricots                                          11.7
oranges                                            8.0
peaches                                            6.5


     The other question that arises is about the quality of the protein.  Proteins are composed of various amino acids; it is these that the body uses to build its own proteins.  If some of the essential amino acids are missing (there are 9 so-called essential amino acids which humans must have supplied in the diet) this synthesis cannot take place.  Plant sources are frequently low in one or more essential amino acids.  This requirement can be met by including some acceptable, low-fat animal protein or by a variety of plant protein.  Just 3 cups of skim milk (about 0.7 liter; a reasonable amount if you total  the milk in cereal, coffee, tea, etc.) provides half the RDA.  This is not really a problem if you eat a variety of foods.  What is low in one food is likely to be high in others, so that the overall protein intake is balanced.  Also, some plant sources such as legumes (e.g., kidney beans, soybeans, peas, lentils) do have protein with a well-balanced amino acid composition.  As was mentioned earlier, there is some evidence that vegetable protein is healthier than animal protein; in one experiment, rats fed soy protein lived significantly longer than rats fed the same amount of animal protein (31).  High consumption of protein, especially animal protein, also increases the body's excretion of calcium; this can contribute to osteoporosis (loss of bone mass).
 My own feeling is that the RDA for protein is somewhat high; in fact the RDA is formulated to allow for a margin of safety (44).  While I can see the reasons for this, if you judge protein intake by what is most likely to lead to a longer and still healthy life, my best judgment would be to set the percent of calories from protein to at most the low side of the RDA's 15 to 20 percent.
 The protein requirements that we have been discussing are for normal adults.  Special circumstances may require greater amounts.  Protein needs in pregnancy and lactation are up to 15 percent higher than normal.  Young children require more protein for growth.  Those convalescing from a serious illness, surgery, or trauma may also need more.  Athletics, even strenuous athletic activities, do not generally add to our protein requirements unless it involves the actual build-up of tissue as in weight lifting and body building (44).
     A number of other dietary components have come into question as either positive or negative factors.  Some will be dealt with in the next chapter on supplements.  Sugar, salt, alcohol, calcium, and caffeine will be discussed here, since they are more like components of an ordinary diet.
     Let me first briefly review what sugars are.  Carbohydrates, one of the broad nutritional groupings, include the simple sugars and molecules which consist of one of the simple sugars linked together to form a chain.  The kind of binding between the sugars, what type of sugar, and whether the chain has branches, determine what type of carbohydrate is formed; this ranges from cellulose, which is completely indigestible, to common starch.  The long chains are therefore called polysaccharides (poly=many, for many sugars).  The single links on the chain, the simple sugars, are called monosaccharides; the most common of these are glucose, fructose, and galactose.  Glucose (also called dextrose) is the sugar found in your blood, and common in many fruits, honey, and other natural products.  Fructose, or fruit sugar, as the name implies, is abundant in fruits, along with other sugars.  Galactose, the least common, is a component of milk sugar.  These three monosaccharides bind together two at a time in various combinations to form disaccharides.  The most common of these are 1)sucrose (glucose+fructose), which is ordinary table sugar, 2)maltose (glucose+glucose), frequently formed as polysaccharides are broken down into smaller chains, and 3)lactose (glucose+galactose), the sugar which constitutes the carbohydrate in milk.  Fructose is the sweetest of the sugars, followed, in order, by sucrose, glucose, maltose, and lactose.  Carbohydrates are abundant in almost all foods derived from plants, either as the simple sugars or as polysaccharides like starch, or both.  Digestion of carbohydrates is rapid, and begins in fact in the mouth, where enzymes in saliva start the process.  During digestion, they are broken down into their component simple sugars, and absorbed into the bloodstream as such.  Fructose is absorbed much more slowly than glucose, but is converted to glucose soon after absorption into the blood.  Glucose is then utilized throughout the body for energy, or converted into the body's own storage polysaccharide until needed.  Our bodies normally produce the hormone insulin, which drives glucose from the blood into cells whenever the blood level becomes high.  On the face of it, then, it does not seem that the simple sugars would have any different effects on the body than more complex carbohydrates.  However, some people have hypothesized that simple sugars are absorbed very quickly into the bloodstream, since they do not have to be broken down much further, if at all, by digestion.  It was suggested that this could lead to a rapid, sharp increase in blood sugar levels, which would in turn have harmful effects in terms of the development of heart disease and possibly diabetes (48-50).  There is some evidence that persistently high blood sugar is detrimental.  Diabetics, who cannot regulate blood glucose very well, have various problems, among which are symptoms of accelerated aging.  A sharp insulin response due to absorption from the intestine of large amounts of sugar was suggested as another possible and reasonable mechanism for the supposed harmful effects.  However, measurements of blood glucose in people after they consumed various types of foods gave some rather surprising results (51).  The rise in blood sugar after eating pure sucrose was not particularly great, and was less than that from many common vegetables like carrots or potatoes.  Even sugar-rich foods like ice-cream did not produce a high response.  The greatest rise in blood sugar came not from candy and ice cream but from the simple sugars glucose and maltose, as you might expect, followed by honey and several vegetables.  Apparently, simple sugars only cause a sharp increase in blood sugar when consumed alone.  They do not have any particularly dramatic effect when eaten as part of or with other foods.
     A few studies have attempted to find a link between sugar and cancer, particularly colorectal cancer (52).  They are not very convincing, especially since sugars are totally absorbed in the small intestine.  Starch may have, if anything, the opposite effect (53).
 While a few scientists continue to believe that dietary sugar is a major factor in the development of cardiovascular and possibly other serious diseases (50), most studies have not found evidence for such a link (54), and the overwhelming consensus is that sugar does not constitute a significant health risk when consumed in moderation.  This is the position taken by the American Dietetic Association (56) and the Royal Society of Medicine (57).  I agree with this general view.  There is scant evidence to implicate sugar to disease.  It would be very difficult to see why sugars would have effects so much different from other carbohydrates when they and complex carbohydrates rapidly take the same form after ingestion and are absorbed at much the same rate.
     Sugars, by the way, do not have any more calories than any other carbohydrate; it is still 4 calories per gram.  They are a more concentrated source of calories only in the sense that, for refined dry sugar for example, there is no associated water and no fiber, so that a gram of table sugar would be very close to an actual gram of carbohydrate, containing 4 calories, whereas a gram of apple is mostly water, plus some fiber, and so has only 0.6 calories.  Because of this, refined sugars are frequently said to have "empty calories"; they provide no other nutrients, fiber, or anything of benefit.  For this and other reasons, it is probably wise to limit refined sugar intake to "moderate" levels.  It has been suggested that the current average consumption in the U.S. of 80 grams a day of total sugars, including naturally occurring sugars (but minus lactose, which has quite different characteristics), while at the high end of what can be considered moderate, is still safe (55).  It is also prudent to avoid sharp increases and high levels of blood glucose.  This can most practically be done by eating the carbohydrates most likely to cause a sharp rise, like sucrose and glucose, with foods containing fiber, protein, or fat.  There is little reason to choose one sugar over another from a nutritional standpoint.  Brown sugar, turbinado sugar, and raw sugar are almost identical to ordinary table sugar: they are all sucrose.  Fructose is slightly sweeter and is absorbed much more slowly; there is some evidence that it raises blood cholesterol and triglyceride levels, but the reports to date have been too inconsistent to draw any conclusions about this.  Honey consists mainly of glucose and fructose, plus water and negligible amounts of other nutrients.  High fructose corn syrup, widely used now in place of sucrose to sweeten soft drinks and other packaged foods, is also primarily fructose and glucose.
     The artificial sweeteners aspartame and saccharine are also safe and useful in this respect (55).  Aspartame (marketed under the brand name NutraSweet) especially has been thoroughly studied.  It is in fact essentially just a combination of two naturally occurring amino acids (the components of protein).  The criticism that is sometimes heard, that it is dangerous because methanol (wood alcohol) is produced during its digestion, is absurd.  Far more methanol is produced from a glass of tomato juice than from the same amount of aspartame-sweetened diet soda (57).  Such trivial amounts are no cause for concern.
 Salt, or sodium, is often mentioned as one of the dietary factors involved in the control and prevention of hypertension (high blood pressure), itself a very significant risk factor in the development of heart disease, atherosclerosis, stroke, kidney disease and possibly other serious diseases.  However, dietary salt is a significant factor only in certain people, not everyone, at least not within reasonable limits.  Most people, even those with hypertension, will have little or no change in blood pressure in response to a reduction in dietary salt (58,59).  Given this, it does not seem justifiable to recommend a salt-restricted diet for everyone.  Blood pressure is something that should be routinely monitored in any case.  Your doctor will measure it as part of any visit, and you can buy an inexpensive pressure gauge and cuff and easily learn to do it yourself.  To determine if you are salt-sensitive, you would decrease your dietary salt intake for a month or so while monitoring the effect on blood pressure.  It is best to take a number of readings over several days at least, since other factors can affect blood pressure.  The reduction in salt intake can be achieved by eliminating very high-salt foods like potato chips, and decreasing the amount of salt added to food during preparation, cooking and at the table.  How best to achieve a reduction depends to a large extent on your normal diet.  That is, what are the high-salt items you eat at present and what can you do without?  If you find that salt reduction does lower your blood pressure significantly, it would be wise to incorporate permanently as much of a reduction as you can live with.  Even if your blood pressure is not high now, it's been found that the rise in blood pressure that usually occurs with age can be eliminated in salt-sensitive people by reducing their sodium consumption.
 I said that, for non-salt-sensitive people, dietary salt had little or no effect within "reasonable" limits.  Populations with significantly higher than normal sodium intakes, as in Japan, do have a relatively high incidence of stroke, even though the cardiovascular disease rate is low, and Japan has the highest life expectancy in the world (32,60).
 While dietary sodium can raise blood pressure, potassium, calcium and magnesium can lower it (58,59,61).  In fact, these minerals may be associated with the prevention of several serious diseases.  Calcium may reduce the risk of colorectal cancer (62).  Calcium and potassium can help prevent osteoporosis, or loss of overall bone mass (63-65).  This process may begin as early as the twenties in women.  It continues throughout life, accelerating after menopause.  A similar process occurs in men, but usually not beginning until their forties or fifties, and usually of lesser severity.  It has been estimated that
at least 10 percent of women over 50 years of age suffer from bone loss severe enough to cause fractures and major orthopedic problems.  Other studies have estimated that 25 to 30 percent of postmenopausal women have significant osteoporosis (66).  The cessation of hormone production at menopause is known to be a major causative factor in this disease.  Bone loss accelerates to 2% to 5% per year immediately before and for about 10 years after menopause.  Dietary calcium alone cannot stop this loss of bone mass, whereas estrogen (the female hormone) plus calcium can completely prevent it in most cases.  In addition to diet, prevention and treatment of osteoporosis involves other factors, more of which later.
     Calcium, of course, is essential to the formation of bone, making up 38% of its mineral composition.  The body of a 70kg (154lb.) adult contains 1.2kg (2.6lbs.) of calcium, 99% of it in the skeleton.  A dietary deficiency of this mineral, or a metabolic imbalance (greater excretion than intake) can be crucial to the development of osteoporosis.  Bone is constantly being broken down and reformed, even in adults.  About 700mg of calcium enter and exit the skeleton every day; this is why an adequate calcium intake must be maintained throughout life.  Potassium is thought to reduce excretion of calcium, while phosphorus increases it (67,68).  Dietary surveys suggest that the average postmenopausal woman in the U.S. ingests only about 60 percent of the recommended dietary allowance of 800 milligrams of calcium.  It has been estimated that this degree of calcium imbalance could lead to a bone loss of about 1.5 percent per year (69).  Poor absorption of dietary calcium in postmenopausal women exacerbates this problem.  A  number of experts in this area have recommended a daily intake of 1200 to 1500 mg of (elemental) calcium per day.  Milk and milk products have the highest calcium content of all foods.  Milk (whole or skim) contains about 300mg per cup (237ml).  The calcium content of cheese ranges from 90mg per 100g (3.5 ounces) of cottage, to 1140mg per 100g of parmesan; most cheeses, of course, have much too high a fat content to serve as dietary staples.  It would take over a quart of milk a day to obtain 1200 to 1500mg, if you obtained no calcium from other sources.  However, around forty percent of a typical person's calcium intake comes from non-dairy sources.  A calcium supplement is a reasonable alternative if you feel that you cannot obtain these recommended amounts in your diet.  Potassium is widely distributed in foods.  Many fruits, especially bananas, apricots, melons, peaches, and oranges, are good sources; squash, tomatoes, and rhubarb also have substantial amounts.  Magnesium is also found in a wide variety of foods; raw wheat bran contains 611mg/100g, whole wheat 130mg/100g, and spinach 80mg/100g, but many other common foods have respectable amounts.
 Vitamin D is essential for proper calcium absorption and metabolism, but a deficiency of this vitamin is not thought to be one of the major causes of osteoporosis in the general population.  Vitamin D can have serious toxic effects in high doses.  The RDA is currently set at 5 micrograms (200 I.U.) for those 25 years and older. The prudent course is to insure an intake at around 5 to 10 micrograms (200 to 400 I.U.), but not more than that.  Excessive caffeine or coffee consumption (and I emphasize excessive) may be related to osteoporosis .  Caffeine is a weak diuretic (increases the volume of urine) and increases urinary excretion of sodium, magnesium, and calcium (70,71).  Epidemiologic studies of young women have found no correlation between caffeine consumption and bone density, but some of the studies on older women have reported adverse effects of caffeine on calcium excretion and bone (70).  Up to about 500 milliliters (2.1 cups; 1 measuring cup equals 237ml, about one normal size coffee mug) of coffee a day seems to have little if any effect even in older women, but 1000ml (4.2 cups) or more could result in significantly greater calcium excretion.  It is thought that young women can compensate for disturbances in their metabolism caused by caffeine, whereas older women cannot.  Adequate amounts of dietary calcium can negate the extra excretion (70).
     Attempts to link coffee or caffeine to other serious diseases like cancer and heart disease have been generally unsuccessful.  An extensive study in Norway involving nearly 14,000 men and 3,000 women  found NO significant correlations between consumption and total mortality, or death from any major cause, including any form of cancer or heart disease (72).  There were actually several statistically significant inverse relationships between coffee and several types of cancer (i.e., the coffee drinkers had lower incidence of those cancers), but the differences of any kind were small.  Almost all recent studies have found that coffee and caffeine have no effect on blood lipids or blood pressure, at least within fairly high levels of consumption of up to a liter a day (4.2 cups) (73,74).  Decaffeinated coffee does not seem to afford any health benefits over regular; in fact, several studies have reported slight negative effects from decaffeinated when there were none associated with regular coffee.  My own assessment is that the two or three cups of coffee a day that most of us drink pose no health risk, even when combined with a similar amount of tea and cola, both of which contain lesser amounts of caffeine.  (Cocoa and chocolates contain trivial amounts.)  While tea leaves contain more caffeine than coffee grounds, much more is extracted into the liquid in making coffee.  The caffeine content of all three beverages varies widely, depending upon method of preparation, brand,  brewing time, etc.  Very roughly, coffee has about twice as much caffeine as tea, which has about twice as much as the average cola.
     Colas and other sodas also contain phosphoric acid, a source of phosphorus.  As I mentioned earlier, phosphorus increases excretion of calcium.  This is something to keep in mind, but it generally will not be a problem unless a person's calcium intake is low, or overall calcium balance is marginal.
     Heavy consumption of alcoholic beverages is related to increased mortality from a number of causes.  But epidemiologic evidence has been building that light to moderate alcohol consumption is associated with decreased risk of heart disease, and probably overall lower mortality, although the latter is somewhat controversial.  One such study of 20 industrialized countries (75) examined consumption of fat, cholesterol, types of fat (saturated or unsaturated), alcohol, and type of alcohol (beer, wine or spirits).  As you might expect, there was a strong correlation between heart disease and saturated fat, and a slight inverse correlation with polyunsaturated fat.  It found an even stronger inverse correlation between total alcohol consumption and the death rate from heart disease.  France has received the most publicity in this regard, with a heart disease rate far below the U.S. and the U.K., despite nearly equal saturated fat consumption, but the correlation fits fairly well for most countries if all three factors (saturated and polyunsaturated fat, and alcohol consumption) are taken into account.  Other studies of populations within the same country (e.g., the U.S., New Zealand) have reached the same conclusion: light to moderate alcohol consumption reduces the risk of heart disease (76,77).  The U.S. (California) study examined 129,000 persons from diverse backgrounds and corrected for other various confounding factors such as smoking, body weight and so on.  It found that heavy drinkers, especially women, were at greater risk from death from noncardiovascular causes, but lighter drinkers (1 to 2 drinks a day) had a decreased risk of heart disease and a slightly decreased overall mortality.  A "drink" was defined in this study, as it usually is, as either a standard 12 ounce (350 milliliter) bottle of beer, or a (wine)glassful of wine, or the usual, smaller glass of spirits.  All have, very roughly, the same amount of alcohol on average.  The New Zealand study of several hundred men and women found that, up to more than 56 drinks per week, people had a 40% reduction in fatal and non-fatal heart disease compared to those who never drank.
     The mechanism through which alcohol protects against heart disease is not known with any certainty; regular consumption of small amounts of alcohol increases blood HDL levels (the "good cholesterol"), but other effects, such as dilation of the blood vessels and the prevention of blood clots, may also be at work.
     The issue becomes more clouded when total mortality is considered, especially for women.  Even moderate drinkers have higher mortality from cirrhosis of the liver (77), although death from this is still rare, so it does not affect the overall mortality rate much.  For women, light drinkers had a slightly higher cancer death rate.  Other studies (78) suggest a link between breast cancer and drinking.  High consumption of alcohol is associated with increased risk of several cancers, particularly of the mouth, larynx and esophagus (79).  Again, this is high consumption; it is doubtful whether light to moderate consumption increased cancer risk in itself, when other confounding factors are accounted for.  Ethanol (ordinary drinking alcohol) is not carcinogenic in itself.  It is thought that alcohol can act as a cancer promoter, enhancing the cancer-causing effects of other substances.  This is believed to be true particularly for ethanol and smoking.
     Many substances found in food (usually in trace amounts) are known or suspected carcinogens.  Aflavtoxins are very carcinogenic toxins produced by a fungus which grows on peanuts and many other foods.  This fungus is widely distributed and has been found in animal feed and fish meal.  Aflavtoxins are known to cause tumors in the livers of rats, fish, mice, monkeys and several other species.  They are quite toxic directly in high enough doses.  Fungi and molds, which can grow on a variety of foods, produce a number of suspected carcinogens.  Many other potentially dangerous substances, like the known human carcinogen benzene, occur naturally in many foods.  Bruce Ames, inventor of the Ames test, which screens for potential carcinogens, published a survey a few years ago (80) on just how widespread they are.  Black pepper, mushrooms, cottonseed oil (and products such as eggs, meat and milk from animals fed cottonseed), potatoes, fava beans, browned or burnt food all contain significant levels of substances which are known carcinogens in animals, suspected carcinogens in humans, or both.  Generally speaking, these do not warrant completely avoiding any specific foods.  Our bodies do have mechanisms to deal with and detoxify a wide variety of potentially harmful substances.  It is prudent to avoid foods that have begun to go stale, certainly if there is evidence of any mold or fungus on them, but this is something that's advisable and is commonly done in any case.  Some compounds which warrant attention can be formed during the processing of food.  Nitrites used in curing meats can react to form N-nitroso compounds, some of which cause cancer in animals.  Charred or fried meats especially are thought to be sources of these.  The actual levels of suspected carcinogens are low; however, if such foods were consumed regularly, it's quite possible that a cumulative effect would occur.  In fact, the epidemiologic evidence shows just such an effect in several cases.  Consumption of salted, pickled, or smoked foods has been linked to cancer of the esophagus, stomach and liver, diseases which are almost always fatal.  Cancers of the stomach and liver are uncommon in the U.S. but are major killers in some parts of the world.  Liver cancer is widespread in many areas of Africa, China and southeast Asia.  Stomach cancer used to be common in the U.S. and developed countries, but its incidence declined steadily and significantly through the twentieth century.  It is still common in China, Japan and South America, though it's not clear whether this is due to consumption of salted, pickled and smoked foods, or the lack of fresh fruits and vegetables containing protective substances such as vitamin C, or to other factors (81).
     I have occasionally been asked whether spices are potentially harmful or beneficial.  Spices include a very diverse group of substances, so one can't generalize too much.  A number of common spices are antioxidants.  In a survey of 32 spices in simple oil-in-water emulsions, many were found to protect the emulsion from oxidation.  Cloves was the most effective; allspice, cinnamon, ginger, mace, nutmeg, oregano, rosemary, sage,  thyme and several others all had significant antioxidant activity  (82,83).  They therefore may well help protect food from oxidative damage, and it's thought they were in fact used as crude preservatives in past centuries; it's unknown whether this effect would continue after consumption.  Garlic and onions (spices from related plants) have been reported to have several beneficial effects.  Garlic may inhibit cancer and atherosclerosis, but the quantities needed for any significant effects are beyond normal dietary levels.  One or two spices, like black pepper, contain carcinogens (80), which are probably not significant at ordinary dietary levels.


References to  CHAPTER 4 are in the book.


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            While I can see the rationale for the strategies of caloric restriction and high antioxidant supplementation, my preference is for a broader-based program of dietary modification, moderate supplementation, and exercise.  This would still include mild caloric restriction.  If you eat anything like the typical high-fat American or Western diet, dietary modification is probably the most important change that you can make to ensure a long and healthy life.  Dietary fat has been linked to heart disease, stroke, prostate cancer, and colorectal cancer, and may well be associated with several other cancers and diseases.  It should be reduced to as low a level as possible, and monounsaturated fats like olive oil should be used whenever possible.  Monounsaturated fats are the safest in all respects and olive oil is the safest of these, mainly because it has been in use for so long and is the most purely monounsaturated of all.  Indeed, there may be no risks associated with olive oil itself, as there are for saturated and polyunsaturated fats….There is overwhelming evidence for the health and longevity benefits of reducing consumption of meat and other animal products, of reducing total dietary fat, and of making vegetables, fruits, and grains the staples of your diet.  There is NO risk in this strategy.  Almost all the evidence is in favor of some benefits; it's just a question of how great they will be.  At worse, the causal links between some cancers and the high-fat Western diet have not been proved….As we have discussed in previous chapters, there is also substantial evidence for the health benefits of increasing the fiber in your diet and minimizing consumption of animal products.  Fortunately, all of these goals can be achieved by essentially the same dietary modifications.  Replacing foods like meat, eggs and other high-fat dairy products, and high-fat processed foods with vegetables, fruits, and grains will substantially decrease the fat in your diet and increase the fiber.  Legumes (beans, peas, lentils, soybeans) and some fish (including shellfish) are also acceptable.  These need not always be fresh; plain canned and frozen foods are fine.  Such a diet also almost automatically decreases total calories consumed, since fats are the most calorie-dense foods.  Fruits and vegetables are almost all remarkable low in calories.  Dried fruits, however, including raisins, prunes, and the like, are much more calorie-dense just because they have had most of their moisture removed.  Grain products tend to be low to moderate in calories, depending not only on what they are, but how they are prepared.  Cooked grains like spaghetti and hot cereals are relatively low in calories.  All oils are pure fat and should be used sparingly.  The same goes for butter and margarine, which are comprised of about 80% fat on average and derive all their calories from fat….

Alcohol can be consumed in moderation; it may even be beneficial.  By moderation, I mean an average of one to two drinks a day for men, and up to one drink a day for women.  Above these amounts, it starts to increase the risk of several serious diseases and overall mortality.

            Exercise should be an important part of your program for the many reasons we have discussed.  It has a small but positive effect on overall longevity; it helps in avoiding a number of serious diseases, including heart disease, stroke, and osteoporosis; it will enable you to extend your independent, active years and possibly avoid an infirm old age; it helps in maintaining proper body weight; it generally has a positive psychological effect.  How much exercise and what kind are things that must be determined largely on an individual basis.  I would avoid the extremes.  Mild exercise totaling less than 30 to 40 minutes a week is not likely to do you a significant amount of good.  An hour or more of daily, high-intensity exercise may be associated with increased risk of injury, several diseases, and shortened life expectancy.  [A]erobic exercises, which promote cardiovascular conditioning, are the most prudent, but weight lifting and other non-aerobic activities are also beneficial.  It is far more important to pick an activity that you will be consistent about doing--whether jogging, walking, tennis, skiing, etc.--than it is to pick some "best" exercise. 

            The other pitfall that some people seem to drift into is relying primarily on exercise for overall health.  Exercise, no matter what kind or how intense, cannot negate the effects of poor diet or the other health and longevity factors we have discussed.


[Revised and updated list of recommended supplements]



Recommended Daily Supplement 

RDA (male/female)

vitamin A*

5000 IU

(1000 RE)

5000/4000 IU

(1000/800 RE)

thiamin (B1)*

1.5-3 mg

1.5/1.1 mg

riboflavin (B2)*

1.7-3.4 mg

1.7/1.3 mg


20 mg

19/15 mg

vitamin B6*

2-3 mg

2.0/1.6 mg

vitamin B12*

6-9 mg

2.0 mg


400 mg

200/180 mg

pantothenic acid

60 mg

4-7 mg

vitamin C

500-600 mg

60 mg

vitamin D*

400 IU

400 IU

vitamin E1

200-250 IU

10/8 IU

vitamin K*

25 mg



30 mg

100-300 mg


500-1000 mg



250-270 mg

70/55 mg


500 mg

350/300 mg


0-1200 mg3

800-1200 mg


100 mg

(as chromium picolinate) 

140 mg


150 mg




15 mg

8-18 mg

15 mg

5-10 mg






160-325 mg


* Can be taken entirely in a multivitamin or multivitamin/multimineral supplement. A multimineral or multivitamin/multimineral combination is advisable about three days a week to ensure an adequate intake of iron, iodine, zinc, and several other minerals needed in very small amounts.

1. Mixed tocopherols

2. Primarily as selenite

3. Depending on dietary intake


Resveratrol is another potentially important supplement that has been discovered since publication.  Although its benefits have not been proven, a supplement of 250 to 300 mg a day may be beneficial.





p92-94 Heart disease.  The major update since publication is the widespread use of statins like Lipitor (Atorvastatin) and Zocor (simvastatin).  These lower cholesterol dramatically and have come into widespread use.  Some (like simvastatin and atorvastatin) are available as generics.



Life Extension: Current and Future Possibilities, Sunbury Press Camp Hill, PA, 2012. 

This book discusses life extension and aging.  It covers diet and dietary supplements, caloric restriction, dietary recommendations, benefits of specific vitamins and minerals, recommended dietary supplements, and substances like resveratrol that may be beneficial but need more study before being recommended.  A chapter discusses practical means of creating a healthful diet that can be followed, including some recipes and desirable foods and beverages.  It goes into detail on the major diseases and problems that typically occur with age, including heart disease, stroke, cancer, diabetes, pain, depression, stress, loss of fitness, osteoporosis, dementia, arthritis, vision problems, cosmetic changes, etc.  Means of avoiding, minimizing the risk, or dealing with such problems are presented.  It proposes means of maintaining a good quality of life as you age.  Recommended monitoring of health is covered, and the book concludes with a summary of the most important points and a discussion of possible future developments and the ultimate limits to human life span.  The book provides a large but not overwhelming number of specific references.  Six appendices list useful data on foods and health not readily available elsewhere and an annotated listing of further resources.  Specific citations to scientific studies are given to support all major conclusions.

Life Extension: Current and Future Possibilities was released by Sunbury Press in 2012. It includes the latest recommendations on extending life plus some speculative material such as a discussion of some far-out ideas like cryonics, transferring human consciousness to a computer, and the ultimate limits to life-span.





















Sunbury Press can be reached at: 



Updates and new information will be posted here as they become available. New information is added at a rapid pace to the biomedical fields, including aging and dietary supplements.  This may affect the statements or recommenations in the book. Other items that I consider newsworthy will be added to "Health and life-extension" news section of the site.

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