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Medical Compass: Increasing Nutrients is a Recipe for Improving Life Expectancy
August 2, 2022
Diet plays an important role in quality of life as we age
By David Dunaief, M.D.
What if I told you that approximately 85 percent of the US population is undernourished, regardless of socioeconomic status and, in many cases, despite being overweight or obese (1)? The definition of malnourished is insufficient nutrition, which in the US results from low levels of much-needed nutrients. Unfortunately, the standard American diet is so low in nutrients that many are at least moderately malnourished.
Most chronic diseases, including common killers such as heart disease, stroke, diabetes and some cancers, can be prevented, modified and even reversed with a focus on nutrients, according to the Centers for Disease Control and Disease Prevention (CDC).
Here’s a startling statistic: More than 50 percent of American adults have a chronic disease, and 27 percent have more than one (2). This is likely a factor in slowing the rate of increase in life expectancy in the US, which has stalled over the past decade and is currently hovering around 77 years.
I regularly monitor patients’ carotenoid levels. Carotenoids are nutrients that are incredibly important for the health of tissues and organs. They are measurable and give the doctor an idea of whether the patient may be lacking in potentially disease-fighting nutrients. A high nutrient intake dietary approach can remedy the situation and increase, among other things, carotenoid levels.
Benefits of a high nutrient intake
A nutrient-dense diet is an approach that focuses on micronutrients, which literally means small nutrients, including antioxidants and phytochemicals—nutrients for plants. Micronutrients are bioactive compounds found primarily in foods and in some supplements. Although fiber is not considered a micronutrient, it also has important disease-modifying effects. Micronutrients interact with each other synergistically, meaning that the sum is greater than the parts. Plant-rich diets significantly raise micronutrient levels in patients.
In a 2017 study that included 73,700 men and women who participated in the Nurses’ Health Study and the Health Professionals Follow-up Study, participants’ diets were rated over a 12-year period using three dietary scores established: the Alternative Healthy Eating Index –2010, the Alternative Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score (3).
A 20 percent increase in diet scores (indicating better diet quality) was significantly associated with an 8 to 17 percent reduction in total mortality, depending on whether two or three scoring methods were used. . Participants who maintained a high-quality diet over a 12-year period reduced their risk of death 9 to 14 percent more than participants with consistently low diet scores over time. In contrast, worsening diet quality over 12 years was associated with increased mortality from 6 to 12 percent. Not surprisingly, longer periods of healthy eating had a greater effect than shorter periods.
This study reinforces the findings of the Greek EPIC trial, a large (forward-looking) prospective cohort study, in which the Mediterranean-type diet significantly reduced mortality: the better the adherence, the greater the effect (4). The most potent dietary components were fruits, vegetables, nuts, olive oil, legumes, and moderate alcohol consumption. Low meat consumption also contributed to the beneficial effects. Dairy and cereals had a neutral or minimal effect.
Improving the quality of life
However, quality of life is also important. Let’s examine some studies that examine the impact of diet on diseases that can reduce our quality of life as we age.
One study showed that olive oil reduced the risk of stroke by 41 percent (5). The authors attribute this effect, at least partially, to oleic acid, a bioactive compound found in olive oil. While olive oil is important, I recommend limiting olive oil to one tablespoon a day. There are 120 calories per tablespoon of olive oil, all of which are fat. If you eat too much, even good fat, it defeats the purpose. The authors commented that the Mediterranean-type diet had recently been used in trials for neurological diseases, and the results suggest benefits in a number of disorders, including Alzheimer’s.
In a case-control study comparing people with and without the disease, high antioxidant intake from food was associated with a significant decrease in the risk of early age-related macular degeneration (AMD), even when participants had a genetic predisposition to the disease. (6). AMD is the leading cause of blindness in people age 55 and older.
There were 2,167 people enrolled in the study with several different genetic variations that made them at high risk for AMD. Those with a higher intake of nutrients, including B-carotene, zinc, lutein, zeaxanthin, EPA and DHA, substances found in fish, had an inverse relationship with the risk of early AMD. Nutrients, therefore, may play a role in modifying gene expression.
Although many Americans are undernourished, nutrients that are effective and available can alter this situation. Hopefully, with a focus on high nutrient intake, we can improve life expectancy and, on an individual level, improve our quality of life.
(1) dieteguidelines.gov. (2) cdc.gov. (3) N Engl J Med 2017; 377:143-153. (4) BMJ. 2009;338:b2337. (5) Neurology June 15, 2011. (6) Arch Ophthalmol. 2011;129(6):758-766.
Dr. David Dunaief is a local lifestyle medicine speaker, author, and physician who focuses on the integration of medicine, nutrition, exercise, and stress management. For more information, visit www.medicalcompassmd.com.