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Human nutrition – Wikipedia

Posted: October 31, 2016 at 2:42 am


For aspects of nutrition science not specific to humans, see Nutrition.

Human nutrition refers to the provision of essential nutrients necessary to support human life and health. Generally, people can survive up to 40 days without food, a period largely depending on the amount of water consumed, stored body fat, muscle mass and genetic factors.[1][2][medical citation needed]

Poor nutrition is a chronic problem often linked to poverty, poor nutrition understanding and practices, and deficient sanitation and food security.[3] Lack of proper nutrition contributes to lower academic performance, lower test scores, and eventually less successful students and a less productive and competitive economy.[4]Malnutrition and its consequences are immense contributors to deaths and disabilities worldwide.[4] Promoting good nutrition helps children grow, promotes human development and advances economic growth and eradication of poverty.[3]

The human body contains chemical compounds, such as water, carbohydrates (sugar, starch, and fiber), amino acids (in proteins), fatty acids (in lipids), and nucleic acids (DNA and RNA). These compounds consist of elements such as carbon, hydrogen, oxygen, nitrogen, phosphorus, calcium, iron, zinc, magnesium, manganese, and so on. All the chemical compounds and elements contained in the human body occur in various forms and combinations such as hormones, vitamins, phospholipids and hydroxyapatite. These compounds are found in the human body and in the different types of organisms that humans eat.[medical citation needed]

Any study done to determine nutritional status must take into account the state of the body before and after experiments, as well as the chemical composition of the whole diet and of all the materials excreted and eliminated from the body (including urine and feces). Comparing food to waste material can help determine the specific compounds and elements absorbed and metabolized by the body.[medical citation needed] The effects of nutrients may only be discernible over an extended period of time, during which all food and waste must be analyzed. The number of variables involved in such experiments is high, making nutritional studies time-consuming and expensive, which explains why the science of human nutrition is still slowly evolving.[medical citation needed]

The seven major classes of nutrients are: carbohydrates, fats, fiber, minerals, proteins, vitamins, and water. These nutrient classes are categorized as either macronutrients (needed in relatively large amounts) or micronutrients (needed in smaller quantities). The macronutrients are carbohydrates, fats, fiber, proteins, and water.[5][dubious discuss] The micronutrients are minerals and vitamins.[6]

The macronutrients (excluding fiber and water) provide structural material (amino acids from which proteins are built, and lipids from which cell membranes and some signaling molecules are built), and energy. Some of the structural material can be used to generate energy internally, and in either case it is measured in Joules or kilocalories (often called "Calories" and written with a capital 'C' to distinguish them from little 'c' calories). Carbohydrates and proteins provide 17kJ approximately (4kcal) of energy per gram, while fats provide 37kJ (9kcal) per gram,[7] though the net energy from either depends on such factors as absorption and digestive effort, which vary substantially from instance to instance.

Vitamins, minerals, fiber, and water do not provide energy, but are required for other reasons. A third class of dietary material, fiber (i.e., nondigestible material such as cellulose), seems also to be required, for both mechanical and biochemical reasons, though the exact reasons remain unclear. For all age groups, males need to consume higher amounts of macronutrients than females. In general, intakes increase with age until the second or third decade of life.[8]

Molecules of carbohydrates and fats consist of carbon, hydrogen, and oxygen atoms. Carbohydrates range from simple monosaccharides (glucose, fructose, galactose) to complex polysaccharides (starch). Fats are triglycerides, made of assorted fatty acid monomers bound to a glycerol backbone. Some fatty acids, but not all, are essential in the diet: they cannot be synthesized in the body. Protein molecules contain nitrogen atoms in addition to carbon, oxygen, and hydrogen.[citation needed] The fundamental components of protein are nitrogen-containing amino acids, some of which are essential in the sense that humans cannot make them internally. Some of the amino acids are convertible (with the expenditure of energy) to glucose and can be used for energy production just as ordinary glucose. By breaking down existing protein, some glucose can be produced internally; the remaining amino acids are discarded, primarily as urea in urine. This occurs naturally when atrophy takes place, or during periods of starvation.[citation needed]

Carbohydrates may be classified as monosaccharides, disaccharides or polysaccharides depending on the number of monomer (sugar) units they contain. They are a diverse group of substances, with a range of chemical, physical and physiological properties.[9] They make up a large part of foods such as rice, noodles, bread, and other grain-based products.[10][11]

Monosaccharides contain one sugar unit, disaccharides two, and polysaccharides three or more. Monosaccharides include glucose, fructose and galactose.[12] Disaccharides include sucrose, lactose, and maltose; purified sucrose, for instance, is used as table sugar.[13] Polysaccharides, which include starch and glycogen, are often referred to as 'complex' carbohydrates because they are typically long multiple-branched chains of sugar units. The difference is that complex carbohydrates take longer to digest and absorb since their sugar units must be separated from the chain before absorption. The spike in blood glucose levels after ingestion of simple sugars is thought to be related to some of the heart and vascular diseases, which have become more common in recent times. Simple sugars form a greater part of modern diets than in the past, perhaps leading to more cardiovascular disease. The degree of causation is still not clear.[medical citation needed]

Simple carbohydrates are absorbed quickly, and therefore raise blood-sugar levels more rapidly than other nutrients. However, the most important plant carbohydrate nutrient, starch, varies in its absorption. Gelatinized starch (starch heated for a few minutes in the presence of water) is far more digestible than plain starch, and starch which has been divided into fine particles is also more absorbable during digestion. The increased effort and decreased availability reduces the available energy from starchy foods substantially and can be seen experimentally in rats and anecdotally in humans. Additionally, up to a third of dietary starch may be unavailable due to mechanical or chemical difficulty.[medical citation needed]

A molecule of dietary fat typically consists of several fatty acids (containing long chains of carbon and hydrogen atoms), bonded to a glycerol. They are typically found as triglycerides (three fatty acids attached to one glycerol backbone). Fats may be classified as saturated or unsaturated depending on the detailed structure of the fatty acids involved.[citation needed] Saturated fats have all of the carbon atoms in their fatty acid chains bonded to hydrogen atoms, whereas unsaturated fats have some of these carbon atoms double-bonded, so their molecules have relatively fewer hydrogen atoms than a saturated fatty acid of the same length. Unsaturated fats may be further classified as monounsaturated (one double-bond) or polyunsaturated (many double-bonds). Furthermore, depending on the location of the double-bond in the fatty acid chain, unsaturated fatty acids are classified as omega-3 or omega-6 fatty acids. Trans fats are a type of unsaturated fat with trans-isomer bonds; these are rare in nature and in foods from natural sources; they are typically created in an industrial process called (partial) hydrogenation.[citation needed]

Many studies have shown that consumption of unsaturated fats, particularly monounsaturated fats, is associated with better health in humans. Saturated fats, typically from animal sources, are next in order of preference, while trans fats are associated with a variety of disease and should be avoided. Saturated and some trans fats are typically solid at room temperature (such as butter or lard), while unsaturated fats are typically liquids (such as olive oil or flaxseed oil). Trans fats are very rare in nature, but have properties useful in the food processing industry, such as rancidity resistance.[citation needed]

Most fatty acids are not essential, meaning the body can produce them as needed, generally from other fatty acids and always by expending energy to do so. However, in humans, at least two fatty acids are essential and must be included in the diet. An appropriate balance of essential fatty acids omega-3 and omega-6 fatty acids seems also important for health, though definitive experimental demonstration has been elusive. Both of these "omega" long-chain polyunsaturated fatty acids are substrates for a class of eicosanoids known as prostaglandins, which have roles throughout the human body. They are hormones, in some respects. The omega-3 eicosapentaenoic acid (EPA), which can be made in the human body from the omega-3 essential fatty acid alpha-linolenic acid (LNA), or taken in through marine food sources, serves as a building block for series 3 prostaglandins (e.g. weakly inflammatory PGE3). The omega-6 dihomo-gamma-linolenic acid (DGLA) serves as a building block for series 1 prostaglandins (e.g. anti-inflammatory PGE1), whereas arachidonic acid (AA) serves as a building block for series 2 prostaglandins (e.g., pro-inflammatory PGE 2). Both DGLA and AA can be made from the omega-6 linoleic acid (LA) in the human body, or can be taken in directly through food. An appropriately balanced intake of omega-3 and omega-6 partly determines the relative production of different prostaglandins: one reason a balance between omega-3 and omega-6 is believed important for cardiovascular health. In industrialized societies, people typically consume large amounts of processed vegetable oils, which have reduced amounts of the essential fatty acids along with too much of omega-6 fatty acids relative to omega-3 fatty acids.[medical citation needed]

Dietary fiber is a carbohydrate, specifically a polysaccharide, which is incompletely absorbed in humans and in some animals. Like all carbohydrates, when it is metabolized, it can produce four Calories (kilocalories) of energy per gram, but in most circumstances, it accounts for less than that because of its limited absorption and digestibility. The two subcategories are insoluble and soluble fiber. Insoluble dietary fiber consists mainly of cellulose, a large carbohydrate polymer that is indigestible by humans, because humans do not have the required enzymes to break it down, and the human digestive system does not harbor enough of the types of microbes that can do so. Soluble dietary fiber comprises a variety of oligosaccharides, waxes, esters, resistant starches, and other carbohydrates that dissolve or gelatinize in water. Many of these soluble fibers can be fermented or partially fermented by microbes in the human digestive system to produce short-chain fatty acids which are absorbed and therefore introduce some caloric content.[medical citation needed]

Whole grains, beans and other legumes, fruits (especially plums, prunes, and figs), and vegetables are good sources of dietary fiber. Fiber is important to digestive health and is thought to reduce the risk of colon cancer.[citation needed] For mechanical reasons, fiber can help in alleviating both constipation and diarrhea. Fiber provides bulk to the intestinal contents, and insoluble fiber especially stimulates peristalsis the rhythmic muscular contractions of the intestines which move digesta along the digestive tract. Some soluble fibers produce a solution of high viscosity; this is essentially a gel, which slows the movement of food through the intestines. Additionally, fiber, perhaps especially that from whole grains, may help lessen insulin spikes and reduce the risk of type 2 diabetes.[citation needed]

Proteins are the basis of many animal body structures (e.g. muscles, skin, and hair) and form the enzymes which catalyse chemical reactions throughout the body. Each protein molecule is composed of amino acids which contain nitrogen and sometimes sulphur (these components are responsible for the distinctive smell of burning protein, such as the keratin in hair). The body requires amino acids to produce new proteins (protein retention) and to replace damaged proteins (maintenance). Amino acids are soluble in the digestive juices within the small intestine, where they are absorbed into the blood. Once absorbed, they cannot be stored in the body, so they are either metabolized as required or excreted in the urine.[medical citation needed]

Proteins consist of amino acids in different proportions. The most important aspect and defining characteristic of protein from a nutritional standpoint is its amino acid composition.[14] Amino acids which an animal cannot synthesize on its own from smaller molecules are deemed essential. The synthesis of some amino acids can be limited under special pathophysiological conditions, such as prematurity in the infant or individuals in severe catabolic distress, and they are called conditionally essential.[14] Foods containing protein can be rated on their relative content of amino acids, for instance by protein digestibility corrected amino acid score and biological value.[medical citation needed]

It is a common misconception that a vegetarian diet will be insufficient in essential proteins; both vegetarians and vegans of any age and gender, with a healthy diet, can flourish throughout all stages of life, although the latter group typically needs to pay more attention to their nutrition than the former. [15][16] See protein combining for more info.[medical citation needed]

Dietary minerals are the chemical elements required by living organisms, other than the four elements carbon, hydrogen, nitrogen, and oxygen that are present in nearly all organic molecules. The term "mineral" is archaic, since the intent is to describe simply the less common elements in the diet. Some are heavier than the four just mentioned including several metals, which often occur as ions in the body. Some dietitians recommend that these be supplied from foods in which they occur naturally, or at least as complex compounds, or sometimes even from natural inorganic sources (such as calcium carbonate from ground oyster shells). Some are absorbed much more readily in the ionic forms found in such sources. On the other hand, minerals are often artificially added to the diet as supplements; the most famous is likely iodine in iodized salt which prevents goiter.[medical citation needed]

include the following:[medical citation needed]

Many elements are required in smaller amounts (microgram quantities), usually because they play a catalytic role in enzymes.[20] Some trace mineral elements (RDA < 200mg/day) are, in alphabetical order:[medical citation needed]

As with the minerals discussed above, some vitamins are recognized as essential nutrients, necessary in the diet for good health. (Vitamin D is the exception: it can alternatively be synthesized in the skin, in the presence of UVB radiation.) Certain vitamin-like compounds that are recommended in the diet, such as carnitine, are thought useful for survival and health, but these are not "essential" dietary nutrients because the human body has some capacity to produce them from other compounds. Moreover, thousands of different phytochemicals have recently been discovered in food (particularly in fresh vegetables), which may have desirable properties including antioxidant activity (see below); experimental demonstration has been suggestive but inconclusive. Other essential nutrients not classed as vitamins include essential amino acids (see above), essential fatty acids (see above), and the minerals discussed in the preceding section.[medical citation needed]

Vitamin deficiencies may result in disease conditions: goiter, scurvy, osteoporosis, impaired immune system, disorders of cell metabolism, certain forms of cancer, symptoms of premature aging, and poor psychological health (including eating disorders), among many others.[21]

Malnutrition refers to insufficient, excessive, or imbalanced consumption of nutrients. In developed countries, the diseases of malnutrition are most often associated with nutritional imbalances or excessive consumption. Although there are more people in the world who are malnourished due to excessive consumption, according to the United Nations World Health Organization, the greatest challenge in developing nations today is not starvation, but insufficient nutrition the lack of nutrients necessary for the growth and maintenance of vital functions. The causes of malnutrition are directly linked to inadequate macronutrient consumption and disease, and are indirectly linked to factors like household food security, maternal and child care, health services, and the environment. [4]

Research indicates that improving the awareness of nutritious meal choices and establishing long-term habits of healthy eating has a positive effect on a cognitive and spatial memory capacity, potentially increasing a student's potential to process and retain academic information.[citation needed]

Some organizations have begun working with teachers, policymakers, and managed foodservice contractors to mandate improved nutritional content and increased nutritional resources in school cafeterias from primary to university level institutions. Health and nutrition have been proven to have close links with overall educational success.[26] Currently less than 10% of American college students report that they eat the recommended five servings of fruit and vegetables daily.[27] Better nutrition has been shown to affect both cognitive and spatial memory performance; a study showed those with higher blood sugar levels performed better on certain memory tests.[28] In another study, those who consumed yogurt performed better on thinking tasks when compared to those who consumed caffeine free diet soda or confections.[29] Nutritional deficiencies have been shown to have a negative effect on learning behavior in mice as far back as 1951.[30]"Better learning performance is associated with diet induced effects on learning and memory ability".[31]

Nutritional supplement treatment may be appropriate for major depression, bipolar disorder, schizophrenia, and obsessive compulsive disorder, the four most common mental disorders in developed countries.[35] It is because Lakhan and Vieira mentioned that the supplements possess amino acids that may change into neurotransmitters and improve mental disorders. Supplements that have been studied most for mood elevation and stabilization include eicosapentaenoic acid and docosahexaenoic acid (each of which are an omega-3 fatty acid contained in fish oil, but not in flaxseed oil), vitamin B12, folic acid, and inositol.[medical citation needed]

Cancer has become common in developing countries. According to a study by the International Agency for Research on Cancer, "In the developing world, cancers of the liver, stomach and esophagus were more common, often linked to consumption of carcinogenic preserved foods, such as smoked or salted food, and parasitic infections that attack organs." Lung cancer rates are rising rapidly in poorer nations because of increased use of tobacco. Developed countries "tended to have cancers linked to affluence or a 'Western lifestyle' cancers of the colon, rectum, breast and prostate that can be caused by obesity, lack of exercise, diet and age."[36]

A comprehensive worldwide report, "Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective", compiled by the World Cancer Research Fund and the American Institute for Cancer Research, reports that there is a significant relation between lifestyle (including food consumption) and cancer prevention. The same report recommends eating mostly foods of plant origin and aiming to meet nutritional needs through diet alone, while limiting consumption of energy-dense foods, red meat, alcoholic drinks and salt and avoiding sugary drinks, processed meat and moldy cereals (grains) or pulses (legumes). Protein consumption leads to an increase in IGF-1, which plays a role in cancer development.[medical citation needed]

Several lines of evidence indicate lifestyle-induced hyperinsulinemia and reduced insulin function (i.e. insulin resistance) as decisive factors in many disease states. For example, hyperinsulinemia and insulin resistance are strongly linked to chronic inflammation, which in turn is strongly linked to a variety of adverse developments such as arterial microinjuries and clot formation (i.e. heart disease) and exaggerated cell division (i.e. cancer).[37] Hyperinsulinemia and insulin resistance (the so-called metabolic syndrome) are characterized by a combination of abdominal obesity, elevated blood sugar, elevated blood pressure, elevated blood triglycerides, and reduced HDL cholesterol.[medical citation needed]

Obesity can unfavourably alter hormonal and metabolic status via resistance to the hormone leptin, and a vicious cycle may occur in which insulin/leptin resistance and obesity aggravate one another. The vicious cycle is putatively fuelled by continuously high insulin/leptin stimulation and fat storage, as a result of high intake of strongly insulin/leptin stimulating foods and energy. Both insulin and leptin normally function as satiety signals to the hypothalamus in the brain; however, insulin/leptin resistance may reduce this signal and therefore allow continued overfeeding despite large body fat stores.[medical citation needed]

There is a debate about how and to what extent different dietary factors such as intake of processed carbohydrates, total protein, fat, and carbohydrate intake, intake of saturated and trans fatty acids, and low intake of vitamins/minerals contribute to the development of insulin and leptin resistance. Evidence indicates that diets possibly protective against metabolic syndrome include low saturated and trans fat intake and foods rich in dietary fiber, such as high consumption of fruits and vegetables and moderate intake of low-fat dairy products.[38]

Excess water intake, without replenishment of sodium and potassium salts, leads to hyponatremia, which can further lead to water intoxication at more dangerous levels. A well-publicized case occurred in 2007, when Jennifer Strange died while participating in a water-drinking contest.[39] More usually, the condition occurs in long-distance endurance events (such as marathon or triathlon competition and training) and causes gradual mental dulling, headache, drowsiness, weakness, and confusion; extreme cases may result in coma, convulsions, and death. The primary damage comes from swelling of the brain, caused by increased osmosis as blood salinity decreases. Effective fluid replacement techniques include Water aid stations during running/cycling races, trainers providing water during team games such as Soccer and devices such as Camel Baks which can provide water for a person without making it too hard to drink the water.[medical citation needed]

The challenges facing global nutrition are disease, child malnutrition, obesity, and vitamin deficiency.[medical citation needed]

The most common non-infectious diseases worldwide, that contribute most to the global mortality rate, are cardiovascular diseases, various cancers, diabetes, and chronic respiratory problems, all of which are linked to poor nutrition. Nutrition and diet are closely associated with the leading causes of death, including cardiovascular disease and cancer. Obesity and high sodium intake can contribute to ischemic heart disease, while consumption of fruits and vegetables can decrease the risk of developing cancer.[40]

Foodborne and infectious diseases can result in malnutrition, and malnutrition exacerbates infectious disease. Poor nutrition leaves children and adults more susceptible to contracting life-threatening diseases such as diarrheal infections and respiratory infections.[3] According to the WHO, in 2011, 6.9 million children died of infectious diseases like pneumonia, diarrhea, malaria, and neonatal conditions, of which at least one third were associated with undernutrition.[41][42][43]

According to UNICEF, in 2011, 101 million children across the globe were underweight and one in four children, 165 million, were stunted in growth.[44] Simultaneously, there are 43 million children under five who are overweight or obese.[4] Nearly 20 million children under 5 suffer from severe acute malnutrition, a life-threatening condition requiring urgent treatment.[4] According to estimations at UNICEF, hunger will be responsible for 5.6 million deaths of children under the age of five this year.[3] These all represent significant public health emergencies.[40] This is because proper maternal and child nutrition has immense consequences for survival, acute and chronic disease incidence, normal growth, and economic productivity of individuals.[45]

Childhood malnutrition is common and contributes to the global burden of disease.[46] Childhood is a particularly important time to achieve good nutrition status, because poor nutrition has the capability to lock a child in a vicious cycle of disease susceptibility and recurring sickness, which threatens cognitive and social development.[3] Undernutrition and bias in access to food and health services leaves children less likely to attend or perform well in school.[3]

UNICEF defines under nutrition as the outcome of insufficient food intake (hunger) and repeated infectious diseases. Under nutrition includes being underweight for ones age, too short for ones age (stunted), dangerously thin (wasted), and deficient in vitamins and minerals (micronutrient malnutrient).[3] Under nutrition causes 53% of deaths of children under five across the world.[3] It has been estimated that undernutrition is the underlying cause for 35% of child deaths.[47] The Maternal and Child Nutrition Study Group estimate that under nutrition, including fetal growth restriction, stunting, wasting, deficiencies of vitamin A and zinc along with suboptimum breastfeeding- is a cause of 3.1 million child deaths and infant mortality, or 45% of all child deaths in 2011.[45]

When humans are undernourished, they no longer maintain normal bodily functions, such as growth, resistance to infection, or have satisfactory performance in school or work.[3] Major causes of under nutrition in young children include lack of proper breast feeding for infants and illnesses such as diarrhea, pneumonia, malaria, and HIV/AIDS.[3] According to UNICEF 146 million children across the globe, that one out of four under the age of five, are underweight.[3] The amount of underweight children has decreased since 1990, from 33 percent to 28 percent between 1990 and 2004.[3] Underweight and stunted children are more susceptible to infection, more likely to fall behind in school, more likely to become overweight and develop non-infectious diseases, and ultimately earn less than their non-stunted coworkers.[48] Therefore, undernutrition can accumulate deficiencies in health which results in less productive individuals and societies [3]

Many children are born with the inherent disadvantage of low birth weight, often caused by intrauterine growth restriction and poor maternal nutrition, which results in worse growth, development, and health throughout the course of their lifetime.[40] Children born at low birthweight (less than 5.5 pounds), are less likely to be healthy and are more susceptible to disease and early death.[3] Those born at low birthweight also are likely to have a depressed immune system, which can increase their chances of heart disease and diabetes later on in life.[3] Because 96% of low birthweight occurs in the developing world, low birthweight is associated with being born to a mother in poverty with poor nutritional status that has had to perform demanding labor.[3]

Stunting and other forms of undernutrition reduces a childs chance of survival and hinders their optimal growth and health.[48] Stunting has demonstrated association with poor brain development, which reduces cognitive ability, academic performance, and eventually earning potential.[48] Important determinants of stunting include the quality and frequency of infant and child feeding, infectious disease susceptibility, and the mothers nutrition and health status.[48] Undernourished mothers are more likely to birth stunted children, perpetuating a cycle of undernutrition and poverty.[48] Stunted children are more likely to develop obesity and chronic diseases upon reaching adulthood.[48] Therefore, malnutrition resulting in stunting can further worsen the obesity epidemic, especially in low and middle income countries.[48] This creates even new economic and social challenges for vulnerable impoverished groups.[48]

Data on global and regional food supply shows that consumption rose from 2011-2012 in all regions. Diets became more diverse, with a decrease in consumption of cereals and roots and an increase in fruits, vegetables, and meat products.[49] However, this increase masks the discrepancies between nations, where Africa, in particular, saw a decrease in food consumption over the same years.[49] This information is derived from food balance sheets that reflect national food supplies, however, this does not necessarily reflect the distribution of micro and macronutrients.[49] Often inequality in food access leaves distribution which uneven, resulting in undernourishment for some and obesity for others.[49]

Undernourishment, or hunger, according to the FAO, is dietary intake below the minimum daily energy requirement.[49] The amount of undernourishment is calculated utilizing the average amount of food available for consumption, the size of the population, the relative disparities in access to the food, and the minimum calories required for each individual.[49] According to FAO, 868 million people (12% of the global population) were undernourished in 2012.[49] This has decreased across the world since 1990, in all regions except for Africa, where undernourishment has steadily increased.[49] However, the rates of decrease are not sufficient to meet the first Millennium Development Goal of halving hunger between 1990 and 2015.[49] The global financial, economic, and food price crisis in 2008 drove many people to hunger, especially women and children. The spike in food prices prevented many people from escaping poverty, because the poor spend a larger proportion of their income on food and farmers are net consumers of food.[50] High food prices cause consumers to have less purchasing power and to substitute more-nutritious foods with low-cost alternatives.[51]

Malnutrition in industrialized nations is primarily due to excess calories and non-nutritious carbohydrates, which has contributed to the obesity epidemic affecting both developed and some developing nations.[52] In 2008, 35% of adults above the age of 20 years were overweight (BMI 25kg/m), a prevalence that has doubled worldwide between 1980 and 2008.[53] Also 10% of men and 14% of women were obese, with an BMI greater than 30.[54] Rates of overweight and obesity vary across the globe, with the highest prevalence in the Americas, followed by European nations, where over 50% of the population is overweight or obese.[54]

Obesity is more prevalent amongst high income and higher middle income groups than lower divisions of income.[54] Women are more likely than men to be obese, where the rate of obesity in women doubled from 8% to 14% between 1980 and 2008.[54] Being overweight as a child has become an increasingly important indicator for later development of obesity and non-infectious diseases such as heart disease.[45] In several western European nations, the prevalence of overweight and obese children rose by 10% from 1980 to 1990, a rate that has begun to accelerate recently.[3]

Vitamins and minerals are essential to the proper functioning and maintenance of the human body.[55] Globally, particularly in developing nations, deficiencies in Iodine, Iron and Zinc amog others are said to impair human health when these minerals are not ingested in an adequate quantity. There are 20 trace elements and minerals that are essential in small quantities to body function and overall human health.[55]

Iron deficiency is the most common inadequate nutrient worldwide, affecting approximately 2 billion people.[56] Globally, anemia affects 1.6 billion people, and represents a public health emergency in children under five and mothers.[57] The World Health Organization estimates that there exists 469 million women of reproductive age and approximately 600 million preschool and school-age children worldwide who are anemic.[58] Anemia, especially iron-deficient anemia, is a critical problem for cognitive developments in children, and its presence leads to maternal deaths and poor brain and motor development in children.[3] The development of anemia affects mothers and children more because infants and children have higher iron requirements for growth.[59] Health consequences for iron deficiency in young children include increased perinatal mortality, delayed mental and physical development, negative behavioral consequences, reduced auditory and visual function, and impaired physical performance.[60] The harm caused by iron deficiency during child development cannot be reversed and result in reduced academic performance, poor physical work capacity, and decreased productivity in adulthood.[4] Mothers are also very susceptible to iron-deficient anemia because women lose iron during menstruation, and rarely supplement it in their diet.[4] Maternal iron deficiency anemia increases the chances of maternal mortality, contributing to at least 18% of maternal deaths in low and middle income countries.[61]

Vitamin A plays an essential role in developing the immune system in children, therefore, it is considered an essential micronutrient that can greatly affect health.[3] However, because of the expense of testing for deficiencies, many developing nations have not been able to fully detect and address vitamin A deficiency, leaving vitamin A deficiency considered a silent hunger.[3] According to estimates, subclinical vitamin A deficiency, characterized by low retinol levels, affects 190 million pre-school children and 19 million mothers worldwide.[62] The WHO estimates that 5.2 million of these children under 5 are affected by night blindness, which is considered clinical vitamin A deficiency.[63] Severe vitamin A deficiency (VAD) for developing children can result in visual impairments, anemia and weakened immunity, and increase their risk of morbidity and mortality from infectious disease.[64] This also presents a problem for women, with WHO estimating that 9.8 million women are affected by night blindness.[65] Clinical vitamin A deficiency is particularly common among pregnant women, with prevalence rates as high as 9.8% in South-East Asia.[62]

Estimates say that 28.5% of the global population is iodine deficient, representing 1.88 billion individuals.[66] Although salt iodization programs have reduced the prevalence of iodine deficiency, this is still a public health concern in 32 nations. Moderate deficiencies are common in Europe and Africa, and over consumption is common in the Americas.[40] Iodine-deficient diets can interfere with adequate thyroid hormone production, which is responsible for normal growth in the brain and nervous system. This ultimately leads to poor school performance and impaired intellectual capabilities.[3]

Improvement of breast feeding practices, like early initiation and exclusive breast feeding for the first two years of life, could save the lives of 1.5 million children annually.[67] Nutrition interventions targeted at infants aged 05 months first encourages early initiation of breastfeeding.[4] Though the relationship between early initiation of breast feeding and improved health outcomes has not been formally established, a recent study in Ghana suggests a causal relationship between early initiation and reduced infection-caused neo-natal deaths.[4] Also, experts promote exclusive breastfeeding, rather than using formula, which has shown to promote optimal growth, development, and health of infants.[68] Exclusive breasfeeding often indicates nutritional status because infants that consume breast milk are more likely to receive all adequate nourishment and nutrients that will aid their developing body and immune system. This leaves children less likely to contract diarrheal diseases and respiratory infections.[3]

Besides the quality and frequency of breastfeeding, the nutritional status of mothers affects infant health. When mothers do not receive proper nutrition, it threatens the wellness and potential of their children.[3] Well-nourished women are less likely to experience risks of birth and are more likely to deliver children who will develop well physically and mentally.[3] Maternal undernutrition increases the chances of low-birth weight, which can increase the risk of infections and asphyxia in fetuses, increasing the probability of neonatal deaths.[69] Growth failure during intrauterine conditions, associated with improper mother nutrition, can contribute to lifelong health complications.[4] Approximately 13 million children are born with intrauterine growth restriction annually.[70]

According to UNICEF, South Asia has the highest levels of underweight children under five, followed by sub-Saharan Africans nations, with Industrialized countries and Latin nations having the lowest rates.[3]

In the United States, 2% of children are underweight, with under 1% stunted and 6% are wasting.[3]

In the US, dietitians are registered (RD) or licensed (LD) with the Commission for Dietetic Registration and the American Dietetic Association, and are only able to use the title "dietitian," as described by the business and professions codes of each respective state, when they have met specific educational and experiential prerequisites and passed a national registration or licensure examination, respectively. In California, registered dietitians must abide by the "Business and Professions Code of Section 2585-2586.8".Anyone may call themselves a nutritionist, including unqualified dietitians, as this term is unregulated. Some states, such as the State of Florida, have begun to include the title "nutritionist" in state licensure requirements. Most governments provide guidance on nutrition, and some also impose mandatory disclosure/labeling requirements for processed food manufacturers and restaurants to assist consumers in complying with such guidance..[citation needed]

In the US, nutritional standards and recommendations are established jointly by the US Department of Agriculture and US Department of Health and Human Services. Dietary and physical activity guidelines from the USDA are presented in the concept of a plate of food which in 2011 superseded the food pyramid that had replaced the Four Food Groups. The Senate committee currently responsible for oversight of the USDA is the Agriculture, Nutrition and Forestry Committee. Committee hearings are often televised on C-SPAN. The U.S. Department of Health and Human Services provides a sample week-long menu which fulfills the nutritional recommendations of the government.[71]Canada's Food Guide is another governmental recommendation..[citation needed]

According to UNICEF, the Commonwealth of Independent States has the lowest rates of stunting and wasting, at 14 percent and 3 percent.[3] The nations of Estonia, Finland, Iceland, Lithuania and Sweden have the lowest prevalence of low birthweight children in the world- at 4%.[3] Proper prenatal nutrition is responsible for this small prevalence of low birthweight infants.[3] However, low birthweight rates are increasing, due to the use of fertility drugs, resulting in multiple births, women bearing children at an older age, and the advancement of technology allowing more pre-term infants to survive.[3] Industrialized nations more often face malnutrition in the form of over-nutrition from excess calories and non-nutritious carbohydrates, which has contributed greatly to the public health epidemic of obesity.[52] Disparities, according to gender, geographic location and socio-economic position, both within and between countries, represent the biggest threat to child nutrition in industrialized countries. These disparities are a direct product of social inequalities and social inequalities are rising throughout the industrialized world, particularly in Europe.[3]

South Asia has the highest percentage and number of underweight children under five in the world, at approximately 78 million children.[3] Patterns of stunting and wasting are similar, where 44% have not reached optimal height and 15% are wasted, rates much higher than any other regions.[3] This region of the world has extremely high rates of child underweight- 46% of its child population under five is underweight.[3] India, Bangladesh, and Pakistan alone account for half the globes underweight child population.[3] South Asian nations have made progress towards the MDGs, considering the rate has decreased from 53% since 1990, however, a 1.7% decrease of underweight prevalence per year will not be sufficient to meet the 2015 goal.[3] Some nations, such as Afghanistan, Bangladesh, and Sri Lanka, on the other hand, have made significant improvements, all decreasing their prevalence by half in ten years.[3] While India and Pakistan have made modest improvements, Nepal has made no significant improvement in underweight child prevalence.[3] Other forms of undernutrition have continued to persist with high resistance to improvement, such as the prevalence of stunting and wasting, which has not changed significantly in the past 10 years.[3] Causes of this poor nutrition include energy-insufficient diets, poor sanitation conditions, and the gender disparities in educational and social status.[3] Girls and women face discrimination especially in nutrition status, where South Asia is the only region in the world where girls are more likely to be underweight than boys.[3] In South Asia, 60% of children in the lowest quintile are underweight, compared to only 26% in the highest quintile, and the rate of reduction of underweight is slower amongst the poorest.[72]

The Eastern and Southern African nations have shown no improvement since 1990 in the rate of underweight children under five.[3] They have also made no progress in halving hunger by 2015, the most prevalent Millennium Development Goal.[3] This is due primarily to the prevalence of famine, declined agricultural productivity, food emergencies, drought, conflict, and increased poverty.[3] This, along with HIV/AIDS, has inhibited the nutrition development of nations such as Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe.[3]Botswana has made remarkable achievements in reducing underweight prevalence, dropping 4% in 4 years, despite its place as the second leader in HIV prevalence amongst adults in the globe.[3]South Africa, the wealthiest nation in this region, has the second lowest proportion of underweight children at 12%, but has been steadily increasing in underweight prevalence since 1995.[3] Almost half of Ethiopian children are underweight, and along with Nigeria, they account for almost one-third of the underweight under five in all of Sub-Saharan Africa.[3]

West/Central Africa has the highest rate of children under five underweight in the world.[3] Of the countries in this region, the Congo has the lowest rate at 14%, while the nations of Democratic Republic of the Congo, Ghana, Guinea, Mali, Nigeria, Senegal and Togo are improving slowly.[3] In Gambia, rates decreased from 26% to 17% in four years, and their coverage of vitamin A supplementation reaches 91% of vulnerable populations.[3] This region has the next highest proportion of wasted children, with 10% of the population under five not at optimal weight.[3] Little improvement has been made between the years of 1990 and 2004 in reducing the rates of underweight children under five, whose rate stayed approximately the same.[3]Sierra Leone has the highest child under five mortality rate in the world, due predominantly to its extreme infant mortality rate, at 238 deaths per 1000 live births.[3] Other contributing factors include the high rate of low birthweight children (23%) and low levels of exclusive breast feeding (4%).[3] Anemia is prevalent in these nations, with unacceptable rates of iron deficient anemia.[3] The nutritional status of children is further indicated by its high rate of child wasting - 10%.[3] Wasting is a significant problem in Sahelian countries Burkina Faso, Chad, Mali, Mauritania and Niger where rates fall between 11% and 19% of under fives, affecting more than 1 million children.[3]

Six countries in the Middle East and North Africa region are on target to meet goals for reducing underweight children by 2015, and 12 countries have prevalence rates below 10%.[3] However, the nutrition of children in the region as a whole has degraded for the past ten years due to the increasing portion of underweight children in three populous nations Iraq, Sudan, and Yemen.[3] Forty six percent of all children in Yemen are underweight, a percentage that has worsened by 4% since 1990.[3] In Yemen, 53% of children under five are stunted and 32% are born at low birth weight.[3] Sudan has an underweight prevalence of 41%, and the highest proportion of wasted children in the region at 16%.[3] One percent of households in Sudan consume iodized salt.[3] Iraq has also seen an increase in child underweight since 1990.[3]Djibouti, Jordan, the Occupied Palestinian Territory (OPT), Oman, the Syrian Arab Republic and Tunisia are all projected to meet minimum nutrition goals, with OPT, Syrian AR, and Tunisia the fastest improving regions.[3] This region demonstrates that undernutrition does not always improve with economic prosperity, where the United Arab Emirates, for example, despite being a wealthy nation, has similar child death rates due to malnutrition to those seen in Yemen.[3]

The East Asia/Pacific region has reached its goals on nutrition, in part due to the improvements contributed by China, the regions most populous country.[3] China has reduced its underweight prevalence from 19 percent to 8 percent between 1990 and 2002.[3] China played the largest role in the world in decreasing the rate of children under five underweight between 1990 and 2004, halving the prevalence.[3] This reduction of underweight prevalence has aided in the lowering of the under 5 mortality rate from 49 to 31 of 1000. They also have a low birthweight rate at 4%, a rate comparable to industrialized countries, and over 90% of households receive adequate iodized salts.[3] However, large disparities exist between children in rural and urban areas, where 5 provinces in China leave 1.5 million children iodine deficient and susceptible to diseases.[3]Singapore, Vietnam, Malaysia, and Indonesia are all projected to reach nutrition MDGs.[3]Singapore has the lowest under five mortality rate of any nation, besides Iceland, in the world, at 3%.[3]Cambodia has the highest rate of child mortality in the region (141 per 1,000 live births), while still its proportion of underweight children increased by 5 percent to 45% in 2000. Further nutrient indicators show that only 12 per cent of Cambodian babies are exclusively breastfed and only 14 per cent of households consume iodized salt.[3]

This region has undergone the fastest progress in decreasing poor nutrition status of children in the world.[3] The Latin American region has reduced underweight children prevalence by 3.8% every year between 1990 and 2004, with a current rate of 7% underweight.[3] They also have the lowest rate of child mortality in the developing world, with only 31 per 1000 deaths, and the highest iodine consumption.[3]Cuba has seen improvement from 9 to 4 percent underweight under 5 between 1996 and 2004.[3] The prevalence has also decreased in the Dominican Republic, Jamaica, Peru, and Chile.[3] Chile has a rate of underweight under 5, at merely 1%.[3] The most populous nations, Brazil and Mexico, mostly have relatively low rates of underweight under 5, with only 6% and 8%.[3]Guatemala has the highest percentage of underweight and stunted children in the region, with rates above 45%.[3] There are disparities amongst different populations in this region. For example, children in rural areas have twice the prevalence of underweight at 13%, compared to urban areas at 5%.[3]

Occurring throughout the world, lack of proper nutrition is both a consequence and cause of poverty.[3] Impoverished individuals are less likely to have access to nutritious food and to escape from poverty than those who have healthy diets.[3] Disparities in socioeconomic status, both between and within nations, provide the largest threat to child nutrition in industrialized nations, where social inequality is on the rise.[73] According to UNICEF, children living in the poorest households are twice as likely to be underweight as those in the richest.[3] Those in the lowest wealth quintile and whose mothers have the least education demonstrate the highest rates of child mortality and stunting.[74] Throughout the developing world, socioeconomic inequality in childhood malnutrition is more severe than in upper income brackets, regardless of the general rate of malnutrition.[75] Concurrently, the greatest increase in childhood obesity has been seen in the lower middle income bracket.[54]

According to UNICEF, children in rural locations are more than twice as likely to be underweight as compared to children under five in urban areas.[3] In Latin American/Caribbean nations, Children living in rural areas in Bolivia, Honduras, Mexico and Nicaragua are more than twice as likely to be underweight as children living in urban areas. That likelihood doubles to four times in Peru. [3]

In the United States, the incidence of low birthweight is on the rise among all populations, but particularly among minorities.[76]

According to UNICEF, boys and girls have almost identical rates as underweight children under age 5 across the world, except in South Asia.[3]

Nutrition directly influences progress towards meeting the Millennium Goals of eradicating hunger and poverty through health and education.[3] Therefore, nutrition interventions take a multi-faceted approach to improve the nutrition status of various populations. Policy and programming must target both individual behavioral changes and policy approaches to public health. While most nutrition interventions focus on delivery through the health-sector, non-health sector interventions targeting agriculture, water and sanitation, and education are important as well.[4] Global nutrition micro-nutrient deficiencies often receive large-scale solution approaches by deploying large governmental and non-governmental organizations. For example, in 1990, iodine deficiency was particularly prevalent, with one in five households, or 1.7 billion people, not consuming adequate iodine, leaving them at risk to develop associated diseases.[3] Therefore, a global campaign to iodize salt to eliminate iodine deficiency successfully boosted the rate to 69% of households in the world consuming adequate amounts of iodine.[3]

Emergencies and crises often exacerbate undernutrition, due to the aftermath of crises that include food insecurity, poor health resources, unhealthy environments, and poor healthcare practices.[3] Therefore, the repercussions of natural disasters and other emergencies can exponentially increase the rates of macro and micronutrient deficiencies in populations.[3] Disaster relief interventions often take a multi-faceted public health approach. UNICEFs programming targeting nutrition services amongst disaster settings include nutrition assessments, measles immunization, vitamin A supplementation, provision of fortified foods and micronutrient supplements, support for breastfeeding and complementary feeding for infants and young children, and therapeutic and supplementary feeding.[3] For example, during Nigerias food crisis of 2005, 300,000 children received therapeutic nutrition feeding programs through the collaboration of UNICEF, the Niger government, the World Food Programme, and 24 NGOs utilizing community and facility based feeding schemes.[3]

Interventions aimed at pregnant women, infants, and children take a behavioral and program-based approach. Behavioral intervention objectives include promoting proper breast-feeding, the immediate initiation of breastfeeding, and its continuation through 2 years and beyond.[4] UNICEF recognizes that to promote these behaviors, healthful environments must be established conducive to promoting these behaviors, like healthy hospital environments, skilled health workers, support in the public and workplace, and removing negative influences.[4] Finally, other interventions include provisions of adequate micro and macro nutrients such as iron, anemia, and vitamin A supplements and vitamin-fortified foods and ready-to-use products.[4] Programs addressing micro-nutrient deficiencies, such as those aimed at anemia, have attempted to provide iron supplementation to pregnant and lactating women. However, because supplementation often occurs too late, these programs have had little effect.[3] Interventions such as womens nutrition, early and exclusive breastfeeding, appropriate complementary food and micronutrient supplementation have proven to reduce stunting and other manifestations of undernutrition.[48] A Cochrane review of community-based maternal health packages showed that this community-based approach improved the initiation of breastfeeding within one hour of birth.[77][needs update] Some programs have had adverse effects. One example is the Formula for Oil relief program in Iraq, which resulted in the replacement of breastfeeding for formula, which has negatively affected infant nutrition.[3]

In April 2010, the World Bank and the IMF released a policy briefing entitled Scaling up Nutrition (SUN): A Framework for action that represented a partnered effort to address the Lancets Series on under nutrition, and the goals it set out for improving under nutrition.[78] They emphasized the 1000 days after birth as the prime window for effective nutrition intervention, encouraging programming that was cost-effective and showed significant cognitive improvement in populations, as well as enhanced productivity and economic growth.[78] This document was labeled the SUN framework, and was launched by the UN General Assembly in 2010 as a road map encouraging the coherence of stakeholders like governments, academia, UN system organizations and foundations in working towards reducing under nutrition.[78] The SUN framework has initiated a transformation in global nutrition- calling for country-based nutrition programs, increasing evidence based and costeffective interventions, and integrating nutrition within national strategies for gender equality, agriculture, food security, social protection, education, water supply, sanitation, and health care.[78] Government often plays a role in implementing nutrition programs through policy. For instance, several East Asian nations have enacted legislation to increase iodization of salt to increase household consumption.[3] Political commitment in the form of evidence-based effective national policies and programs, trained skilled community nutrition workers, and effective communication and advocacy can all work to decrease malnutrition.[48] Market and industrial production can play a role as well. For example, in the Philippines, improved production and market availability of iodized salt increased household consumption.[3] While most nutrition interventions are delivered directly through governments and health services, other sectors, such as agriculture, water and sanitation, and education, are vital for nutrition promotion as well.[4]

Nutrition is taught in schools in many countries. In England and Wales the Personal and Social Education and Food Technology curricula include nutrition, stressing the importance of a balanced diet and teaching how to read nutrition labels on packaging. In many schools a Nutrition class will fall within the Family and Consumer Science or Health departments. In some American schools, students are required to take a certain number of FCS or Health related classes. Nutrition is offered at many schools, and if it is not a class of its own, nutrition is included in other FCS or Health classes such as: Life Skills, Independent Living, Single Survival, Freshmen Connection, Health etc. In many Nutrition classes, students learn about the food groups, the food pyramid, Daily Recommended Allowances, calories, vitamins, minerals, malnutrition, physical activity, healthy food choices and how to live a healthy life.[medical citation needed]

A 1985 US National Research Council report entitled Nutrition Education in US Medical Schools concluded that nutrition education in medical schools was inadequate.[79] Only 20% of the schools surveyed taught nutrition as a separate, required course. A 2006 survey found that this number had risen to 30%.[80]

Individuals with highly active lifestyles require more nutrients. Furthermore, recent studies declared that increasing dietary intake of carbohydrates, proteins and Vitamin D may be part of improving athlete's level of performance [81]

Protein is an important component of every cell in the body. Hair and nails are mostly made of protein. The body uses protein to build and repair tissues. Also protein is used to make enzymes, hormones, and other body chemicals. Protein is an important building block of bones, muscles, cartilage, skin, and blood.[medical citation needed]

The protein requirement for each individual differs, as do opinions about whether and to what extent physically active people require more protein. The 2005 Recommended Dietary Allowances (RDA), aimed at the general healthy adult population, provide for an intake of 0.8 1grams of protein per kilogram of body weight (according to the BMI formula), with the review panel stating that "no additional dietary protein is suggested for healthy adults undertaking resistance or endurance exercise".[82]

The main fuel used by the body during exercise is carbohydrates, which is stored in muscle as glycogen a form of sugar. During exercise, muscle glycogen reserves can be used up, especially when activities last longer than 90min.[83] Because the amount of glycogen stored in the body is limited, it is important for athletes to replace glycogen by consuming a diet high in carbohydrates. Meeting energy needs can help improve performance during the sport, as well as improve overall strength and endurance..[medical citation needed]

There are different kinds of carbohydrates: simple (for example from fruits) and complex (for example from grains such as wheat). Simple sugars can be from an unrefined natural source, or may be refined and added to processed food. A typical American consumes about 50% of their carbohydrates as refined sugars. Over the course of a year, the average American consumes 204 litres (54 US gallons @ 3.78l per gallon) of soft drinks, which contain the highest amount of added sugars.[84] Even though carbohydrates are necessary for humans to function, they are not all equally healthful. When machinery has been used to remove bits of high fiber, the carbohydrates are refined. These are the carbohydrates found in white bread and fast food.[85]

Studies have shown that nutritional status of women pre-conception (specifically body weight) has an influence on foetal growth. However during pregnancy, nutritional intake by the mother is believed not to have any effect during the first and second trimesters, but maternal nutritional intake in the last trimester is widely believed to have some effect on the foetal growth, and therefore maternal nutrition plays a vital role in the development and growth of the foetus.[86]

Adequate nutrition is essential for the growth of children from infancy right through until adolescence. Some nutrients are specifically required for growth on top of nutrients required for normal body maintenance, in particular calcium and iron.[87]

Chwang (2012) reports that malnutrition is higher among the elderly.[88] This article highlights the uneven distribution of nutrients between developed and undeveloped countries. For example, most European countries has a high fat intake; while, the Malaysian elderly were found to have insufficient intake of calcium, thiamine and riboflavin.[88]

Humans have evolved as omnivorous hunter-gatherers over the past 250,000 years. The diet of early modern humans varied significantly depending on location and climate. The diet in the tropics tended to depend more heavily on plant foods, while the diet at higher latitudes tended more towards animal products. Analyses of postcranial and cranial remains of humans and animals from the Neolithic, along with detailed bone-modification studies, have shown that cannibalism also occurred among prehistoric humans.[89]

Agriculture developed about 10,000 years ago in multiple locations throughout the world, providing grains (such as wheat, rice and maize) and potatoes; and originating staples such as bread, pasta (attested from 1154[90]), and tortillas. Farming also provided milk and dairy products, and sharply increased the availability of meats and the diversity of vegetables.[citation needed] The importance of food purity was recognized[by whom?] when bulk storage led to infestation and contamination risks.[citation needed]Cooking developed as an often ritualistic activity,[91] due to efficiency and reliability concerns requiring adherence to strict recipes and procedures, and in response to demands for food purity and consistency.[92]

Around 3000 BC the Vedic texts made mention of scientific research on nutrition. The Bible's Book of Daniel recounts first recorded nutritional experiment. During an invasion of Judah, King Nebuchadnezzar of Babylon captured Daniel and his friends. Selected as court servants, they were to share in the king's fine foods and wine. But they objected, preferring vegetables (pulses) and water in accordance with their Jewish dietary restrictions. The king's chief steward reluctantly agreed to a trial.[citation needed] Daniel and his friends received their diet for 10 days. On comparison with the king's men, they appeared healthier, and were allowed to continue with their diet.[93] Around 475 BC, Anaxagoras stated that food is absorbed by the human body and therefore contained "homeomerics" (generative components), suggesting the existence of nutrients.[92] Around 400 BC, Hippocrates said: "Let food be your medicine and medicine be your food."[94]

The 16th-century scientist and artist Leonardo da Vinci (14521519) compared metabolism to a burning candle. In 1747 Dr. James Lind, a physician in the British navy, performed the first attested scientific nutrition experiment, discovering that lime juice saved sailors who had been at sea for years from scurvy, a deadly and painful bleeding disorder. The discovery was ignored[by whom?] for forty years, but after about 1850 British sailors became known as "limeys". (Scientists would not identify the essential vitamin C within lime juice until the 1930s.)[citation needed]

Around 1770 Antoine Lavoisier, the "Father of Nutrition and Chemistry", discovered the details of metabolism, demonstrating that the oxidation of food is the source of body heat. In 1790 George Fordyce recognized calcium as necessary for fowl survival. In the early 19th century, the elements carbon, nitrogen, hydrogen and oxygen were recognized[by whom?] as the primary components of food, and methods to measure their proportions were developed.[citation needed]

In 1816 Franois Magendie discovered that dogs fed only carbohydrates and fat lost their body protein and died in a few weeks, but dogs also fed protein survived, identifying protein as an essential dietary component.[citation needed] In 1840, Justus Liebig discovered the chemical makeup of carbohydrates (sugars), fats (fatty acids) and proteins (amino acids). In the 1860s Claude Bernard discovered that body fat can be synthesized from carbohydrate and protein, showing that the energy in blood glucose can be stored as fat or as glycogen.[medical citation needed]In the early 1880s Kanehiro Takaki observed that Japanese sailors (whose diets consisted almost entirely of white rice) developed beriberi (or endemic neuritis, a disease causing heart problems and paralysis), but British sailors and Japanese naval officers did not. Adding various types of vegetables and meats to the diets of Japanese sailors prevented the disease.[medical citation needed]

In 1896 Eugen Baumann observed iodine in thyroid glands. In 1897, Christiaan Eijkman worked with natives of Java, who also suffered from beriberi. Eijkman observed that chickens fed the native diet of white rice developed the symptoms of beriberi, but remained healthy when fed unprocessed brown rice with the outer bran intact. Eijkman cured the natives by feeding them brown rice, demonstrating that food can cure disease. Over two decades later, nutritionists learned that the outer rice bran contains vitamin B[medical citation needed]

In the early 20th century Carl von Voit and Max Rubner independently measured caloric energy expenditure in different species of animals, applying principles of physics in nutrition. In 1906, Wilcock and Hopkins showed that the amino acid tryptophan was necessary for the survival of rats. He[who?] fed them a special mixture of food containing all the nutrients he believed were essential for survival, but the rats died. A second group of rats to which he also fed an amount of milk containing vitamins.[95]Gowland Hopkins recognized "accessory food factors" other than calories, protein and minerals, as organic materials essential to health but which the body cannot synthesize. In 1907 Stephen M. Babcock and Edwin B. Hart conducted the single-grain experiment. This experiment ran through 1911.[citation needed]

In 1912 Casimir Funk coined the term vitamin to label a vital factor in the diet: from the words "vital" and "amine," because these unknown substances preventing scurvy, beriberi, and pellagra, were thought then to derive from ammonia. The vitamins were studied[by whom?] in the first half of the 20th century. In 1913 Elmer McCollum discovered the first vitamins, fat-soluble vitamin A and water-soluble vitamin B (in 1915; later identified as a complex of several water-soluble vitamins) and named vitamin C as the then-unknown substance preventing scurvy. Lafayette Mendel (1872-1935) and Thomas Osborne (18591929) also performed pioneering work on vitamins A and B. In 1919 Sir Edward Mellanby incorrectly identified rickets as a vitamin A deficiency, because he could cure it in dogs with cod-liver oil.[96] In 1922 McCollum destroyed the vitamin A in cod liver oil but found it still cured rickets, thus identifying vitamin D. Also in 1922, H.M. Evans and L.S. Bishop discovered vitamin E as essential for rat pregnancy, and originally called it "food factor X" until 1925.[citation needed]

In 1925 Hart discovered that iron absorption requires trace amounts of copper. In 1927 Adolf Otto Reinhold Windaus synthesized vitamin D, for which he won the Nobel Prize in Chemistry in 1928. In 1928 Albert Szent-Gyrgyi isolated ascorbic acid, and in 1932 proved that it is vitamin C by preventing scurvy. In 1935 he synthesized it, and in 1937 won a Nobel Prize for his efforts. Szent-Gyrgyi concurrently elucidated much of the citric acid cycle. In the 1930s William Cumming Rose identified essential amino acids, necessary protein components which the body cannot synthesize. In 1935 Eric Underwood and Hedley Marston independently discovered the necessity of cobalt. In 1936 Eugene Floyd Dubois showed that work and school performance relate to caloric intake. In 1938 Erhard Fernholz discovered the chemical structure of vitamin E. It was synthesised by Paul Karrer (18891971).[citation needed]

From 1940 rationing in the United Kingdom during and after World War II took place according to nutritional principles drawn up by Elsie Widdowson and others. In 1941 the National Research Council established the first Recommended Dietary Allowances (RDAs). In 1992 the U.S. Department of Agriculture introduced the Food Guide Pyramid. In 2002 a Natural Justice study showed a relation between nutrition and violent behavior. In 2005 a study found that in addition to bad nutrition, adenovirus may cause obesity.[97]

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Alzheimer’s Disease – Cedars-Sinai

Posted: October 28, 2016 at 8:42 pm


Symptoms of Alzheimers disease include:

The severity of these symptoms is related directly to the stage of disease, which often progresses slowly. Most patients are diagnosed once the disease progresses to mild dementia, when the patient or their family notice mood swings, personality changes, memory loss, or difficulty organizing and expressing thoughts or performing complex tasks. Patients may find themselves becoming more easily confused and having difficulty coping with new situations.

As the disease progresses, patients may need help with daily activities that were once routine, such as grooming. In the late stages of Alzheimers disease, the patients physical capabilities will be affected.

The causes of Alzheimers disease are still under investigation, but scientists currently believe a combination of genetic, lifestyle and environmental factors is responsible.

While Alzheimers disease is not a normal part of the aging process, the risk of developing the disease increases significantly in patients older than 65. The risk of developing the disease also is increased if the patient has a parent or sibling diagnosed with the condition, or if they have experienced severe or repeated head trauma. In fewer than 5 percent of cases, the disease is linked to specific changes in a persons genetic makeup.

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Perricone MD Official Site | Anti-Aging Skin Care

Posted: October 26, 2016 at 1:41 pm


Extreme Loss of Elasticity Shop All Products

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Help prevent and correct the signs of sun damage such as surface discoloration and loss of radiance with Dr. Perricones proprietary anti-aging technologies including Vitamin C Ester.

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Longevity – Wikipedia

Posted: October 25, 2016 at 5:40 pm


The word "longevity" is sometimes used as a synonym for "life expectancy" in demography - however, the term "longevity" is sometimes meant to refer only to especially long-lived members of a population, whereas "life expectancy" is always defined statistically as the average number of years remaining at a given age. For example, a population's life expectancy at birth is the same as the average age at death for all people born in the same year (in the case of cohorts). Longevity is best thought of as a term for general audiences meaning 'typical length of life' and specific statistical definitions should be clarified when necessary.

Reflections on longevity have usually gone beyond acknowledging the brevity of human life and have included thinking about methods to extend life. Longevity has been a topic not only for the scientific community but also for writers of travel, science fiction, and utopian novels.

There are many difficulties in authenticating the longest human life span ever by modern verification standards, owing to inaccurate or incomplete birth statistics. Fiction, legend, and folklore have proposed or claimed life spans in the past or future vastly longer than those verified by modern standards, and longevity narratives and unverified longevity claims frequently speak of their existence in the present.

A life annuity is a form of longevity insurance.

Various factors contribute to an individual's longevity. Significant factors in life expectancy include gender, genetics, access to health care, hygiene, diet and nutrition, exercise, lifestyle, and crime rates. Below is a list of life expectancies in different types of countries:[3]

Population longevities are increasing as life expectancies around the world grow:[1][4]

The Gerontology Research Group validates current longevity records by modern standards, and maintains a list of supercentenarians; many other unvalidated longevity claims exist. Record-holding individuals include:[citation needed]

Evidence-based studies indicate that longevity is based on two major factors, genetics and lifestyle choices.[5]

Twin studies have estimated that approximately 20-30% the variation in human lifespan can be related to genetics, with the rest due to individual behaviors and environmental factors which can be modified.[6] Although over 200 gene variants have been associated with longevity according to a US-Belgian-UK research database of human genetic variants,[7] these explain only a small fraction of the heritability.[8] A 2012 study found that even modest amounts of leisure time physical exercise can extend life expectancy by as much as 4.5 years.[9]

Lymphoblastoid cell lines established from blood samples of centenarians have significantly higher activity of the DNA repair protein PARP (Poly ADP ribose polymerase) than cell lines from younger (20 to 70 year old) individuals.[10] The lymphocytic cells of centenarians have characteristics typical of cells from young people, both in their capability of priming the mechanism of repair after H2O2 sublethal oxidative DNA damage and in their PARP gene expression.[11] These findings suggest that elevated PARP gene expression contributes to the longevity of centenarians, consistent with the DNA damage theory of aging.[12]

A study of the regions of the world known as blue zones, where people commonly live active lives past 100 years of age, speculated that longevity is related to a healthy social and family life, not smoking, eating a plant-based diet, frequent consumption of legumes and nuts, and engaging in regular physical activity.[13] In a cohort study, the combination of a plant based diet, normal BMI, and not smoking accounted for differences up to 15 years in life expectancy.[14] Korean court records going back to 1392 indicate that the average lifespan of eunuchs was 70.0 1.76 years, which was 14.419.1 years longer than the lifespan of non-castrated men of similar socio-economic status.[15] The Alameda County Study hypothesized three additional lifestyle characteristics that promote longevity: limiting alcohol consumption, sleeping 7 to 8 hours per night, and not snacking (eating between meals), although the study found the association between these characteristics and mortality is "weak at best".[16] There are however many other possible factors potentially affecting longevity, including the impact of high peer competition, which is typically experienced in large cities.[17]

In preindustrial times, deaths at young and middle age were more common than they are today. This is not due to genetics, but because of environmental factors such as disease, accidents, and malnutrition, especially since the former were not generally treatable with pre-20th century medicine. Deaths from childbirth were common in women, and many children did not live past infancy. In addition, most people who did attain old age were likely to die quickly from the above-mentioned untreatable health problems. Despite this, we do find many examples of pre-20th century individuals attaining lifespans of 75 years or greater, including Benjamin Franklin, Thomas Jefferson, John Adams, Cato the Elder, Thomas Hobbes, Eric of Pomerania, Christopher Polhem, and Michelangelo. This was also true for poorer people like peasants or laborers. Genealogists will almost certainly find ancestors living to their 70s, 80s and even 90s several hundred years ago.

For example, an 1871 census in the UK (the first of its kind, but personal data from other censuses dates back to 1841 and numerical data back to 1801) found the average male life expectancy as being 44, but if infant mortality is subtracted, males who lived to adulthood averaged 75 years. The present male life expectancy in the UK is 77 years for males and 81 for females, while the United States averages 74 for males and 80 for females.

Studies have shown that black American males have the shortest lifespans of any group of people in the US, averaging only 69 years (Asian-American females average the longest).[18] This reflects overall poorer health and greater prevalence of heart disease, obesity, diabetes, and cancer among black American men.

Women normally outlive men, and this was as true in pre-industrial times as today. Theories for this include smaller bodies (and thus less stress on the heart), a stronger immune system (since testosterone acts as an immunosuppressant), and less tendency to engage in physically dangerous activities.

There is a current debate as to whether or not the pursuit of longevity is a worthwhile health care goal for the United States. Bioethicist Ezekiel Emanuel, who is also one of the architects of ObamaCare, has stated that the pursuit of longevity via the compression of morbidity explanation is a "fantasy" and that life is not worth living after age 75; therefore longevity should not be a goal of health care policy.[19] This has been refuted by neurosurgeon Miguel Faria, who states that life can be worthwhile in healthy old age; that the compression of morbidity is a real phenomenon; that longevity should be pursued in association with quality of life.[20] Faria has discussed how longevity in association with leading healthy lifestyles can lead to the postponement of senescence as well as happiness and wisdom in old age.[21]

All of the biological organisms have a limited longevity, and different species of animals and plants have different potentials of longevity. Misrepair-accumulation aging theory [22][23] suggests that the potential of longevity of an organism is related to its structural complexity.[24] Limited longevity is due to the limited structural complexity of the organism. If a species of organisms has too high structural complexity, most of its individuals would die before the reproduction age, and the species could not survive. This theory suggests that limited structural complexity and limited longevity are essential for the survival of a species.

Longevity traditions are traditions about long-lived people (generally supercentenarians), and practices that have been believed to confer longevity.[25][26] A comparison and contrast of "longevity in antiquity" (such as the Sumerian King List, the genealogies of Genesis, and the Persian Shahnameh) with "longevity in historical times" (common-era cases through twentieth-century news reports) is elaborated in detail in Lucian Boia's 2004 book Forever Young: A Cultural History of Longevity from Antiquity to the Present and other sources.[27]

The Fountain of Youth reputedly restores the youth of anyone who drinks of its waters. The New Testament, following older Jewish tradition, attributes healing to the Pool of Bethesda when the waters are "stirred" by an angel.[28] After the death of Juan Ponce de Len, Gonzalo Fernndez de Oviedo y Valds wrote in Historia General y Natural de las Indias (1535) that Ponce de Len was looking for the waters of Bimini to cure his aging.[29] Traditions that have been believed to confer greater human longevity also include alchemy,[30] such as that attributed to Nicolas Flamel. In the modern era, the Okinawa diet has some reputation of linkage to exceptionally high ages.[31]

More recent longevity claims are subcategorized by many editions of Guinness World Records into four groups: "In late life, very old people often tend to advance their ages at the rate of about 17 years per decade .... Several celebrated super-centenarians (over 110 years) are believed to have been double lives (father and son, relations with the same names or successive bearers of a title) .... A number of instances have been commercially sponsored, while a fourth category of recent claims are those made for political ends ...."[32] The estimate of 17 years per decade was corroborated by the 1901 and 1911 British censuses.[32] Mazess and Forman also discovered in 1978 that inhabitants of Vilcabamba, Ecuador, claimed excessive longevity by using their fathers' and grandfathers' baptismal entries.[32][33]Time magazine considered that, by the Soviet Union, longevity had been elevated to a state-supported "Methuselah cult".[34]Robert Ripley regularly reported supercentenarian claims in Ripley's Believe It or Not!, usually citing his own reputation as a fact-checker to claim reliability.[35]

The U.S. Census Bureau view on the future of longevity is that life expectancy in the United States will be in the mid-80s by 2050 (up from 77.85 in 2006) and will top out eventually in the low 90s, barring major scientific advances that can change the rate of human aging itself, as opposed to merely treating the effects of aging as is done today. The Census Bureau also predicted that the United States would have 5.3 million people aged over 100 in 2100. The United Nations has also made projections far out into the future, up to 2300, at which point it projects that life expectancies in most developed countries will be between 100 and 106 years and still rising, though more and more slowly than before. These projections also suggest that life expectancies in poor countries will still be less than those in rich countries in 2300, in some cases by as much as 20 years. The UN itself mentioned that gaps in life expectancy so far in the future may well not exist, especially since the exchange of technology between rich and poor countries and the industrialization and development of poor countries may cause their life expectancies to converge fully with those of rich countries long before that point, similarly to the way life expectancies between rich and poor countries have already been converging over the last 60 years as better medicine, technology, and living conditions became accessible to many people in poor countries. The UN has warned that these projections are uncertain, and cautions that any change or advancement in medical technology could invalidate such projections.[36]

Recent increases in the rates of lifestyle diseases, such as obesity, diabetes, hypertension, and heart disease, may eventually slow or reverse this trend toward increasing life expectancy in the developed world, but have not yet done so. The average age of the US population is getting higher[37] and these diseases show up in older people.[38]

Jennifer Couzin-Frankel examined how much mortality from various causes would have to drop in order to boost life expectancy and concluded that most of the past increases in life expectancy occurred because of improved survival rates for young people. She states that it seems unlikely that life expectancy at birth will ever exceed 85 years.[39]Michio Kaku argues that genetic engineering, nanotechnology and future breakthroughs will accelerate the rate of life expectancy increase indefinitely.[40] Already genetic engineering has allowed the life expectancy of certain primates to be doubled, and for human skin cells in labs to divide and live indefinitely without becoming cancerous.[41]

However, since 1840, record life expectancy has risen linearly for men and women, albeit more slowly for men. For women the increase has been almost three months per year, for men almost 2.7 months per year. In light of steady increase, without any sign of limitation, the suggestion that life expectancy will top out must be treated with caution. Scientists Oeppen and Vaupel observe that experts who assert that "life expectancy is approaching a ceiling ... have repeatedly been proven wrong." It is thought that life expectancy for women has increased more dramatically owing to the considerable advances in medicine related to childbirth.[42]

Mice have been genetically engineered to live twice as long as ordinary mice. Drugs such as deprenyl are a part of the prescribing pharmacopia of veterinarians specifically to increase mammal lifespan. A large plurality of research chemicals have been described at the scientific literature that increase the lifespan of a number of species.

Some argue that molecular nanotechnology will greatly extend human life spans. If the rate of increase of life span can be raised with these technologies to a level of twelve months increase per year, this is defined as effective biological immortality and is the goal of radical life extension.

Currently living:

Non-living:

Certain exotic organisms do not seem to be subject to aging and can live indefinitely. Examples include Tardigrades and Hydras. That is not to say that these organisms cannot die, merely that they only die as a result of disease or injury rather than age-related deterioration (and that they are not subject to the Hayflick limit).

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Life extension – Wikipedia

Posted: October 24, 2016 at 10:40 am


Life extension science, also known as anti-aging medicine, indefinite life extension, experimental gerontology, and biomedical gerontology, is the study of slowing down or reversing the processes of aging to extend both the maximum and average lifespan. Some researchers in this area, and "life extensionists", "immortalists" or "longevists" (those who wish to achieve longer lives themselves), believe that future breakthroughs in tissue rejuvenation, stem cells, regenerative medicine, molecular repair, gene therapy, pharmaceuticals, and organ replacement (such as with artificial organs or xenotransplantations) will eventually enable humans to have indefinite lifespans (agerasia[1]) through complete rejuvenation to a healthy youthful condition.

The sale of purported anti-aging products such as nutrition, physical fitness, skin care, hormone replacements, vitamins, supplements and herbs is a lucrative global industry, with the US market generating about $50billion of revenue each year.[2] Some medical experts state that the use of such products has not been proven to affect the aging process and many claims regarding the efficacy of these marketed products have been roundly criticized by medical experts, including the American Medical Association.[2][3][4][5][6]

The ethical ramifications of life extension are debated by bioethicists.

During the process of aging, an organism accumulates damage to its macromolecules, cells, tissues, and organs. Specifically, aging is characterized as and thought to be caused by "genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication."[7]Oxidation damage to cellular contents caused by free radicals is believed to contribute to aging as well.[8][8][9]

The longest a human has ever been proven to live is 122 years, the case of Jeanne Calment who was born in 1875 and died in 1997, whereas the maximum lifespan of a wildtype mouse, commonly used as a model in research on aging, is about three years.[10] Genetic differences between humans and mice that may account for these different aging rates include differences in efficiency of DNA repair, antioxidant defenses, energy metabolism, proteostasis maintenance, and recycling mechanisms such as autophagy.[11]

Average lifespan in a population is lowered by infant and child mortality, which are frequently linked to infectious diseases or nutrition problems. Later in life, vulnerability to accidents and age-related chronic disease such as cancer or cardiovascular disease play an increasing role in mortality. Extension of expected lifespan can often be achieved by access to improved medical care, vaccinations, good diet, exercise and avoidance of hazards such as smoking.

Maximum lifespan is determined by the rate of aging for a species inherent in its genes and by environmental factors. Widely recognized methods of extending maximum lifespan in model organisms such as nematodes, fruit flies, and mice include caloric restriction, gene manipulation, and administration of pharmaceuticals.[12] Another technique uses evolutionary pressures such as breeding from only older members or altering levels of extrinsic mortality.[13][14] Some animals such as hydra, planarian flatworms, and certain sponges, corals, and jellyfish do not die of old age and exhibit potential immortality.[15][16][17][18]

Theoretically, extension of maximum lifespan in humans could be achieved by reducing the rate of aging damage by periodic replacement of damaged tissues, molecular repair or rejuvenation of deteriorated cells and tissues, reversal of harmful epigenetic changes, or the enhancement of telomerase enzyme activity.[19][20]

Research geared towards life extension strategies in various organisms is currently under way at a number of academic and private institutions. Since 2009, investigators have found ways to increase the lifespan of nematode worms and yeast by 10-fold; the record in nematodes was achieved through genetic engineering and the extension in yeast by a combination of genetic engineering and caloric restriction.[21] A 2009 review of longevity research noted: "Extrapolation from worms to mammals is risky at best, and it cannot be assumed that interventions will result in comparable life extension factors. Longevity gains from dietary restriction, or from mutations studied previously, yield smaller benefits to Drosophila than to nematodes, and smaller still to mammals. This is not unexpected, since mammals have evolved to live many times the worm's lifespan, and humans live nearly twice as long as the next longest-lived primate. From an evolutionary perspective, mammals and their ancestors have already undergone several hundred million years of natural selection favoring traits that could directly or indirectly favor increased longevity, and may thus have already settled on gene sequences that promote lifespan. Moreover, the very notion of a "life-extension factor" that could apply across taxa presumes a linear response rarely seen in biology."[21]

Much life extension research focuses on nutritiondiets or supplementsas a means to extend lifespan, although few of these have been systematically tested for significant longevity effects. The many diets promoted by anti-aging advocates are often contradictory.[original research?] A dietary pattern with some support from scientific research is caloric restriction.[22][23]

Preliminary studies of caloric restriction on humans using surrogate measurements have provided evidence that caloric restriction may have powerful protective effect against secondary aging in humans. Caloric restriction in humans may reduce the risk of developing Type 2 diabetes and atherosclerosis.[24]

The free-radical theory of aging suggests that antioxidant supplements, such as vitaminC, vitaminE, Q10, lipoic acid, carnosine, and N-acetylcysteine, might extend human life. However, combined evidence from several clinical trials suggest that -carotene supplements and high doses of vitaminE increase mortality rates.[25]Resveratrol is a sirtuin stimulant that has been shown to extend life in animal models, but the effect of resveratrol on lifespan in humans is unclear as of 2011.[26]

There are many traditional herbs purportedly used to extend the health-span, including a Chinese tea called Jiaogulan (Gynostemma pentaphyllum), dubbed "China's Immortality Herb."[27]Ayurveda, the traditional Indian system of medicine, describes a class of longevity herbs called rasayanas, including Bacopa monnieri, Ocimum sanctum, Curcuma longa, Centella asiatica, Phyllanthus emblica, Withania somnifera and many others.[27]

The anti-aging industry offers several hormone therapies. Some of these have been criticized for possible dangers to the patient and a lack of proven effect. For example, the American Medical Association has been critical of some anti-aging hormone therapies.[2]

Although some recent clinical studies have shown that low-dose growth hormone (GH) treatment for adults with GH deficiency changes the body composition by increasing muscle mass, decreasing fat mass, increasing bone density and muscle strength, improves cardiovascular parameters (i.e. decrease of LDL cholesterol), and affects the quality of life without significant side effects,[28][29][30] the evidence for use of growth hormone as an anti-aging therapy is mixed and based on animal studies. There are mixed reports that GH or IGF-1 signaling modulates the aging process in humans and about whether the direction of its effect is positive or negative.[31]

Some critics dispute the portrayal of aging as a disease. For example, Leonard Hayflick, who determined that fibroblasts are limited to around 50cell divisions, reasons that aging is an unavoidable consequence of entropy. Hayflick and fellow biogerontologists Jay Olshansky and Bruce Carnes have strongly criticized the anti-aging industry in response to what they see as unscrupulous profiteering from the sale of unproven anti-aging supplements.[4]

Politics relevant to the substances of life extension pertain mostly to communications and availability.[citation needed]

In the United States, product claims on food and drug labels are strictly regulated. The First Amendment (freedom of speech) protects third-party publishers' rights to distribute fact, opinion and speculation on life extension practices. Manufacturers and suppliers also provide informational publications, but because they market the substances, they are subject to monitoring and enforcement by the Federal Trade Commission (FTC), which polices claims by marketers. What constitutes the difference between truthful and false claims is hotly debated and is a central controversy in this arena.[citation needed]

Research by Sobh and Martin (2011) suggests that people buy anti-aging products to obtain a hoped-for self (e.g., keeping a youthful skin) or to avoid a feared-self (e.g., looking old). The research shows that when consumers pursue a hoped-for self, it is expectations of success that most strongly drive their motivation to use the product. The research also shows why doing badly when trying to avoid a feared self is more motivating than doing well. Interestingly, when product use is seen to fail it is more motivating than success when consumers seek to avoid a feared-self.[32]

The best-characterized anti-aging therapy was, and still is, CR. In some studies calorie restriction has been shown to extend the life of mice, yeast, and rhesus monkeys significantly.[33][34] However, a more recent study has shown that in contrast, calorie restriction has not improved the survival rate in rhesus monkeys.[35] Long-term human trials of CR are now being done. It is the hope of the anti-aging researchers that resveratrol, found in grapes, or pterostilbene, a more bio-available substance, found in blueberries, as well as rapamycin, a biotic substance discovered on Easter Island, may act as CR mimetics to increase the life span of humans.[36]

More recent work reveals that the effects long attributed to caloric restriction may be obtained by restriction of protein alone, and specifically of just the sulfur-containing amino acids cysteine and methionine.[37][38] Current research is into the metabolic pathways affected by variation in availability of products of these amino acids.

There are a number of chemicals intended to slow the aging process currently being studied in animal models.[39] One type of research is related to the observed effects a calorie restriction (CR) diet, which has been shown to extend lifespan in some animals[40] Based on that research, there have been attempts to develop drugs that will have the same effect on the aging process as a caloric restriction diet, which are known as Caloric restriction mimetic drugs. Some drugs that are already approved for other uses have been studied for possible longevity effects on laboratory animals because of a possible CR-mimic effect; they include rapamycin,[41]metformin and other geroprotectors.[42]MitoQ, Resveratrol and pterostilbene are dietary supplements that have also been studied in this context.[36][43][44]

Other attempts to create anti-aging drugs have taken different research paths. One notable direction of research has been research into the possibility of using the enzyme telomerase in order to counter the process of telomere shortening.[45] However, there are potential dangers in this, since some research has also linked telomerase to cancer and to tumor growth and formation.[46] In addition, some preparations, called senolytics are designed to effectively deplete senescent cells which poison an organism by their secretions.[47]

Future advances in nanomedicine could give rise to life extension through the repair of many processes thought to be responsible for aging. K. Eric Drexler, one of the founders of nanotechnology, postulated cell repair machines, including ones operating within cells and utilizing as yet hypothetical molecular computers, in his 1986 book Engines of Creation. Raymond Kurzweil, a futurist and transhumanist, stated in his book The Singularity Is Near that he believes that advanced medical nanorobotics could completely remedy the effects of aging by 2030.[48] According to Richard Feynman, it was his former graduate student and collaborator Albert Hibbs who originally suggested to him (circa 1959) the idea of a medical use for Feynman's theoretical micromachines (see nanotechnology). Hibbs suggested that certain repair machines might one day be reduced in size to the point that it would, in theory, be possible to (as Feynman put it) "swallow the doctor". The idea was incorporated into Feynman's 1959 essay There's Plenty of Room at the Bottom.[49]

Some life extensionists suggest that therapeutic cloning and stem cell research could one day provide a way to generate cells, body parts, or even entire bodies (generally referred to as reproductive cloning) that would be genetically identical to a prospective patient. Recently, the US Department of Defense initiated a program to research the possibility of growing human body parts on mice.[50] Complex biological structures, such as mammalian joints and limbs, have not yet been replicated. Dog and primate brain transplantation experiments were conducted in the mid-20th century but failed due to rejection and the inability to restore nerve connections. As of 2006, the implantation of bio-engineered bladders grown from patients' own cells has proven to be a viable treatment for bladder disease.[51] Proponents of body part replacement and cloning contend that the required biotechnologies are likely to appear earlier than other life-extension technologies.

The use of human stem cells, particularly embryonic stem cells, is controversial. Opponents' objections generally are based on interpretations of religious teachings or ethical considerations. Proponents of stem cell research point out that cells are routinely formed and destroyed in a variety of contexts. Use of stem cells taken from the umbilical cord or parts of the adult body may not provoke controversy.[52]

The controversies over cloning are similar, except general public opinion in most countries stands in opposition to reproductive cloning. Some proponents of therapeutic cloning predict the production of whole bodies, lacking consciousness, for eventual brain transplantation.

Replacement of biological (susceptible to diseases) organs with mechanical ones could extend life. This is the goal of 2045 Initiative.[53]

For cryonicists (advocates of cryopreservation), storing the body at low temperatures after death may provide an "ambulance" into a future in which advanced medical technologies may allow resuscitation and repair. They speculate cryogenic temperatures will minimize changes in biological tissue for many years, giving the medical community ample time to cure all disease, rejuvenate the aged and repair any damage that is caused by the cryopreservation process.

Many cryonicists do not believe that legal death is "real death" because stoppage of heartbeat and breathingthe usual medical criteria for legal deathoccur before biological death of cells and tissues of the body. Even at room temperature, cells may take hours to die and days to decompose. Although neurological damage occurs within 46 minutes of cardiac arrest, the irreversible neurodegenerative processes do not manifest for hours.[54] Cryonicists state that rapid cooling and cardio-pulmonary support applied immediately after certification of death can preserve cells and tissues for long-term preservation at cryogenic temperatures. People, particularly children, have survived up to an hour without heartbeat after submersion in ice water. In one case, full recovery was reported after 45 minutes underwater.[55] To facilitate rapid preservation of cells and tissue, cryonics "standby teams" are available to wait by the bedside of patients who are to be cryopreserved to apply cooling and cardio-pulmonary support as soon as possible after declaration of death.[56]

No mammal has been successfully cryopreserved and brought back to life, with the exception of frozen human embryos. Resuscitation of a postembryonic human from cryonics is not possible with current science. Some scientists still support the idea based on their expectations of the capabilities of future science.[57][58]

Another proposed life extension technology would combine existing and predicted future biochemical and genetic techniques. SENS proposes that rejuvenation may be obtained by removing aging damage via the use of stem cells and tissue engineering, telomere-lengthening machinery, allotopic expression of mitochondrial proteins, targeted ablation of cells, immunotherapeutic clearance, and novel lysosomal hydrolases.[59]

While many biogerontologists find these ideas "worthy of discussion"[60][61] and SENS conferences feature important research in the field,[62][63] some contend that the alleged benefits are too speculative given the current state of technology, referring to it as "fantasy rather than science".[3][5]

Gene therapy, in which nucleic acid polymers are delivered as a drug and are either expressed as proteins, interfere with the expression of proteins, or correct genetic mutations, has been proposed as a future strategy to prevent aging.[64][65]

A large array of genetic modifications have been found to increase lifespan in model organisms such as yeast, nematode worms, fruit flies, and mice. As of 2013, the longest extension of life caused by a single gene manipulation was roughly 150% in mice and 10-fold in nematode worms.[66]

In The Selfish Gene, Richard Dawkins describes an approach to life-extension that involves "fooling genes" into thinking the body is young.[67] Dawkins attributes inspiration for this idea to Peter Medawar. The basic idea is that our bodies are composed of genes that activate throughout our lifetimes, some when we are young and others when we are older. Presumably, these genes are activated by environmental factors, and the changes caused by these genes activating can be lethal. It is a statistical certainty that we possess more lethal genes that activate in later life than in early life. Therefore, to extend life, we should be able to prevent these genes from switching on, and we should be able to do so by "identifying changes in the internal chemical environment of a body that take place during aging... and by simulating the superficial chemical properties of a young body".[68]

According to some lines of thinking, the ageing process is routed into a basic reduction of biological complexity,[69] and thus loss of information. In order to reverse this loss, gerontologist Marios Kyriazis suggested that it is necessary to increase input of actionable and meaningful information both individually (into individual brains),[70] and collectively (into societal systems).[71] This technique enhances overall biological function through up-regulation of immune, hormonal, antioxidant and other parameters, resulting in improved age-repair mechanisms. Working in parallel with natural evolutionary mechanisms that can facilitate survival through increased fitness, Kryiazis claims that the technique may lead to a reduction of the rate of death as a function of age, i.e. indefinite lifespan.[72]

One hypothetical future strategy that, as some suggest, "eliminates" the complications related to a physical body, involves the copying or transferring (e.g. by progressively replacing neurons with transistors) of a conscious mind from a biological brain to a non-biological computer system or computational device. The basic idea is to scan the structure of a particular brain in detail, and then construct a software model of it that is so faithful to the original that, when run on appropriate hardware, it will behave in essentially the same way as the original brain.[73] Whether or not an exact copy of one's mind constitutes actual life extension is matter of debate.

The extension of life has been a desire of humanity and a mainstay motif in the history of scientific pursuits and ideas throughout history, from the Sumerian Epic of Gilgamesh and the Egyptian Smith medical papyrus, all the way through the Taoists, Ayurveda practitioners, alchemists, hygienists such as Luigi Cornaro, Johann Cohausen and Christoph Wilhelm Hufeland, and philosophers such as Francis Bacon, Ren Descartes, Benjamin Franklin and Nicolas Condorcet. However, the beginning of the modern period in this endeavor can be traced to the end of the 19th beginning of the 20th century, to the so-called fin-de-sicle (end of the century) period, denoted as an end of an epoch and characterized by the rise of scientific optimism and therapeutic activism, entailing the pursuit of life extension (or life-extensionism). Among the foremost researchers of life extension at this period were the Nobel Prize winning biologist Elie Metchnikoff (1845-1916) -- the author of the cell theory of immunity and vice director of Institut Pasteur in Paris, and Charles-douard Brown-Squard (1817-1894) -- the president of the French Biological Society and one of the founders of modern endocrinology.[74]

Sociologist James Hughes claims that science has been tied to a cultural narrative of conquering death since the Age of Enlightenment. He cites Francis Bacon (15611626) as an advocate of using science and reason to extend human life, noting Bacon's novel New Atlantis, wherein scientists worked toward delaying aging and prolonging life. Robert Boyle (16271691), founding member of the Royal Society, also hoped that science would make substantial progress with life extension, according to Hughes, and proposed such experiments as "to replace the blood of the old with the blood of the young". Biologist Alexis Carrel (18731944) was inspired by a belief in indefinite human lifespan that he developed after experimenting with cells, says Hughes.[75]

In 1970, the American Aging Association was formed under the impetus of Denham Harman, originator of the free radical theory of aging. Harman wanted an organization of biogerontologists that was devoted to research and to the sharing of information among scientists interested in extending human lifespan.

In 1976, futurists Joel Kurtzman and Philip Gordon wrote No More Dying. The Conquest Of Aging And The Extension Of Human Life, (ISBN 0-440-36247-4) the first popular book on research to extend human lifespan. Subsequently, Kurtzman was invited to testify before the House Select Committee on Aging, chaired by Claude Pepper of Florida, to discuss the impact of life extension on the Social Security system.

Saul Kent published The Life Extension Revolution (ISBN 0-688-03580-9) in 1980 and created a nutraceutical firm called the Life Extension Foundation, a non-profit organization that promotes dietary supplements. The Life Extension Foundation publishes a periodical called Life Extension Magazine. The 1982 bestselling book Life Extension: A Practical Scientific Approach (ISBN 0-446-51229-X) by Durk Pearson and Sandy Shaw further popularized the phrase "life extension".

In 1983, Roy Walford, a life-extensionist and gerontologist, published a popular book called Maximum Lifespan. In 1988, Walford and his student Richard Weindruch summarized their research into the ability of calorie restriction to extend the lifespan of rodents in The Retardation of Aging and Disease by Dietary Restriction (ISBN 0-398-05496-7). It had been known since the work of Clive McCay in the 1930s that calorie restriction can extend the maximum lifespan of rodents. But it was the work of Walford and Weindruch that gave detailed scientific grounding to that knowledge.[citation needed] Walford's personal interest in life extension motivated his scientific work and he practiced calorie restriction himself. Walford died at the age of 80 from complications caused by amyotrophic lateral sclerosis.

Money generated by the non-profit Life Extension Foundation allowed Saul Kent to finance the Alcor Life Extension Foundation, the world's largest cryonics organization. The cryonics movement had been launched in 1962 by Robert Ettinger's book, The Prospect of Immortality. In the 1960s, Saul Kent had been a co-founder of the Cryonics Society of New York. Alcor gained national prominence when baseball star Ted Williams was cryonically preserved by Alcor in 2002 and a family dispute arose as to whether Williams had really wanted to be cryopreserved.

Regulatory and legal struggles between the Food and Drug Administration (FDA) and the Life Extension Foundation included seizure of merchandise and court action. In 1991, Saul Kent and Bill Faloon, the principals of the Foundation, were jailed. The LEF accused the FDA of perpetrating a "Holocaust" and "seeking gestapo-like power" through its regulation of drugs and marketing claims.[76]

In 2003, Doubleday published "The Immortal Cell: One Scientist's Quest to Solve the Mystery of Human Aging," by Michael D. West. West emphasised the potential role of embryonic stem cells in life extension.[77]

Other modern life extensionists include writer Gennady Stolyarov, who insists that death is "the enemy of us all, to be fought with medicine, science, and technology";[78]transhumanist philosopher Zoltan Istvan, who proposes that the "transhumanist must safeguard one's own existence above all else";[79] futurist George Dvorsky, who considers aging to be a problem that desperately needs to be solved;[80] and recording artist Steve Aoki, who has been called "one of the most prolific campaigners for life extension".[81]

In 1991, the American Academy of Anti-Aging Medicine (A4M) was formed as a non-profit organization to create what it considered an anti-aging medical specialty distinct from geriatrics, and to hold trade shows for physicians interested in anti-aging medicine. The A4M trains doctors in anti-aging medicine and publicly promotes the field of anti-aging research. It has about 26,000 members, of whom about 97% are doctors and scientists.[82] The American Board of Medical Specialties recognizes neither anti-aging medicine nor the A4M's professional standing.[83]

In 2003, Aubrey de Grey and David Gobel formed the Methuselah Foundation, which gives financial grants to anti-aging research projects. In 2009, de Grey and several others founded the SENS Research Foundation, a California-based scientific research organization which conducts research into aging and funds other anti-aging research projects at various universities.[84] In 2013, Google announced Calico, a new company based in San Francisco that will harness new technologies to increase scientific understanding of the biology of aging.[85] It is led by Arthur D. Levinson,[86] and its research team includes scientists such as Hal V. Barron, David Botstein, and Cynthia Kenyon. In 2014, biologist Craig Venter founded Human Longevity Inc., a company dedicated to scientific research to end aging through genomics and cell therapy. They received funding with the goal of compiling a comprehensive human genotype, microbiome, and phenotype database.[87]

Aside from private initiatives, aging research is being conducted in university laboratories, and includes universities such as Harvard and UCLA. University researchers have made a number of breakthroughs in extending the lives of mice and insects by reversing certain aspects of aging.[88][89][90][91]

Though many scientists state[92] that life extension and radical life extension are possible, there are still no international or national programs focused on radical life extension. There are political forces staying for and against life extension. By 2012, in Russia, the United States, Israel, and the Netherlands, the Longevity political parties started. They aimed to provide political support to radical life extension research and technologies, and ensure the fastest possible and at the same time soft transition of society to the next step life without aging and with radical life extension, and to provide access to such technologies to most currently living people.[93]

Leon Kass (chairman of the US President's Council on Bioethics from 2001 to 2005) has questioned whether potential exacerbation of overpopulation problems would make life extension unethical.[94] He states his opposition to life extension with the words:

"simply to covet a prolonged life span for ourselves is both a sign and a cause of our failure to open ourselves to procreation and to any higher purpose ... [The] desire to prolong youthfulness is not only a childish desire to eat one's life and keep it; it is also an expression of a childish and narcissistic wish incompatible with devotion to posterity."[95]

John Harris, former editor-in-chief of the Journal of Medical Ethics, argues that as long as life is worth living, according to the person himself, we have a powerful moral imperative to save the life and thus to develop and offer life extension therapies to those who want them.[96]

Transhumanist philosopher Nick Bostrom has argued that any technological advances in life extension must be equitably distributed and not restricted to a privileged few.[97] In an extended metaphor entitled "The Fable of the Dragon-Tyrant", Bostrom envisions death as a monstrous dragon who demands human sacrifices. In the fable, after a lengthy debate between those who believe the dragon is a fact of life and those who believe the dragon can and should be destroyed, the dragon is finally killed. Bostrom argues that political inaction allowed many preventable human deaths to occur.[98]

Life extension is a controversial topic due to fear of overpopulation and possible effects on society.[99] Biogerontologist Aubrey De Grey counters the overpopulation critique by pointing out that the therapy could postpone or eliminate menopause, allowing women to space out their pregnancies over more years and thus decreasing the yearly population growth rate.[100] Moreover, the philosopher and futurist Max More argues that, given the fact the worldwide population growth rate is slowing down and is projected to eventually stabilize and begin falling, superlongevity would be unlikely to contribute to overpopulation.[99]

A Spring 2013 Pew Research poll in the United States found that 38% of Americans would want life extension treatments, and 56% would reject it. However, it also found that 68% believed most people would want it and that only 4% consider an "ideal lifespan" to be more than 120 years. The median "ideal lifespan" was 91 years of age and the majority of the public (63%) viewed medical advances aimed at prolonging life as generally good. 41% of Americans believed that radical life extension (RLE) would be good for society, while 51% said they believed it would be bad for society.[101] One possibility for why 56% of Americans claim they would reject life extension treatments may be due to the cultural perception that living longer would result in a longer period of decrepitude, and that the elderly in our current society are unhealthy.[102]

Religious people are no more likely to oppose life extension than the unaffiliated,[101] though some variation exists between religious denominations.

Most mainstream medical organizations and practitioners do not consider aging to be a disease. David Sinclair says: "Idon't see aging as a disease, but as a collection of quite predictable diseases caused by the deterioration of the body".[103] The two main arguments used are that aging is both inevitable and universal while diseases are not.[104] However, not everyone agrees. Harry R. Moody, Director of Academic Affairs for AARP, notes that what is normal and what is disease strongly depends on a historical context.[105] David Gems, Assistant Director of the Institute of Healthy Ageing, strongly argues that aging should be viewed as a disease.[106] In response to the universality of aging, David Gems notes that it is as misleading as arguing that Basenji are not dogs because they do not bark.[107] Because of the universality of aging he calls it a 'special sort of disease'. Robert M. Perlman, coined the terms aging syndrome and disease complex in 1954 to describe aging.[108]

The discussion whether aging should be viewed as a disease or not has important implications. It would stimulate pharmaceutical companies to develop life extension therapies and in the United States of America, it would also increase the regulation of the anti-aging market by the FDA. Anti-aging now falls under the regulations for cosmetic medicine which are less tight than those for drugs.[107][109]

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Life extension - Wikipedia

Anti-aging cream – Wikipedia

Posted: October 22, 2016 at 6:43 pm


Anti-aging creams are predominantly moisturiser-based cosmeceutical skin care products marketed with the promise of making the consumer look younger by reducing, masking or preventing signs of skin aging. These signs are laxity (sagging), rhytids (wrinkles), and photoaging, which includes erythema (redness), dyspigmentation (brown discolorations), solar elastosis (yellowing), keratoses (abnormal growths), and poor texture.[1]

Despite great demand, many anti-aging products and treatments have not been proven to give lasting or major positive effects. One study found that the best performing creams reduced wrinkles by less than 10% over 12 weeks, which is not noticeable to the human eye.[2] Another study found that cheap moisturisers were as effective as high-priced anti-wrinkle creams.[3][4] A 2009 study at Manchester University showed that some ingredients had an effect.[5][6]

Traditionally, anti-aging creams have been marketed towards women, but products specifically targeting men are increasingly common.[7]

Anti-aging creams may include conventional moisturising ingredients. They also usually contain specific anti-aging ingredients, such as:

Traditional moisturisers or sunscreens may provide many of the same benefits as some anti-aging creams.

Facial toning, either by hand, hands-free devices or through electrostimulation of the facial muscles, is thought by some to reduce wrinkles.

Mechanical exfoliation is an alternative to chemical peels using ingredients such as crushed apricot kernals, salt, sponges or brushes.

Advertising sometimes presents anti-aging creams as an alternative to plastic surgery and botox injections, which may be more costly and invasive treatments.

Anti-aging and wrinkle creams are criticised by some for being expensive, unnatural, and not clinically proven to work.

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Anti-aging cream - Wikipedia

Face Exercises For Anti-Aging And Killer Non-Invasive …

Posted: October 18, 2016 at 2:42 am


FACELIFT WITHOUT SURGERYFACE EXERCISES FOR THE ULTIMATE NATURAL FACELIFT Looking younger for men and women has never been simpler: an acupressure facelift is easy to maintain and involves the massaging of certain nodal points on the face and body on a daily basis for the first 30 days. Then the results can be maintained 2 or 3 times a week. The regimens only take a few minutes, so they are ideal for people who are on the go.

In her ebook Facelift Without Surgery, Wendy Wilken demonstrates the facial exercise routines on each of the energy points. The system uses ancient Chinese facial yoga regimens that take mere minutes to apply(1 minute for each of the acupressure points), and are very easy to learn.

The benefits of this natural facial toning methodology illustrated in her downloadable ebook are:

She is living proof that these easy-to-learn facial aerobics exercises work miracles on the face! Feel free to browse this web page for more information on the ultimate anti-aging treatment.

THE BEST FACIAL YOGA TONING SYSTEM TO LOOK YOUNGER!

YOU NEED A NON-SURGICAL FACELIFT IF YOU ANSWER "YES" TO ANY OF THESE QUESTIONS

Facelift Without Surgery will make you look considerably younger using acupressure.

Your lines will soften or disappear with these facial yoga exercises.

Face exercises will halt and reduce the fatty deposits in eye bags and lessen dark rings.

This facelift exercise program will lift and firm the sagging skin.

Aging in the face and neck will be reversed using face gymnastics principles.

If you are not completely satisfied with this product, simply notify us any time within 60 Days and we will refund your money, in full, with absolutely no questions asked!

We only want happy super-satisfied customers proud to show off their DIY non-surgical facelifts, and if for some reason you don't get the results you desire, then we don't deserve your money.

All we ask is that you honestly apply the face yoga toning regimens demonstrated in Facelift Without Surgery every day for at least the first 30 days. That's it!

That's 60 full days to look younger by putting this facial workout system to the test. Read it, follow its advice, glean your own natural facelift and put an end to looking and feeling old, tired, and haggard once and for all - or get a full refund.

We dont think we could be any fairer than that.

So what are you waiting for? You have everything to gain and absolutely nothing to lose except the wrinkles!

=Cosmetic Surgery Facelift

Acupressure non-surgical facelifts are free of charge. No knife, no surgeon.

The Facelift Without Surgery program teaches oriental face gymnastics regimens that restore color, tone, youth, and beauty to the face and neck. Stimulating the underlying tissue and muscles of the face and neck is the secret to shedding years off one's looks!

The facial toning regimens demonstrated in the program plump up the underlying tissue, increase the blood circulation in the face and neck, open the energy points between the head, face, neck, and body and tighten the skin.

Facial aerobics workouts enhance the natural radiant glow to your face. It looks perfectly organic, and does not have that pulled look in places.

Facelift exercises will make you appear younger over a period. Proper anti-aging is an ongoing process that takes at least 30 days to perform, and beyond. People that have not seen you for a month will notice a considerable improvement in your appearance.

Facelift Without Surgery is the only true facial exercise program that treats stress, poor circulation, restores and channels energy and blood to the face and neck, and regenerates cell growth in the places where it matters.

Because Wendy's facial yoga toning system regenerates cell growth, the skin on your face and neck will look invigorated and will have a new glow. Youth will be restored to a considerable extent.

There is no risk with these face aerobics routines - you will definitely enjoy a fresher, firmer, younger appearance.

There is no risk of infection from facial workouts because they are not invasive.

This is an organic non-invasive face exercise program that leaves no cuts, bandages, swelling, or skin discoloration.

This form of non-surgical acupressure facelift is permanent because it also treats the underlying tissue as long as it is performed every day for the first 30 days, then routinely maintained a few minutes a week thereafter.

The techniques demonstrated in the program are performed, controlled, and maintained with the use of your own fingertips. You can perform the techniques in the comfort of your own home.

These facial gymnastics routines enhance and channel the energy and blood flow to the face, head and neck. They stimulates cell growth and regeneration.

WHAT WENDY WILKEN FACELIFT WITHOUT SURGERY PROGRAM REVEALS

BEFORE & AFTER PHOTOS OF NON-SURGICAL FACELIFTS

The outcome, after performing the techniques revealed in Facelift Without Surgery will be similar or better than these. Results will vary and are dependent on one's commitment to facial exercises. Men and women benefit hugely from face yoga toning.

Wow! Look at that!

She looks a lot younger now...and counting!

Sagging neck and face skin tightened...

EXAMPLE FROM THE DOWNLOADABLE FACIAL YOGA EBOOK

You should see the difference after a few days. In fact, dont be surprised if others notice it first. You might be accused of having a cosmetic facelift, but how did you get that face glow? Your facial yoga workouts will freshen your face and give it a healthy, natural flush. And your facelift can last as long as you wish.

Everybody will be amazed at your new youthful radiance, whether youre male or female. Try the only true facial exercise routines based on Chinese principles in Wendy Wilken's famous Facelift Without Surgery toning system.

FAQ'S

100% MONEY-BACK GUARANTEE ON THIS ULTIMATE FACIAL EXERCISE PROGRAM

60 PAGES IN DOWNLOADABLE PDF FORMAT

When acupressure facial toning is applied to the face and neck muscles, the underlying muscles become oxygenated.

Simultaneously, elastin production is stimulated as the skin is stretched and contracted during face exercise routines, thus increasing the skins elasticity. Elastin is the stuff that makes the skin springy and is present in the face and neck skin. Elastin gets depleted with age.

Blood and oxygen is channeled to the muscles during the finger massaging and toning. The connective tissue against the bone, which holds the muscles and the skin, becomes more flexible and firm. So do the muscles.

Baggy skin starts to lift, wrinkles fade, eye bags diminish, and your complexion glows and becomes smooth. All because of the magic of facial exercises...

Face toning flexes the muscles like a body builder using weights.

This stretching and relaxing of the face and neck muscles during facial exercise workouts, builds and expands muscle fiber. The muscle pulls the skin towards itself and the bone, at the same time it expands in girth, thereby appearing more full. A younger looking skin and smooth, shapely countenance with a glowing complexion is possible in less than a month.

This form of natural neck and facelift firms sagging skin. It lifts hanging jowls, firms the cheeks, and yields a sharper jawline. Skin wrinkles and creases fade and eventually become totally indiscernible with time as yoga facial exercises are practiced.

When conducting yoga facial exercises a slight burning sensation can sometimes be felt with the flexing and contracting of the toning workouts on the face and neck.

So, what is this? This is a good sign. Its not because of lactic acid being expelled like some so- called facial yoga experts claim, but fluid and blood flow being pumped back into the muscle and the skin.

The more moist the skin and muscle becomes, the more supple they become, which is great for the entire area being exercised. This prevents and reduces wrinkles, increases the blood flow, and pulls up the baggy skin towards the muscle, leaving a firmer, younger face.

Facial aerobics exercises open the energy lines in the body which become blocked as we age. These are called meridians. The energy meridians in the body are called Chi in Chinese, and Ki in Japanese.

By stimulating certain points on the face and neck, they are opened wider so that the Chi and blood flow can flow unhindered to feed once starved muscle, tissue, and skin cells.

Not only does this increase the skins elastin levels, but it also improves your complexion as the skin cells become nourished. As facelift exercises are continued, the skin begins to glow freshly, and become firm and supple again as the collagen and elastin levels rise.

The augmented circulation will improve the complexion and restore color to the face as in your youth.

When the skin and underlying tissue is worked with the fingertips, not only is blood flow increased to the area, but the pores in the skin are opened up which makes them more receptive to organic face creams, moisturizers and anti-aging skin care products.

Remember, moisture is good for the skin. It prolongs and rejuvenates the elasticity of the skin on the face and neck. Feeding the tissue with blood and stimulating the elastin in the skin with face gymnastics exercises will firm and fill out these areas.

This means that you can kiss wrinkles, eye bags, crows feet, saggy skin, smile and frown lines goodbye!

Wrinkles are caused by repetitive face movements, such as frowning or smiling. Facial exercises rub out wrinkles because of the regular tensing and contraction of the underlying muscles. They become toned due to the shortening of muscle fiber and the increase in blood and oxygen flow. This is much like toning muscles in the gym.

The overlying skin tightens along the expanding muscle and tissue. This leads to a huge improvement in your appearance, and fast-forwards you to your DIY non-surgical facelift.

After Botox injections, the muscles in that region are basically paralyzed and left totally relaxed. After face exercises, the muscles are expanded, yet relaxed - but you can still form normal expressions. When the muscles are stretched and released with facial yoga toning, furrows and wrinkles become shallow, or disappear altogether with time.

Botox causes you to lose character in your face for up to 6 months! Face workouts enhance the features without any numbing or paralyzing effect. Botox cannot be injected in certain parts of the face and neck and can be harmful if done too regularly. You have to also "rinse and repeat" every few months. It's a losing battle!

Facial yoga gives you a natural DIY facelift that permanently benefits the whole face and neck, leaving you looking young again, without poisons being injected into you!

With constant body workouts, the skin on the legs, arms, and stomach expand, ripple, and become toned. The skin looks healthy and has a renewed glow to it. This is because the skin is attached to the muscle via connective tissue to the bone.

Similarly, face and neck skin tightens around the muscles being exercised which becomes more filled, toned, and yields improved color.

Exercise of the face and neck skin, underlying muscles, and tissue has so many benefits - just like being in the gym. Your complexion will glow and gain much needed blood circulation and cell regeneration.

As we get older, the subcutaneous layer of fat in our skin lessens. This causes the skin to sag and lose it's youthful glow and smoothness. From our late twenties, the results become noticeable.

Regular toning creates an opportunity for muscles and tissue to be stimulated, re-energized, and nourished on the face and neck. The underlying muscle fiber expands and becomes healthier and more flexible. Collagen production is boosted. This mimics the appearance of the lost subcutaneous fat layer due to aging. The face and neck now appear fuller, firmer, younger. Wrinkles and lines fade or disappear.

Once you start Wendy Wilken's face exercise program, the muscles on the face and neck skin start building fiber. The tissue oxygenates and fills out, and the connective tissue between the skin, muscle, and bone becomes supple and firms up.

This results in sagging jowls lifting, facial blemishes and tiny veins fading. The eyes look more open, the eyebrows lift, the jaw and cheek bones becomes sharper and defined, and you get a younger looking skin that has a new, revitalized glow.

This overall improvement results in the inevitable non-invasive facelift you rightly deserve. Your entire complexion looks flushed as the blood flow increases to the skin of the face and neck. The pores of the skin become more open and receptive to moisturizing, too.

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A WOMAN'S GUIDE TO SURVIVE DIVORCE

As a recently divorced woman, life can be tough, but it can also be a fresh start. Regain your self confidence, and reach your true potential...

A MAN'S GUIDE TO SURVIVE DIVORCE

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HOW TO STOP SMOKING IN A WEEK

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HOW TO STOP YOUR DEPRESSION NOW

A retired clinical counselor reveals the secrets successful psychiatrists and psychologists don't want you to know. Discover how to permanently end your depression!

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Face Exercises For Anti-Aging And Killer Non-Invasive ...

Nutrition for People with Cancer | American Cancer Society

Posted: October 17, 2016 at 5:40 am


Nutrition for the Person with Cancer

Good nutrition is especially important if you have cancer because both the illness and its treatment can affect your appetite. Cancer and cancer treatments can also affect your body's ability to tolerate certain foods and use nutrients. This guide can help you and your loved ones learn about your nutrition needs and cope with treatment side effects that may affect how well you can eat.

Good nutrition is especially important if you have cancer because both the illness and its treatment can affect your appetite. Cancer and cancer treatments can also affect your body's ability to tolerate certain foods and use nutrients. This guide can help you and your loved ones learn about your nutrition needs and cope with treatment side effects that may affect how well you can eat.

Your doctor may recommend a low fiber diet for diarrhea, cramping, trouble digesting food, or after some types of surgery. Here you'll find lists of low fiber foods, along with lists of foods to avoid.

Cancer survivors often ask questions about food choices, physical activity, and dietary supplements. They want to know whether nutrition and physical activity can help them live longer or feel better. The information here is meant to answer some of those questions.

For a quick, easy way to learn important facts and practical tips about cancer and related issues, participate in our interactive online program, I Can CopeOnline. There is never any charge to participate, and you set the pacewhenever and wherever is most convenient for you.

Originally posted here:
Nutrition for People with Cancer | American Cancer Society

Mount Sinai Health System – New York City | Mount Sinai …

Posted: at 5:40 am


Select Specialty Addiction Psychiatry Adolescent Medicine Allergy and Immunology Alzheimer's Disease Anatomic Pathology Anatomic Pathology and Clinical Pathology Anesthesiology Bariatric Surgery Blood Banking/Transfusion Medicine Body Imaging Breast Cancer - Surgery Breast Imaging Cardiology Cardiovascular Disease Cardiovascular Surgery Cerebrovascular Diseases/Stroke Child and Adolescent Psychiatry Clinical Genetics - MD Clinical Pathology Clinical Pathology (Laboratory Hematology) Clinical and Laboratory Immunology - Pediatrics Colon and Rectal Surgery/Proctology Cornea, External Disease & Refractive Surgery Critical Care Medicine Critical Care Medicine - Anesthesiology Cytopathology Dentistry Dermatology Dermatopathology - Dermatology Diagnostic Radiology Ear, Nose, Throat/ Otolaryngology Emergency Medicine Endocrinology, Diabetes and Metabolism Endodontics Facial Plastic Surgery Family Medicine Family Planning Female Pelvic Medicine Gastroenterology Geriatric Medicine Geriatric Psychiatry Geriatrics, Palliative Care Glaucoma Gynecologic Oncology Hand Surgery Hand Surgery - Plastic and Reconstructive Surgery Head & Neck Surgery Headache Medicine Hematology Hematology - Clinical Pathology Hematology-Oncology Hospital Medicine Infectious Disease Internal Medicine Interventional Cardiology Interventional Neuroradiology Interventional Radiology Intestinal Transplantation Intestinal Transplantation and Rehabilitation Kidney/Pancreas Transplantation Liver Medicine Liver Surgery Liver Transplantation Living Donor Surgery Maternal and Fetal Medicine Medical Genetics and Genomics Medical Oncology Medical Toxicology - Emergency Medicine Medical and Surgical Retina Nephrology Neuro-Ophthalmology Neurocritical Care Neurology Neuropathology Neuroradiology Neurosurgery Nuclear Medicine Obstetrics and Gynecology Occupational Medicine Oncology Ophthalmic Pathology Ophthalmic Plastic Surgery Ophthalmology Optometry Oral/Maxillofacial Surgery Orthodontics Orthopaedic Surgery Pain Management Pediatric Allergy and Immunology Pediatric Anesthesia Pediatric Cardiology Pediatric Critical Care Medicine Pediatric Dentistry Pediatric Emergency Medicine - Pediatrics Pediatric Endocrinology Pediatric Gastroenterology and Hepatology Pediatric Hematology-Oncology Pediatric Infectious Diseases Pediatric Liver Transplantation Pediatric Nephrology and Hypertension Pediatric Neurology Pediatric Neurosurgery Pediatric Ophthalmology Pediatric Orthopaedic Surgery Pediatric Pulmonology Pediatric Radiology - Radiological Physics Pediatric Rheumatology Pediatric Surgery Pediatric Urology Pediatrics Pediatrics Neonatal-Perinatal Medicine Periodontics Plastic and Reconstructive Surgery Podiatry Primary Care Prosthodontics Psychiatry Psychology-PhD Public Health and General Preventive Medicine Pulmonary Medicine Radiation Oncology Radiology Reconstructive Surgery Rehabilitation and Physical Medicine Reproductive Endocrinology Rheumatology Sleep Medicine Spinal Cord Injury Medicine Spine Surgery Sports Medicine (Rehabilitation) Surgery Surgical Critical Care - Surgery Surgical Oncology Thoracic Surgery Transplantation Urogynecology Urology Uveitis Vascular Surgery

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Nutrition – Wikipedia

Posted: October 16, 2016 at 7:43 am


Nutrition is the science that interprets the interaction of nutrients and other substances in food in relation to maintenance, growth, reproduction, health and disease of an organism. It includes food intake, absorption, assimilation, biosynthesis, catabolism and excretion.[1]

The diet of an organism is what it eats, which is largely determined by the availability, the processing and palatability of foods. A healthy diet includes preparation of food and storage methods that preserve nutrients from oxidation, heat or leaching, and that reduce risk of foodborne illness.

Registered dietitian nutritionists (RDs or RDNs)[2] are health professionals qualified to provide safe, evidence-based dietary advice which includes a review of what is eaten, a thorough review of nutritional health, and a personalized nutritional treatment plan. They also provide preventive and therapeutic programs at work places, schools and similar institutions. Certified Clinical Nutritionists or CCNs, are trained health professionals who also offer dietary advice on the role of nutrition in chronic disease, including possible prevention or remediation by addressing nutritional deficiencies before resorting to drugs.[3] Government regulation especially in terms of licensing, is currently less universal for the CCN than that of RD or RDN. Another advanced Nutrition Professional is a Certified Nutrition Specialist or CNS. These Board Certified Nutritionists typically specialize in obesity and chronic disease. In order to become board certified, potential CNS candidate must pass an examination, much like Registered Dieticians. This exam covers specific domains within the health sphere including; Clinical Intervention and Human Health.[4]

A poor diet may cause health problems, causing deficiency diseases such as blindness, anemia, scurvy, preterm birth, stillbirth and cretinism;[5] health-threatening conditions like obesity[6][7] and metabolic syndrome;[8] and such common chronic systemic diseases as cardiovascular disease,[9]diabetes,[10][11] and osteoporosis.[12][13][14] A poor diet can cause the wasting of kwashiorkor in acute cases, and the stunting of marasmus in chronic cases of malnutrition.[5]

The first recorded dietary advice, carved into a Babylonian stone tablet in about 2500 BC, cautioned those with pain inside to avoid eating onions for three days. Scurvy, later found to be a vitamin C deficiency, was first described in 1500 BC in the Ebers Papyrus.[15]

According to Walter Gratzer, the study of nutrition probably began during the 6th century BC. In China, the concept of Qi developed, a spirit or "wind" similar to what Western Europeans later called pneuma.[16] Food was classified into "hot" (for example, meats, blood, ginger, and hot spices) and "cold" (green vegetables) in China, India, Malaya, and Persia.[17]Humours developed perhaps first in China alongside qi.[16] Ho the Physician concluded that diseases are caused by deficiencies of elements (Wu Xing: fire, water, earth, wood, and metal), and he classified diseases as well as prescribed diets.[17] About the same time in Italy, Alcmaeon of Croton (a Greek) wrote of the importance of equilibrium between what goes in and what goes out, and warned that imbalance would result in disease marked by obesity or emaciation.[18]

The first recorded nutritional experiment with human subjects is found in the Bible's Book of Daniel. Daniel and his friends were captured by the king of Babylon during an invasion of Israel. Selected as court servants, they were to share in the king's fine foods and wine. But they objected, preferring vegetables (pulses) and water in accordance with their Jewish dietary restrictions. The king's chief steward reluctantly agreed to a trial. Daniel and his friends received their diet for ten days and were then compared to the king's men. Appearing healthier, they were allowed to continue with their diet.[19][20]

Around 475 BC, Anaxagoras stated that food is absorbed by the human body and, therefore, contains "homeomerics" (generative components), suggesting the existence of nutrients.[21] Around 400 BC, Hippocrates, who recognized and was concerned with obesity, which may have been common in southern Europe at the time,[18] said, "Let food be your medicine and medicine be your food."[22] The works that are still attributed to him, Corpus Hippocraticum, called for moderation and emphasized exercise.[18]

Salt, pepper and other spices were prescribed for various ailments in various preparations for example mixed with vinegar. In the 2nd century BC, Cato the Elder believed that cabbage (or the urine of cabbage-eaters) could cure digestive diseases, ulcers, warts, and intoxication. Living about the turn of the millennium, Aulus Celsus, an ancient Roman doctor, believed in "strong" and "weak" foods (bread for example was strong, as were older animals and vegetables).[23]

One mustn't overlook the doctrines of Galen: In use from his life in the 1st century AD until the 17th century, it was heresy to disagree with him for 1500 years.[24] Galen was physician to gladiators in Pergamon, and in Rome, physician to Marcus Aurelius and the three emperors who succeeded him.[25] Most of Galen's teachings were gathered and enhanced in the late 11th century by Benedictine monks at the School of Salerno in Regimen sanitatis Salernitanum, which still had users in the 17th century.[26] Galen believed in the bodily humours of Hippocrates, and he taught that pneuma is the source of life. Four elements (earth, air, fire and water) combine into "complexion", which combines into states (the four temperaments: sanguine, phlegmatic, choleric, and melancholic). The states are made up of pairs of attributes (hot and moist, cold and moist, hot and dry, and cold and dry), which are made of four humours: blood, phlegm, green (or yellow) bile, and black bile (the bodily form of the elements). Galen thought that for a person to have gout, kidney stones, or arthritis was scandalous, which Gratzer likens to Samuel Butler's Erehwon (1872) where sickness is a crime.[24]

In the 1500s, Paracelsus was probably the first to criticize Galen publicly.[24] Also in the 16th century, scientist and artist Leonardo da Vinci compared metabolism to a burning candle. Leonardo did not publish his works on this subject, but he was not afraid of thinking for himself and he definitely disagreed with Galen.[17] Ultimately, 16th century works of Andreas Vesalius, sometimes called the father of modern medicine, overturned Galen's ideas.[28] He was followed by piercing thought amalgamated with the era's mysticism and religion sometimes fueled by the mechanics of Newton and Galileo. Jan Baptist van Helmont, who discovered several gases such as carbon dioxide, performed the first quantitative experiment. Robert Boyle advanced chemistry. Sanctorius measured body weight. Physician Herman Boerhaave modeled the digestive process. Physiologist Albrecht von Haller worked out the difference between nerves and muscles.[29]

Sometimes overlooked during his life, James Lind, a physician in the British navy, performed the first scientific nutrition experiment in 1747. Lind discovered that lime juice saved sailors that had been at sea for years from scurvy, a deadly and painful bleeding disorder. Between 1500 and 1800, an estimated two million sailors had died of scurvy.[30] The discovery was ignored for forty years, after which British sailors became known as "limeys."[31] The essential vitamin C within citrus fruits would not be identified by scientists until 1932.[30]

Around 1770, Antoine Lavoisier discovered the details of metabolism, demonstrating that the oxidation of food is the source of body heat. Called the most fundamental chemical discovery of the 18th century,[33] Lavoisier discovered the principle of conservation of mass. His ideas made the phlogiston theory of combustion obsolete.[34]

In 1790, George Fordyce recognized calcium as necessary for the survival of fowl. In the early 19th century, the elements carbon, nitrogen, hydrogen, and oxygen were recognized as the primary components of food, and methods to measure their proportions were developed.[35]

In 1816, Franois Magendie discovered that dogs fed only carbohydrates (sugar), fat (olive oil), and water died evidently of starvation, but dogs also fed protein survived, identifying protein as an essential dietary component.[36]William Prout in 1827 was the first person to divide foods into carbohydrates, fat, and protein.[37] During the 19th century, Jean-Baptiste Dumas and Justus von Liebig quarrelled over their shared belief that animals get their protein directly from plants (animal and plant protein are the same and that humans do not create organic compounds).[38] With a reputation as the leading organic chemist of his day but with no credentials in animal physiology,[39] Liebig grew rich making food extracts like beef bouillon and infant formula that were later found to be of questionable nutritious value.[40] In the 1860s, Claude Bernard discovered that body fat can be synthesized from carbohydrate and protein, showing that the energy in blood glucose can be stored as fat or as glycogen.[41]

In the early 1880s, Kanehiro Takaki observed that Japanese sailors (whose diets consisted almost entirely of white rice) developed beriberi (or endemic neuritis, a disease causing heart problems and paralysis), but British sailors and Japanese naval officers did not. Adding various types of vegetables and meats to the diets of Japanese sailors prevented the disease, (not because of the increased protein as Takaki supposed but because it introduced a few parts per million of thiamine to the diet, later understood as a cure[42]).

In 1896, Eugen Baumann observed iodine in thyroid glands. In 1897, Christiaan Eijkman worked with natives of Java, who also suffered from beriberi. Eijkman observed that chickens fed the native diet of white rice developed the symptoms of beriberi but remained healthy when fed unprocessed brown rice with the outer bran intact. Eijkman cured the natives by feeding them brown rice, discovering that food can cure disease. Over two decades later, nutritionists learned that the outer rice bran contains vitamin B1, also known as thiamine.

In the early 20th century, Carl von Voit and Max Rubner independently measured caloric energy expenditure in different species of animals, applying principles of physics in nutrition. In 1906, Edith G. Willcock and Frederick Hopkins showed that the amino acid tryptophan aids the well-being of mice but it did not assure their growth.[43] In the middle of twelve years of attempts to isolate them,[44] Hopkins said in a 1906 lecture that "unsuspected dietetic factors," other than calories, protein, and minerals, are needed to prevent deficiency diseases.[45] In 1907, Stephen M. Babcock and Edwin B. Hart conducted the single-grain experiment, which took nearly four years to complete.[35]

In 1912, Casimir Funk coined the term vitamin, a vital factor in the diet, from the words "vital" and "amine," because these unknown substances preventing scurvy, beriberi, and pellagra, were thought then to be derived from ammonia. The vitamins were studied in the first half of the 20th century.

In 1913, Elmer McCollum and Marguerite Davis discovered the first vitamin, fat-soluble vitamin A, then water-soluble vitamin B (in 1915; now known to be a complex of several water-soluble vitamins) and named vitamin C as the then-unknown substance preventing scurvy. Lafayette Mendel and Thomas Osborne also performed pioneering work on vitamins A and B. In 1919, Sir Edward Mellanby incorrectly identified rickets as a vitamin A deficiency because he could cure it in dogs with cod liver oil.[48] In 1922, McCollum destroyed the vitamin A in cod liver oil, but found that it still cured rickets.[48] Also in 1922, H.M. Evans and L.S. Bishop discover vitamin E as essential for rat pregnancy, originally calling it "food factor X" until 1925.

In 1925, Hart discovered that trace amounts of copper are necessary for iron absorption. In 1927, Adolf Otto Reinhold Windaus synthesized vitamin D, and was awarded the Nobel Prize in Chemistry in 1928. In 1928, Albert Szent-Gyrgyi isolated ascorbic acid, and in 1932 proved that it is vitamin C by preventing scurvy. In 1935, he synthesized it, and in 1937, he won a Nobel Prize for his efforts. Szent-Gyrgyi concurrently elucidated much of the citric acid cycle.

In the 1930s, William Cumming Rose identified essential amino acids, necessary protein components that the body cannot synthesize. In 1935, Underwood and Marston independently discovered the necessity of cobalt. In 1936, Eugene Floyd DuBois showed that work and school performance are related to caloric intake. In 1938, Erhard Fernholz discovered the chemical structure of vitamin E and then he tragically disappeared.[49][50] It was synthesised the same year by Paul Karrer.[49]

In 1940, rationing in the United Kingdom during and after World War II took place according to nutritional principles drawn up by Elsie Widdowson and others. In 1941, the first Recommended Dietary Allowances (RDAs) were established by the National Research Council.

In 1992, The U.S. Department of Agriculture introduced the Food Guide Pyramid.[51] In 2002, a Natural Justice study showed a relation between nutrition and violent behavior.[35] In 2005, one inconclusive study found that obesity could be caused by adenovirus in addition to bad nutrition.[52]

World leaders are looking at alternatives like genetically modified foods to tackle the problem of world hunger and food shortages.[53]

The list of nutrients that people are known to require is, in the words of Marion Nestle, "almost certainly incomplete".[54] As of 2014, nutrients are thought to be of two types: macro-nutrients which are needed in relatively large amounts, and micronutrients which are needed in smaller quantities.[55] A type of carbohydrate, dietary fiber, i.e. non-digestible material such as cellulose, is required,[56] for both mechanical and biochemical reasons, although the exact reasons remain unclear. Other micronutrients include antioxidants and phytochemicals, which are said to influence (or protect) some body systems. Their necessity is not as well established as in the case of, for instance, vitamins.

Most foods contain a mix of some or all of the nutrient types, together with other substances, such as toxins of various sorts. Some nutrients can be stored internally (e.g., the fat-soluble vitamins), while others are required more or less continuously. Poor health can be caused by a lack of required nutrients or, in extreme cases, too much of a required nutrient. For example, both salt and water (both absolutely required) will cause illness or even death in excessive amounts.[57][58]

The macronutrients are carbohydrates, fiber, fats, protein, and water.[55] The macronutrients (excluding fiber and water) provide structural material (amino acids from which proteins are built, and lipids from which cell membranes and some signaling molecules are built) and energy. Some of the structural material can be used to generate energy internally, and in either case it is measured in Joules or kilocalories (often called "Calories" and written with a capital C to distinguish them from little 'c' calories). Carbohydrates and proteins provide 17kJ approximately (4kcal) of energy per gram, while fats provide 37kJ (9kcal) per gram,[59] though the net energy from either depends on such factors as absorption and digestive effort, which vary substantially from instance to instance. Vitamins, minerals, fiber, and water do not provide energy, but are required for other reasons.

Molecules of carbohydrates and fats consist of carbon, hydrogen, and oxygen atoms. Carbohydrates range from simple monosaccharides (glucose, fructose, galactose) to complex polysaccharides (starch). Fats are triglycerides, made of assorted fatty acid monomers bound to a glycerol backbone. Some fatty acids, but not all, are essential in the diet: they cannot be synthesized in the body. Protein molecules contain nitrogen atoms in addition to carbon, oxygen, and hydrogen. The fundamental components of protein are nitrogen-containing amino acids, some of which are essential in the sense that humans cannot make them internally. Some of the amino acids are convertible (with the expenditure of energy) to glucose and can be used for energy production, just as ordinary glucose, in a process known as gluconeogenesis. By breaking down existing protein, the carbon skeleton of the various amino acids can be metabolized to intermediates in cellular respiration; the remaining ammonia is discarded primarily as urea in urine. This occurs normally only during prolonged starvation.

Carbohydrates may be classified as monosaccharides, disaccharides, or polysaccharides depending on the number of monomer (sugar) units they contain. They constitute a large part of foods such as rice, noodles, bread, and other grain-based products. Monosaccharides, disaccharides, and polysaccharides contain one, two, and three or more sugar units, respectively. Polysaccharides are often referred to as complex carbohydrates because they are typically long, multiple branched chains of sugar units.

Traditionally, simple carbohydrates are believed to be absorbed quickly, and therefore to raise blood-glucose levels more rapidly than complex carbohydrates. This, however, is not accurate.[60][61][62][63] Some simple carbohydrates (e.g., fructose) follow different metabolic pathways (e.g., fructolysis) that result in only a partial catabolism to glucose, while, in essence, many complex carbohydrates may be digested at the same rate as simple carbohydrates.[64] Glucose stimulates the production of insulin through food entering the bloodstream, which is grasped by the beta cells in the pancreas.

Dietary fiber is a carbohydrate that is incompletely absorbed in humans and in some animals. Like all carbohydrates, when it is metabolized it can produce four Calories (kilocalories) of energy per gram. However, in most circumstances it accounts for less than that because of its limited absorption and digestibility. Dietary fiber consists mainly of cellulose, a large carbohydrate polymer which is indigestible as humans do not have the required enzymes to disassemble it. There are two subcategories: soluble and insoluble fiber. Whole grains, fruits (especially plums, prunes, and figs), and vegetables are good sources of dietary fiber. There are many health benefits of a high-fiber diet. Dietary fiber helps reduce the chance of gastrointestinal problems such as constipation and diarrhea by increasing the weight and size of stool and softening it. Insoluble fiber, found in whole wheat flour, nuts and vegetables, especially stimulates peristalsis the rhythmic muscular contractions of the intestines, which move digesta along the digestive tract. Soluble fiber, found in oats, peas, beans, and many fruits, dissolves in water in the intestinal tract to produce a gel that slows the movement of food through the intestines. This may help lower blood glucose levels because it can slow the absorption of sugar. Additionally, fiber, perhaps especially that from whole grains, is thought to possibly help lessen insulin spikes, and therefore reduce the risk of type 2 diabetes. The link between increased fiber consumption and a decreased risk of colorectal cancer is still uncertain.

A molecule of dietary fat typically consists of several fatty acids (containing long chains of carbon and hydrogen atoms), bonded to a glycerol. They are typically found as triglycerides (three fatty acids attached to one glycerol backbone). Fats may be classified as saturated or unsaturated depending on the detailed structure of the fatty acids involved. Saturated fats have all of the carbon atoms in their fatty acid chains bonded to hydrogen atoms, whereas unsaturated fats have some of these carbon atoms double-bonded, so their molecules have relatively fewer hydrogen atoms than a saturated fatty acid of the same length. Unsaturated fats may be further classified as monounsaturated (one double-bond) or polyunsaturated (many double-bonds). Furthermore, depending on the location of the double-bond in the fatty acid chain, unsaturated fatty acids are classified as omega-3 or omega-6 fatty acids. Trans fats are a type of unsaturated fat with trans-isomer bonds; these are rare in nature and in foods from natural sources; they are typically created in an industrial process called (partial) hydrogenation. There are nine kilocalories in each gram of fat. Fatty acids such as conjugated linoleic acid, catalpic acid, eleostearic acid and punicic acid, in addition to providing energy, represent potent immune modulatory molecules.

Saturated fats (typically from animal sources) have been a staple in many world cultures for millennia. Unsaturated fats (e. g., vegetable oil) are considered healthier, while trans fats are to be avoided. Saturated and some trans fats are typically solid at room temperature (such as butter or lard), while unsaturated fats are typically liquids (such as olive oil or flaxseed oil). Trans fats are very rare in nature, and have been shown to be highly detrimental to human health, but have properties useful in the food processing industry, such as rancidity resistance.[citation needed]

Most fatty acids are non-essential, meaning the body can produce them as needed, generally from other fatty acids and always by expending energy to do so. However, in humans, at least two fatty acids are essential and must be included in the diet. An appropriate balance of essential fatty acidsomega-3 and omega-6 fatty acidsseems also important for health, although definitive experimental demonstration has been elusive. Both of these "omega" long-chain polyunsaturated fatty acids are substrates for a class of eicosanoids known as prostaglandins, which have roles throughout the human body. They are hormones, in some respects. The omega-3 eicosapentaenoic acid (EPA), which can be made in the human body from the omega-3 essential fatty acid alpha-linolenic acid (ALA), or taken in through marine food sources, serves as a building block for series 3 prostaglandins (e.g., weakly inflammatory PGE3). The omega-6 dihomo-gamma-linolenic acid (DGLA) serves as a building block for series 1 prostaglandins (e.g. anti-inflammatory PGE1), whereas arachidonic acid (AA) serves as a building block for series 2 prostaglandins (e.g. pro-inflammatory PGE 2). Both DGLA and AA can be made from the omega-6 linoleic acid (LA) in the human body, or can be taken in directly through food. An appropriately balanced intake of omega-3 and omega-6 partly determines the relative production of different prostaglandins, which is one reason why a balance between omega-3 and omega-6 is believed important for cardiovascular health. In industrialized societies, people typically consume large amounts of processed vegetable oils, which have reduced amounts of the essential fatty acids along with too much of omega-6 fatty acids relative to omega-3 fatty acids.

The conversion rate of omega-6 DGLA to AA largely determines the production of the prostaglandins PGE1 and PGE2. Omega-3 EPA prevents AA from being released from membranes, thereby skewing prostaglandin balance away from pro-inflammatory PGE2 (made from AA) toward anti-inflammatory PGE1 (made from DGLA). Moreover, the conversion (desaturation) of DGLA to AA is controlled by the enzyme delta-5-desaturase, which in turn is controlled by hormones such as insulin (up-regulation) and glucagon (down-regulation). The amount and type of carbohydrates consumed, along with some types of amino acid, can influence processes involving insulin, glucagon, and other hormones; therefore, the ratio of omega-3 versus omega-6 has wide effects on general health, and specific effects on immune function and inflammation, and mitosis (i.e., cell division).

Proteins are structural materials in much of the animal body (e.g. muscles, skin, and hair). They also form the enzymes that control chemical reactions throughout the body. Each protein molecule is composed of amino acids, which are characterized by inclusion of nitrogen and sometimes sulphur (these components are responsible for the distinctive smell of burning protein, such as the keratin in hair). The body requires amino acids to produce new proteins (protein retention) and to replace damaged proteins (maintenance). As there is no protein or amino acid storage provision, amino acids must be present in the diet. Excess amino acids are discarded, typically in the urine. For all animals, some amino acids are essential (an animal cannot produce them internally) and some are non-essential (the animal can produce them from other nitrogen-containing compounds). About twenty amino acids are found in the human body, and about ten of these are essential and, therefore, must be included in the diet. A diet that contains adequate amounts of amino acids (especially those that are essential) is particularly important in some situations: during early development and maturation, pregnancy, lactation, or injury (a burn, for instance). A complete protein source contains all the essential amino acids; an incomplete protein source lacks one or more of the essential amino acids.

It is possible with protein combinations of two incomplete protein sources (e.g., rice and beans) to make a complete protein source, and characteristic combinations are the basis of distinct cultural cooking traditions. However, complementary sources of protein do not need to be eaten at the same meal to be used together by the body.[65] Excess amino acids from protein can be converted into glucose and used for fuel through a process called gluconeogenesis. The amino acids remaining after such conversion are discarded.

Water is excreted from the body in multiple forms; including urine and feces, sweating, and by water vapour in the exhaled breath. Therefore, it is necessary to adequately rehydrate to replace lost fluids.

Early recommendations for the quantity of water required for maintenance of good health suggested that 68 glasses of water daily is the minimum to maintain proper hydration.[66] However the notion that a person should consume eight glasses of water per day cannot be traced to a credible scientific source.[67] The original water intake recommendation in 1945 by the Food and Nutrition Board of the National Research Council read: "An ordinary standard for diverse persons is 1 milliliter for each calorie of food. Most of this quantity is contained in prepared foods."[68] More recent comparisons of well-known recommendations on fluid intake have revealed large discrepancies in the volumes of water we need to consume for good health.[69] Therefore, to help standardize guidelines, recommendations for water consumption are included in two recent European Food Safety Authority (EFSA) documents (2010): (i) Food-based dietary guidelines and (ii) Dietary reference values for water or adequate daily intakes (ADI).[70] These specifications were provided by calculating adequate intakes from measured intakes in populations of individuals with desirable osmolarity values of urine and desirable water volumes per energy unit consumed.[70] For healthful hydration, the current EFSA guidelines recommend total water intakes of 2.0 L/day for adult females and 2.5 L/day for adult males. These reference values include water from drinking water, other beverages, and from food. About 80% of our daily water requirement comes from the beverages we drink, with the remaining 20% coming from food.[71] Water content varies depending on the type of food consumed, with fruit and vegetables containing more than cereals, for example.[72] These values are estimated using country-specific food balance sheets published by the Food and Agriculture Organisation of the United Nations.[72] Other guidelines for nutrition also have implications for the beverages we consume for healthy hydration- for example, the World Health Organization (WHO) recommend that added sugars should represent no more than 10% of total energy intake.[73]

The EFSA panel also determined intakes for different populations. Recommended intake volumes in the elderly are the same as for adults as despite lower energy consumption, the water requirement of this group is increased due to a reduction in renal concentrating capacity.[70]Pregnant and breastfeeding women require additional fluids to stay hydrated. The EFSA panel proposes that pregnant women should consume the same volume of water as non-pregnant women, plus an increase in proportion to the higher energy requirement, equal to 300 mL/day.[70] To compensate for additional fluid output, breastfeeding women require an additional 700 mL/day above the recommended intake values for non-lactating women.[70]

For those who have healthy kidneys, it is somewhat difficult to drink too much water,[70] but (especially in warm humid weather and while exercising) it is dangerous to drink too little. While overhydration is much less common than dehydration, it is also possible to drink far more water than necessary, which can result in water intoxication, a serious and potentially fatal condition.[74] In particular, large amounts of de-ionized water are dangerous.[70]

The micronutrients are minerals, vitamins, and others.[55]

Dietary minerals are inorganic chemical elements required by living organisms,[75] other than the four elements carbon, hydrogen, nitrogen, and oxygen that are present in nearly all organic molecules. The term "mineral" is archaic, since the intent is to describe simply the less common elements in the diet. Some are heavier than the four just mentioned, including several metals, which often occur as ions in the body. Some dietitians recommend that these be supplied from foods in which they occur naturally, or at least as complex compounds, or sometimes even from natural inorganic sources (such as calcium carbonate from ground oyster shells). Some minerals are absorbed much more readily in the ionic forms found in such sources. On the other hand, minerals are often artificially added to the diet as supplements; the most famous is likely iodine in iodized salt which prevents goiter.

Many elements are essential in relative quantity; they are usually called "bulk minerals". Some are structural, but many play a role as electrolytes.[76] Elements with recommended dietary allowance (RDA) greater than 150 mg/day are, in alphabetical order (with informal or folk-medicine perspectives in parentheses):

Many elements are required in trace amounts, usually because they play a catalytic role in enzymes.[78] Some trace mineral elements (RDA < 200mg/day) are, in alphabetical order:

As with the minerals discussed above, some vitamins are recognized as organic essential nutrients,[75] necessary in the diet for good health. (Vitamin D is the exception: it can be synthesized in the skin, in the presence of UVB radiation.) Certain vitamin-like compounds that are recommended in the diet, such as carnitine, are thought useful for survival and health, but these are not "essential" dietary nutrients because the human body has some capacity to produce them from other compounds. Moreover, thousands of different phytochemicals have recently been discovered in food (particularly in fresh vegetables), which may have desirable properties including antioxidant activity (see below); however, experimental demonstration has been suggestive but inconclusive. Other essential nutrients that are not classified as vitamins include essential amino acids (see above), choline, essential fatty acids (see above), and the minerals discussed in the preceding section.

Vitamin deficiencies may result in disease conditions, including goitre, scurvy, osteoporosis, impaired immune system, disorders of cell metabolism, certain forms of cancer, symptoms of premature aging, and poor psychological health (including eating disorders), among many others.[79] Excess levels of some vitamins are also dangerous to health (notably vitamin A). Deficient or excess levels of minerals can also have serious health consequences.

Heart disease, cancer, obesity, and diabetes are commonly called "Western" diseases because these maladies were once rarely seen in developing countries. An international study in China found some regions had virtually no cancer or heart disease, while in other areas they reflected "up to a 100-fold increase" coincident with shifts from diets that were found to be entirely plant-based to heavily animal-based, respectively.[80] In contrast, diseases of affluence like cancer and heart disease are common throughout the developed world, including the United States. Adjusted for age and exercise, large regional clusters of people in China rarely suffered from these "Western" diseases possibly because their diets are rich in vegetables, fruits, and whole grains, and have little dairy and meat products.[80] Some studies show these to be, in high quantities, possible causes of some cancers. There are arguments for and against this controversial issue.

The United Healthcare/Pacificare nutrition guideline recommends a whole plant food diet, and recommends using protein only as a condiment with meals. A National Geographic cover article from November 2005, entitled The Secrets of Living Longer, also recommends a whole plant food diet. The article is a lifestyle survey of three populations, Sardinians, Okinawans, and Adventists, who generally display longevity and "suffer a fraction of the diseases that commonly kill people in other parts of the developed world, and enjoy more healthy years of life." In common with all three groups is to "Eat fruits, vegetables, and whole grains."

The National Geographic article noted that an NIH funded study of 34,000 Seventh-day Adventists between 1976 and 1988 "...found that the Adventists' habit of consuming beans, soy milk, tomatoes, and other fruits lowered their risk of developing certain cancers. It also suggested that eating whole grain bread, drinking five glasses of water a day, and, most surprisingly, consuming four servings of nuts a week reduced their risk of heart disease."

The French paradox is the observation that the French suffer a relatively low incidence of coronary heart disease, despite having a diet relatively rich in saturated fats. A number of explanations have been suggested:

However, statistics collected by the World Health Organization from 19902000 show that the incidence of heart disease in France may have been underestimated and, in fact, may be similar to that of neighboring countries.[83]

Phytochemicals such as polyphenols are compounds produced naturally in plants (phyto means "plant" in Greek). In general, the term is used to refer to those chemicals under research to assess whether they have biological significance. To date, there is no evidence in humans that polyphenols or other non-nutrient compounds from plants have health effects.[84] Further, dietary supplements containing phytochemicals also have no proven health benefit.[84][85]

While initial studies sought to reveal if antioxidant or phytochemical supplements might promote health, later large clinical trials did not detect any benefit and showed instead that excess supplementation could be harmful.[86][87]

Animal intestines contain a large population of gut flora. In humans, the four dominant phyla are Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria.[88] They are essential to digestion and are also affected by food that is consumed. Bacteria in the gut perform many important functions for humans, including breaking down and aiding in the absorption of otherwise indigestible food; stimulating cell growth; repressing the growth of harmful bacteria, training the immune system to respond only to pathogens; producing vitamin B12; and defending against some infectious diseases.[89]

Nutritional science investigates the metabolic and physiological responses of the body to diet. With advances in the fields of molecular biology, biochemistry, nutritional immunology, molecular medicine and genetics, the study of nutrition is increasingly concerned with metabolism and metabolic pathways: the sequences of biochemical steps through which substances in living things change from one form to another.

Carnivore and herbivore diets are contrasting, with basic nitrogen and carbon proportions vary for their particular foods. "The nitrogen content of plant tissues averages about 2%, while in fungi, animals, and bacteria it averages about 5% to 10%." Many herbivores rely on bacterial fermentation to create digestible nutrients from indigestible plant cellulose, while obligate carnivores must eat animal meats to obtain certain vitamins or nutrients their bodies cannot otherwise synthesize. All animals' diets must provide sufficient amounts of the basic building blocks they need, up to the point where their particular biology can synthesize the rest.[90] Animal tissue contains chemical compounds, such as water, carbohydrates (sugar, starch, and fiber), amino acids (in proteins), fatty acids (in lipids), and nucleic acids (DNA and RNA). These compounds in turn consist of elements such as carbon, hydrogen, oxygen, nitrogen, phosphorus, calcium, iron, zinc, magnesium, manganese, and so on. All of these chemical compounds and elements occur in various forms and combinations (e.g. hormones, vitamins, phospholipids, hydroxyapatite).

Animal tissue consists of elements and compounds ingested, digested, absorbed, and circulated through the bloodstream to feed the cells of the body. Except in the unborn fetus, the digestive system is the first system involved[vague]. Digestive juices break chemical bonds in ingested molecules, and modify their conformations and energy states. Though some molecules are absorbed into the bloodstream unchanged, digestive processes release them from the matrix of foods. Unabsorbed matter, along with some waste products of metabolism, is eliminated from the body in the feces.

Studies of nutritional status must take into account the state of the body before and after experiments, as well as the chemical composition of the whole diet and of all material excreted and eliminated from the body (in urine and feces). Comparing the food to the waste can help determine the specific compounds and elements absorbed and metabolized in the body. The effects of nutrients may only be discernible over an extended period, during which all food and waste must be analyzed. The number of variables involved in such experiments is high, making nutritional studies time-consuming and expensive, which explains why the science of animal nutrition is still slowly evolving.

In particular, the consumption of whole-plant foods slows digestion and allows better absorption, and a more favorable balance of essential nutrients per Calorie, resulting in better management of cell growth, maintenance, and mitosis (cell division), as well as better regulation of appetite and blood sugar[citation needed]. Regularly scheduled meals (every few hours) have also proven more wholesome than infrequent or haphazard ones.[91]

Plant nutrition is the study of the chemical elements that are necessary for plant growth.[92] There are several principles that apply to plant nutrition. Some elements are directly involved in plant metabolism. However, this principle does not account for the so-called beneficial elements, whose presence, while not required, has clear positive effects on plant growth.

A nutrient that is able to limit plant growth according to Liebig's law of the minimum is considered an essential plant nutrient if the plant cannot complete its full life cycle without it. There are 16 essential plant soil nutrients, besides the three major elemental nutrients carbon and oxygen that are obtained by photosynthetic plants from carbon dioxide in air, and hydrogen, which is obtained from water.

Plants uptake essential elements from the soil through their roots and from the air (consisting of mainly nitrogen and oxygen) through their leaves. Green plants obtain their carbohydrate supply from the carbon dioxide in the air by the process of photosynthesis. Carbon and oxygen are absorbed from the air, while other nutrients are absorbed from the soil. Nutrient uptake in the soil is achieved by cation exchange, wherein root hairs pump hydrogen ions (H+) into the soil through proton pumps. These hydrogen ions displace cations attached to negatively charged soil particles so that the cations are available for uptake by the root. In the leaves, stomata open to take in carbon dioxide and expel oxygen. The carbon dioxide molecules are used as the carbon source in photosynthesis.

Although nitrogen is plentiful in the Earth's atmosphere, very few plants can use this directly. Most plants, therefore, require nitrogen compounds to be present in the soil in which they grow. This is made possible by the fact that largely inert atmospheric nitrogen is changed in a nitrogen fixation process to biologically usable forms in the soil by bacteria.[93]

Plant nutrition is a difficult subject to understand completely, partially because of the variation between different plants and even between different species or individuals of a given clone. Elements present at low levels may cause deficiency symptoms, and toxicity is possible at levels that are too high. Furthermore, deficiency of one element may present as symptoms of toxicity from another element, and vice versa.

Research in the field of nutrition has greatly contributed in finding out the essential facts about how environmental depletion can lead to crucial nutrition-related health problems like contamination, spread of contagious diseases, malnutrition, etc. Moreover, environmental contamination due to discharge of agricultural as well as industrial chemicals like organocholrines, heavy metal, and radionucleotides may adversely affect the human and the ecosystem as a whole. As far as safety of the human health is concerned, then these environmental contaminants can reduce people's nutritional status and health. This could directly or indirectly cause drastic changes in their diet habits. Hence, food-based remedial as well as preventive strategies are essential to address global issues like hunger and malnutrition and to enable the susceptible people to adapt themselves to all these environmental as well as socio-economic alterations.[94]

Canada's Food Guide is another example government-run nutrition program. Produced by Health Canada, the guide advises food quantities, provides education on balanced nutrition, and promotes physical activity in accordance with government-mandated nutrient needs. Like other nutrition programs around the world, Canada's Food Guide divides nutrition into four main food groups: vegetables and fruit, grain products, milk and alternatives, and meat and alternatives.[95]It is interesting to note that, unlike its American counterpart, the Canadian guide references and provides alternative to meat and dairy, which can be attributed to the growing vegan and vegetarian movements.

In the US, dietitians are registered (RD) or licensed (LD) with the Commission for Dietetic Registration and the American Dietetic Association, and are only able to use the title "dietitian," as described by the business and professions codes of each respective state, when they have met specific educational and experiential prerequisites and passed a national registration or licensure examination, respectively. In California, registered dietitians must abide by the "Business and Professions Code of Section 2585-2586.8".Anyone may call themselves a nutritionist, including unqualified dietitians, as this term is unregulated. Some states, such as the State of Florida, have begun to include the title "nutritionist" in state licensure requirements. Most governments provide guidance on nutrition, and some also impose mandatory disclosure/labeling requirements for processed food manufacturers and restaurants to assist consumers in complying with such guidance.

In the US, nutritional standards and recommendations are established jointly by the US Department of Agriculture and US Department of Health and Human Services. Dietary and physical activity guidelines from the USDA are presented in the concept of MyPlate, which superseded the food pyramid, which replaced the Four Food Groups. The Senate committee currently responsible for oversight of the USDA is the Agriculture, Nutrition and Forestry Committee. Committee hearings are often televised on C-SPAN. The U.S. Department of Health and Human Services provides a sample week-long menu that fulfills the nutritional recommendations of the government.[96]

Governmental organisations have been working on nutrition literacy interventions in non-primary health care settings to address the nutrition information problem in the U.S. Some programs include:

The Family Nutrition Program (FNP) is a free nutrition education program serving low-income adults around the U.S. This program is funded by the Food Nutrition Services (FNS) branch of the United States Department of Agriculture (USDA) usually through a local state academic institution that runs the program. The FNP has developed a series of tools to help families participating in the Food Stamp Program stretch their food dollar and form healthful eating habits including nutrition education.

Expanded Food and Nutrition Education Program (ENFEP) is a unique program that currently operates in all 50 states and in American Samoa, Guam, Micronesia, Northern Marianas, Puerto Rico, and the Virgin Islands. It is designed to assist limited-resource audiences in acquiring the knowledge, skills, attitudes, and changed behavior necessary for nutritionally sound diets, and to contribute to their personal development and the improvement of the total family diet and nutritional well-being.

An example of a state initiative to promote nutrition literacy is Smart Bodies, a public-private partnership between the states largest university system and largest health insurer, Louisiana State Agricultural Center and Blue Cross and Blue Shield of Louisiana Foundation. Launched in 2005, this program promotes lifelong healthful eating patterns and physically active lifestyles for children and their families. It is an interactive educational program designed to help prevent childhood obesity through classroom activities that teach children healthful eating habits and physical exercise.

Nutrition is taught in schools in many countries. In England and Wales, the Personal and Social Education and Food Technology curricula include nutrition, stressing the importance of a balanced diet and teaching how to read nutrition labels on packaging. In many schools, a Nutrition class will fall within the Family and Consumer Science or Health departments. In some American schools, students are required to take a certain number of FCS or Health related classes. Nutrition is offered at many schools, and, if it is not a class of its own, nutrition is included in other FCS or Health classes such as: Life Skills, Independent Living, Single Survival, Freshmen Connection, Health etc. In many Nutrition classes, students learn about the food groups, the food pyramid, Daily Recommended Allowances, calories, vitamins, minerals, malnutrition, physical activity, healthful food choices, portion sizes, and how to live a healthy life.

A 1985, US National Research Council report entitled Nutrition Education in US Medical Schools concluded that nutrition education in medical schools was inadequate.[97] Only 20% of the schools surveyed taught nutrition as a separate, required course. A 2006 survey found that this number had risen to 30%.[98]

At the time of this entry, we were not able to identify any specific nutrition literacy studies in the U.S. at a national level. However, the findings of the 2003 National Assessment of Adult Literacy (NAAL) provide a basis upon which to frame the nutrition literacy problem in the U.S. NAAL introduced the first ever measure of "the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions" an objective of Healthy People 2010[99] and of which nutrition literacy might be considered an important subset. On a scale of below basic, basic, intermediate and proficient, NAAL found 13 percent of adult Americans have proficient health literacy, 44% have intermediate literacy, 29 percent have basic literacy and 14 percent have below basic health literacy. The study found that health literacy increases with education and people living below the level of poverty have lower health literacy than those above it.

Another study examining the health and nutrition literacy status of residents of the lower Mississippi Delta found that 52 percent of participants had a high likelihood of limited literacy skills.[100] While a precise comparison between the NAAL and Delta studies is difficult, primarily because of methodological differences, Zoellner et al. suggest that health literacy rates in the Mississippi Delta region are different from the U.S. general population and that they help establish the scope of the problem of health literacy among adults in the Delta region. For example, only 12 percent of study participants identified the My Pyramid graphic two years after it had been launched by the USDA. The study also found significant relationships between nutrition literacy and income level and nutrition literacy and educational attainment[100] further delineating priorities for the region.

These statistics point to the complexities surrounding the lack of health/nutrition literacy and reveal the degree to which they are embedded in the social structure and interconnected with other problems. Among these problems are the lack of information about food choices, a lack of understanding of nutritional information and its application to individual circumstances, limited or difficult access to healthful foods, and a range of cultural influences and socioeconomic constraints such as low levels of education and high levels of poverty that decrease opportunities for healthful eating and living.

The links between low health literacy and poor health outcomes has been widely documented[101] and there is evidence that some interventions to improve health literacy have produced successful results in the primary care setting. More must be done to further our understanding of nutrition literacy specific interventions in non-primary care settings[100] in order to achieve better health outcomes.

Malnutrition refers to insufficient, excessive, or imbalanced consumption of nutrients by an organism. In developed countries, the diseases of malnutrition are most often associated with nutritional imbalances or excessive consumption. In developing countries, malnutrition is more likely to be caused by poor access to a range of nutritious foods or inadequate knowledge. In Mali the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) and the Aga Khan Foundation, trained women's groups to make equinut, a healthy and nutritional version of the traditional recipe di-dgu (comprising peanut paste, honey and millet or rice flour). The aim was to boost nutrition and livelihoods by producing a product that women could make and sell, and which would be accepted by the local community because of its local heritage.[102]

Although there are more organisms in the world who are malnourished due to insufficient consumption, increasingly more organisms suffer from excessive over-nutrition; a problem caused by an over abundance of sustenance coupled with the instinctual desire (by animals in particular) to consume all that it can.

Nutritionism is the view that excessive reliance on food science and the study of nutrition can lead to poor nutrition and to ill health. It was originally credited to Gyorgy Scrinis,[103] and was popularized by Michael Pollan. Since nutrients are invisible, policy makers rely on nutrition experts to advise on food choices. Because science has an incomplete understanding of how food affects the human body, Pollan argues, nutritionism can be blamed for many of the health problems relating to diet in the Western World today.[104][105]

In general, under-consumption refers to the long-term consumption of insufficient sustenance in relation to the energy that an organism expends or expels, leading to poor health.

In general, over-consumption refers to the long-term consumption of excess sustenance in relation to the energy that an organism expends or expels, leading to poor health and, in animals, obesity. It can cause excessive hair loss, brittle nails, and irregular premenstrual cycles for females.

When too much of one or more nutrients is present in the diet to the exclusion of the proper amount of other nutrients, the diet is said to be unbalanced.

Research indicates that improving the awareness of nutritious meal choices and establishing long-term habits of healthy eating have a positive effect on cognitive and spatial memory capacity, with potential to increase a student's ability to process and retain academic information.

Some organizations have begun working with teachers, policymakers, and managed foodservice contractors to mandate improved nutritional content and increased nutritional resources in school cafeterias from primary to university level institutions. Health and nutrition have been proven to have close links with overall educational success.[106] Currently, less than 10% of American college students report that they eat the recommended five servings of fruit and vegetables daily.[107] Better nutrition has been shown to affect both cognitive and spatial memory performance; a study showed those with higher blood sugar levels performed better on certain memory tests.[108] In another study, those who consumed yogurt performed better on thinking tasks when compared to those that consumed caffeine-free diet soda or confections.[109] Nutritional deficiencies have been shown to have a negative effect on learning behavior in mice as far back as 1951.[110]

There is limited research available that directly links a student's Grade Point Average (G.P.A.) to their overall nutritional health. Additional substantive data is needed to prove that overall intellectual health is closely linked to a person's diet, rather than just another correlation fallacy.

Nutritional supplement treatment may be appropriate for major depression, bipolar disorder, schizophrenia, and obsessive compulsive disorder, the four most common mental disorders in developed countries.[116] Supplements that have been studied most for mood elevation and stabilization include eicosapentaenoic acid and docosahexaenoic acid (each of which an omega-3 fatty acid contained in fish oil but not in flaxseed oil), vitamin B12, folic acid, and inositol.

Cancer is now common in developing countries. According to a study by the International Agency for Research on Cancer, "In the developing world, cancers of the liver, stomach and esophagus were more common, often linked to consumption of carcinogenic preserved foods, such as smoked or salted food, and parasitic infections that attack organs." Lung cancer rates are rising rapidly in poorer nations because of increased use of tobacco. Developed countries "tended to have cancers linked to affluence or a 'Western lifestyle' cancers of the colon, rectum, breast and prostate that can be caused by obesity, lack of exercise, diet and age."[117]

Several lines of evidence indicate lifestyle-induced hyperinsulinemia and reduced insulin function (i.e., insulin resistance) as a decisive factor in many disease states. For example, hyperinsulinemia and insulin resistance are strongly linked to chronic inflammation, which in turn is strongly linked to a variety of adverse developments such as arterial microinjuries and clot formation (i.e., heart disease) and exaggerated cell division (i.e., cancer). Hyperinsulinemia and insulin resistance (the so-called metabolic syndrome) are characterized by a combination of abdominal obesity, elevated blood sugar, elevated blood pressure, elevated blood triglycerides, and reduced HDL cholesterol. The negative effect of hyperinsulinemia on prostaglandin PGE1/PGE2 balance may be significant.

The state of obesity clearly contributes to insulin resistance, which in turn can cause type 2 diabetes. Virtually all obese and most type 2 diabetic individuals have marked insulin resistance. Although the association between overweight and insulin resistance is clear, the exact (likely multifarious) causes of insulin resistance remain less clear. It is important to note that it has been demonstrated that appropriate exercise, more regular food intake, and reducing glycemic load (see below) all can reverse insulin resistance in overweight individuals (and thereby lower blood sugar levels in those with type 2 diabetes).

Obesity can unfavourably alter hormonal and metabolic status via resistance to the hormone leptin, and a vicious cycle may occur in which insulin/leptin resistance and obesity aggravate one another. The vicious cycle is putatively fuelled by continuously high insulin/leptin stimulation and fat storage, as a result of high intake of strongly insulin/leptin stimulating foods and energy. Both insulin and leptin normally function as satiety signals to the hypothalamus in the brain; however, insulin/leptin resistance may reduce this signal and therefore allow continued overfeeding despite large body fat stores. In addition, reduced leptin signalling to the brain may reduce leptin's normal effect to maintain an appropriately high metabolic rate.

There is a debate about how and to what extent different dietary factors such as intake of processed carbohydrates, total protein, fat, and carbohydrate intake, intake of saturated and trans fatty acids, and low intake of vitamins/mineralscontribute to the development of insulin and leptin resistance. In any case, analogous to the way modern man-made pollution may possess the potential to overwhelm the environment's ability to maintain homeostasis, the recent explosive introduction of high glycemic index and processed foods into the human diet may possess the potential to overwhelm the body's ability to maintain homeostasis and health (as evidenced by the metabolic syndrome epidemic).

Excess water intake, without replenishment of sodium and potassium salts, leads to hyponatremia, which can further lead to water intoxication at more dangerous levels. A well-publicized case occurred in 2007, when Jennifer Strange died while participating in a water-drinking contest.[118] More usually, the condition occurs in long-distance endurance events (such as marathon or triathlon competition and training) and causes gradual mental dulling, headache, drowsiness, weakness, and confusion; extreme cases may result in coma, convulsions, and death. The primary damage comes from swelling of the brain, caused by increased osmosis as blood salinity decreases. Effective fluid replacement techniques include water aid stations during running/cycling races, trainers providing water during team games, such as soccer, and devices such as Camel Baks, which can provide water for a person without making it too hard to drink the water.

Antinutrients are natural or synthetic compounds that interfere with the absorption of nutrients. Nutrition studies focus on antinutrients commonly found in food sources and beverages.

Sugar consumption in the United States

The relatively recent increased consumption of sugar has been linked to the rise of some afflictions such as diabetes, obesity, and more recently heart disease. Increased consumption of sugar has been tied to these three, among others. Obesity levels have more than doubled in the last 30 years among adults, going from 15% to 35% in the United States.[119] Obesity and diet also happen to be high risk factors for diabetes. In the same time span that obesity doubled, diabetes numbers quadrupled in America. Increased weight, especially in the form of belly fat, and high sugar intake are also high risk factors for heart disease.[120] Both sugar intake and fatty tissue increase the probability of elevated LDL cholesterol in the bloodstream. Elevated amounts of Low-density lipoprotein (LDL) cholesterol, is the primary factor in heart disease. In order to avoid all the dangers of sugar, moderate consumption is paramount.

Since the Industrial Revolution some two hundred years ago, the food processing industry has invented many technologies that both help keep foods fresh longer and alter the fresh state of food as they appear in nature. Cooling is the primary technology used to maintain freshness, whereas many more technologies have been invented to allow foods to last longer without becoming spoiled. These latter technologies include pasteurisation, autoclavation, drying, salting, and separation of various components, all of which appearing to alter the original nutritional contents of food. Pasteurisation and autoclavation (heating techniques) have no doubt improved the safety of many common foods, preventing epidemics of bacterial infection. But some of the (new) food processing technologies have downfalls as well.

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Supercourse: Epidemiology, the Internet, and Global Health

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Barnabas Health – Comprehensive Healthcare in New Jersey

Posted: October 15, 2016 at 5:42 am


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Alternative medicine – Wikipedia

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Alternative medicine is any practice claimed to have the healing effects of medicine and is proven not to work, has no scientific evidence showing that it works, or that is solely harmful.[n 1][n 2][n 3] Alternative medicine is not a part of medicine.[n 1][n 4][n 5][n 6] It consists of a wide variety of practices, products, and therapiesranging from those that are biologically plausible but not well tested, to those directly contradicted by evidence, to those that are harmful and toxic.[n 4][1][2][3][4][5] Alternative medicine is not part of science-based healthcare systems.[6][7][9] Despite significant costs in research testing alternative medicine, including $2.5 billion spent by the United States government, almost none have shown any effectiveness beyond that of false treatments (placebo). Alternative medicine has been criticized by prominent figures in science and medicine as being quackery, nonsense, fraudulent, unethical, or all of the previous.[10][11]

Complementary medicine or integrative medicine is when alternative medicine is used together with functional medical treatment, in a belief that it "complements" (improves the efficacy of) the treatment.[n 7][13][14][15][16] However, significant drug interactions caused by alternative therapies may instead negatively influence the treatment, making treatments less effective, notably in cancer treatment.[17][18]CAM is an abbreviation of complementary and alternative medicine.[19][20]Holistic health or holistic medicine claims to take into account the "whole" person, including spirituality in its treatmentsand is a similar concept.

Alternative medical diagnoses and treatments are not included in the science-based treatments taught in medical schools, and are not used in medical practice where treatments are based on scientific knowledge. Alternative therapies lack scientific validation, and their effectiveness is either unproven, disproved, or impossible to prove.[n 8][1][13][22][23] Alternative medicine is based on religion, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, or fraud.[1][24][2][13] Regulation and licensing of alternative medicine and health care providers varies from country to country, and within countries. Marketing alternative treatments for cancer is illegal in many countries including the United States and most parts of the European Union.

Alternative medicine has been criticized for being based on misleading statements, quackery, pseudoscience, antiscience, fraud, or poor scientific methodology. Promoting alternative medicine has been called dangerous and unethical.[n 9][26] Testing alternative medicine when based on no scientific underpinning has been called a waste of scarce medical research resources.[27][28] Critics have said "there is really no such thing as alternative medicine, just medicine that works and medicine that doesn't",[29] and that the concept of alternative medicine that works is paradoxical, as any treatment proven to work is simply "medicine".[30]

Alternative medicine consists of a wide range of health care practices, products, and therapies. The shared feature is a claim to heal that is not based on the scientific method. Alternative medicine practices are diverse in their foundations and methodologies.[6] Alternative medicine practices may be classified by their cultural origins or by the types of beliefs upon which they are based.[1][24][6][13] Methods may incorporate or be based on traditional medicinal practices of a particular culture, folk knowledge, supersition, spiritual beliefs, belief in supernatural energies (antiscience), pseudoscience, errors in reasoning, propaganda, fraud, new or different concepts of health and disease, and any bases other than being proven by scientific methods.[1][24][2][13] Different cultures may have their own unique traditional or belief based practices developed recently or over thousands of years, and specific practices or entire systems of practices.

Alternative medicine, such as using naturopathy or homeopathy in place of conventional medicine, is based on belief systems not grounded in science.[6]

Homeopathy is a system developed in a belief that a substance that causes the symptoms of a disease in healthy people cures similar symptoms in sick people.[n 10] It was developed before knowledge of atoms and molecules, and of basic chemistry, which shows that repeated dilution as practiced in homeopathy produces only water, and that homeopathy is scientifically implausible.[33][34][35][36] Homeopathy is considered quackery in the medical community.[37]

Naturopathic medicine is based on a belief that the body heals itself using a supernatural vital energy that guides bodily processes,[38] a view in conflict with the paradigm of evidence-based medicine.[39] Many naturopaths have opposed vaccination,[40] and "scientific evidence does not support claims that naturopathic medicine can cure cancer or any other disease".[41]

Alternative medical systems may be based on traditional medicine practices, such as traditional Chinese medicine, Ayurveda in India, or practices of other cultures around the world.[6]

Traditional Chinese medicine is a combination of traditional practices and beliefs developed over thousands of years in China, together with modifications made by the Communist party. Common practices include herbal medicine, acupuncture (insertion of needles in the body at specified points), massage (Tui na), exercise (qigong), and dietary therapy. The practices are based on belief in a supernatural energy called qi, considerations of Chinese Astrology and Chinese numerology, traditional use of herbs and other substances found in Chinaa belief that the tongue contains a map of the body that reflects changes in the body, and an incorrect model of the anatomy and physiology of internal organs.[1][42][43][44][45][46]

The Chinese Communist Party Chairman Mao Zedong, in response to a lack of modern medical practitioners, revived acupuncture, and had its theory rewritten to adhere to the political, economic, and logistic necessities of providing for the medical needs of China's population.[47][pageneeded] In the 1950s the "history" and theory of traditional Chinese medicine was rewritten as communist propaganda, at Mao's insistence, to correct the supposed "bourgeois thought of Western doctors of medicine".Acupuncture gained attention in the United States when President Richard Nixon visited China in 1972, and the delegation was shown a patient undergoing major surgery while fully awake, ostensibly receiving acupuncture rather than anesthesia. Later it was found that the patients selected for the surgery had both a high pain tolerance and received heavy indoctrination before the operation; these demonstration cases were also frequently receiving morphine surreptitiously through an intravenous drip that observers were told contained only fluids and nutrients.[42]Cochrane reviews found acupuncture is not effective for a wide range of conditions.[49] A systematic review of systematic reviews found that for reducing pain, real acupuncture was no better than sham acupuncture.[50] Although, other reviews have found that acupuncture is successful at reducing chronic pain, where as sham acupuncture was not found to be better than a placebo as well as no-acupuncture groups.[51]

Ayurvedic medicine is a traditional medicine of India. Ayurveda believes in the existence of three elemental substances, the doshas (called Vata, Pitta and Kapha), and states that a balance of the doshas results in health, while imbalance results in disease. Such disease-inducing imbalances can be adjusted and balanced using traditional herbs, minerals and heavy metals. Ayurveda stresses the use of plant-based medicines and treatments, with some animal products, and added minerals, including sulfur, arsenic, lead, copper sulfate.[citation needed]

Safety concerns have been raised about Ayurveda, with two U.S. studies finding about 20 percent of Ayurvedic Indian-manufactured patent medicines contained toxic levels of heavy metals such as lead, mercury and arsenic. Other concerns include the use of herbs containing toxic compounds and the lack of quality control in Ayurvedic facilities. Incidents of heavy metal poisoning have been attributed to the use of these compounds in the United States.[4][54][55][56]

Bases of belief may include belief in existence of supernatural energies undetected by the science of physics, as in biofields, or in belief in properties of the energies of physics that are inconsistent with the laws of physics, as in energy medicine.[6]

Biofield therapies are intended to influence energy fields that, it is purported, surround and penetrate the body.[6] Writers such as noted astrophysicist and advocate of skeptical thinking (Scientific skepticism) Carl Sagan (1934-1996) have described the lack of empirical evidence to support the existence of the putative energy fields on which these therapies are predicated.

Acupuncture is a component of traditional Chinese medicine. Proponents of acupuncture believe that a supernatural energy called qi flows through the universe and through the body, and helps propel the bloodand that blockage of this energy leads to disease.[43] They believe that inserting needles in various parts of the body, determined by astrological calculations, can restore balance to the blocked flows and thereby cure disease.[43]

Chiropractic was developed in the belief that manipulating the spine affects the flow of a supernatural vital energy and thereby affects health and disease.

In the western version of Japanese Reiki, practitioners place their palms on the patient near Chakras that they believe are centers of supernatural energies, and believe that these supernatural energies can transfer from the practitioner's palms to heal the patient.

Bioelectromagnetic-based therapies use verifiable electromagnetic fields, such as pulsed fields, alternating-current, or direct-current fields in an unconventional manner.[6]Magnetic healing does not claim existence of supernatural energies, but asserts that magnets can be used to defy the laws of physics to influence health and disease.

Mind-body medicine takes a holistic approach to health that explores the interconnection between the mind, body, and spirit. It works under the premise that the mind can affect "bodily functions and symptoms".[6] Mind body medicines includes healing claims made in yoga, meditation, deep-breathing exercises, guided imagery, hypnotherapy, progressive relaxation, qi gong, and tai chi.[6]

Yoga, a method of traditional stretches, exercises, and meditations in Hinduism, may also be classified as an energy medicine insofar as its healing effects are believed to be due to a healing "life energy" that is absorbed into the body through the breath, and is thereby believed to treat a wide variety of illnesses and complaints.[58]

Since the 1990s, tai chi (t'ai chi ch'uan) classes that purely emphasise health have become popular in hospitals, clinics, as well as community and senior centers. This has occurred as the baby boomers generation has aged and the art's reputation as a low-stress training method for seniors has become better known.[59][60] There has been some divergence between those that say they practice t'ai chi ch'uan primarily for self-defence, those that practice it for its aesthetic appeal (see wushu below), and those that are more interested in its benefits to physical and mental health.

Qigong, chi kung, or chi gung, is a practice of aligning body, breath, and mind for health, meditation, and martial arts training. With roots in traditional Chinese medicine, philosophy, and martial arts, qigong is traditionally viewed as a practice to cultivate and balance qi (chi) or what has been translated as "life energy".[61]

Substance based practices use substances found in nature such as herbs, foods, non-vitamin supplements and megavitamins, animal and fungal products, and minerals, including use of these products in traditional medical practices that may also incorporate other methods.[6][11][62] Examples include healing claims for nonvitamin supplements, fish oil, Omega-3 fatty acid, glucosamine, echinacea, flaxseed oil, and ginseng.[63]Herbal medicine, or phytotherapy, includes not just the use of plant products, but may also include the use of animal and mineral products.[11] It is among the most commercially successful branches of alternative medicine, and includes the tablets, powders and elixirs that are sold as "nutritional supplements".[11] Only a very small percentage of these have been shown to have any efficacy, and there is little regulation as to standards and safety of their contents.[11] This may include use of known toxic substances, such as use of the poison lead in traditional Chinese medicine.[63]

Manipulative and body-based practices feature the manipulation or movement of body parts, such as is done in bodywork and chiropractic manipulation.

Osteopathic manipulative medicine, also known as osteopathic manipulative treatment, is a core set of techniques of osteopathy and osteopathic medicine distinguishing these fields from mainstream medicine.[64]

Religion based healing practices, such as use of prayer and the laying of hands in Christian faith healing, and shamanism, rely on belief in divine or spiritual intervention for healing.

Shamanism is a practice of many cultures around the world, in which a practitioner reaches an altered states of consciousness in order to encounter and interact with the spirit world or channel supernatural energies in the belief they can heal.[65]

Some alternative medicine practices may be based on pseudoscience, ignorance, or flawed reasoning.[66] This can lead to fraud.[1]

Practitioners of electricity and magnetism based healing methods may deliberately exploit a patient's ignorance of physics to defraud them.[13]

"Alternative medicine" is a loosely defined set of products, practices, and theories that are believed or perceived by their users to have the healing effects of medicine,[n 2][n 4] but whose effectiveness has not been clearly established using scientific methods,[n 2][n 3][1][2][21][23] whose theory and practice is not part of biomedicine,[n 4][n 1][n 5][n 6] or whose theories or practices are directly contradicted by scientific evidence or scientific principles used in biomedicine.[1][24][2] "Biomedicine" is that part of medical science that applies principles of biology, physiology, molecular biology, biophysics, and other natural sciences to clinical practice, using scientific methods to establish the effectiveness of that practice. Alternative medicine is a diverse group of medical and health care systems, practices, and products that originate outside of biomedicine,[n 1] are not considered part of biomedicine,[6] are not widely used by the biomedical healthcare professions,[71] and are not taught as skills practiced in biomedicine.[71] Unlike biomedicine,[n 1] an alternative medicine product or practice does not originate from the sciences or from using scientific methodology, but may instead be based on testimonials, religion, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources.[n 3][1][2][13] The expression "alternative medicine" refers to a diverse range of related and unrelated products, practices, and theories, originating from widely varying sources, cultures, theories, and belief systems, and ranging from biologically plausible practices and products and practices with some evidence, to practices and theories that are directly contradicted by basic science or clear evidence, and products that have proven to be ineffective or even toxic and harmful.[n 4][3][4]

Alternative medicine, complementary medicine, holistic medicine, natural medicine, unorthodox medicine, fringe medicine, unconventional medicine, and new age medicine are used interchangeably as having the same meaning (are synonyms) in some contexts,[72][73][74] but may have different meanings in other contexts, for example, unorthodox medicine may refer to biomedicine that is different from what is commonly practiced, and fringe medicine may refer to biomedicine that is based on fringe science, which may be scientifically valid but is not mainstream.

The meaning of the term "alternative" in the expression "alternative medicine", is not that it is an actual effective alternative to medical science, although some alternative medicine promoters may use the loose terminology to give the appearance of effectiveness.[1]Marcia Angell stated that "alternative medicine" is "a new name for snake oil. There's medicine that works and medicine that doesn't work."[75] Loose terminology may also be used to suggest meaning that a dichotomy exists when it does not, e.g., the use of the expressions "western medicine" and "eastern medicine" to suggest that the difference is a cultural difference between the Asiatic east and the European west, rather than that the difference is between evidence-based medicine and treatments that don't work.[1]

"Complementary medicine" refers to use of alternative medical treatments alongside conventional medicine, in the belief that it increases the effectiveness of the science-based medicine.[76][77][78] An example of "complementary medicine" is use of acupuncture (sticking needles in the body to influence the flow of a supernatural energy), along with using science-based medicine, in the belief that the acupuncture increases the effectiveness or "complements" the science-based medicine.[78] "CAM" is an abbreviation for "complementary and alternative medicine".

The expression "Integrative medicine" (or "integrated medicine") is used in two different ways. One use refers to a belief that medicine based on science can be "integrated" with practices that are not. Another use refers only to a combination of alternative medical treatments with conventional treatments that have some scientific proof of efficacy, in which case it is identical with CAM.[16] "holistic medicine" (or holistic health) is an alternative medicine practice that claims to treat the "whole person" and not just the illness.

"Traditional medicine" and "folk medicine" refer to prescientific practices of a culture, not to what is traditionally practiced in cultures where medical science dominates. "Eastern medicine" typically refers to prescientific traditional medicines of Asia. "Western medicine", when referring to modern practice, typically refers to medical science, and not to alternative medicines practiced in the west (Europe and the Americas). "Western medicine", "biomedicine", "mainstream medicine", "medical science", "science-based medicine", "evidence-based medicine", "conventional medicine", "standard medicine", "orthodox medicine", "allopathic medicine", "dominant health system", and "medicine", are sometimes used interchangeably as having the same meaning, when contrasted with alternative medicine, but these terms may have different meanings in some contexts, e.g., some practices in medical science are not supported by rigorous scientific testing so "medical science" is not strictly identical with "science-based medicine", and "standard medical care" may refer to "best practice" when contrasted with other biomedicine that is less used or less recommended.[n 11][81]

Prominent members of the science[29][82] and biomedical science community[22] assert that it is not meaningful to define an alternative medicine that is separate from a conventional medicine, that the expressions "conventional medicine", "alternative medicine", "complementary medicine", "integrative medicine", and "holistic medicine" do not refer to anything at all.[22][29][82][83] Their criticisms of trying to make such artificial definitions include: "There's no such thing as conventional or alternative or complementary or integrative or holistic medicine. There's only medicine that works and medicine that doesn't;"[22][29][82] "By definition, alternative medicine has either not been proved to work, or been proved not to work. You know what they call alternative medicine that's been proved to work? Medicine;"[30] "There cannot be two kinds of medicine conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted;"[22] and "There is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking."[83]

Others in both the biomedical and CAM communities point out that CAM cannot be precisely defined because of the diversity of theories and practices it includes, and because the boundaries between CAM and biomedicine overlap, are porous, and change. The expression "complementary and alternative medicine" (CAM) resists easy definition because the health systems and practices it refers to are diffuse, and its boundaries poorly defined.[3][n 12] Healthcare practices categorized as alternative may differ in their historical origin, theoretical basis, diagnostic technique, therapeutic practice and in their relationship to the medical mainstream. Some alternative therapies, including traditional Chinese medicine (TCM) and Ayurveda, have antique origins in East or South Asia and are entirely alternative medical systems;[88] others, such as homeopathy and chiropractic, have origins in Europe or the United States and emerged in the eighteenth and nineteenth centuries. Some, such as osteopathy and chiropractic, employ manipulative physical methods of treatment; others, such as meditation and prayer, are based on mind-body interventions. Treatments considered alternative in one location may be considered conventional in another.[91] Thus, chiropractic is not considered alternative in Denmark and likewise osteopathic medicine is no longer thought of as an alternative therapy in the United States.[91]

One common feature of all definitions of alternative medicine is its designation as "other than" conventional medicine. For example, the widely referenced descriptive definition of complementary and alternative medicine devised by the US National Center for Complementary and Integrative Health (NCCIH) of the National Institutes of Health (NIH), states that it is "a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine."[6] For conventional medical practitioners, it does not necessarily follow that either it or its practitioners would no longer be considered alternative.[n 13]

Some definitions seek to specify alternative medicine in terms of its social and political marginality to mainstream healthcare.[96] This can refer to the lack of support that alternative therapies receive from the medical establishment and related bodies regarding access to research funding, sympathetic coverage in the medical press, or inclusion in the standard medical curriculum.[96] In 1993, the British Medical Association (BMA), one among many professional organizations who have attempted to define alternative medicine, stated that it[n 14] referred to "...those forms of treatment which are not widely used by the conventional healthcare professions, and the skills of which are not taught as part of the undergraduate curriculum of conventional medical and paramedical healthcare courses."[71] In a US context, an influential definition coined in 1993 by the Harvard-based physician,[97] David M. Eisenberg,[98] characterized alternative medicine "as interventions neither taught widely in medical schools nor generally available in US hospitals".[99] These descriptive definitions are inadequate in the present-day when some conventional doctors offer alternative medical treatments and CAM introductory courses or modules can be offered as part of standard undergraduate medical training;[100] alternative medicine is taught in more than 50 per cent of US medical schools and increasingly US health insurers are willing to provide reimbursement for CAM therapies. In 1999, 7.7% of US hospitals reported using some form of CAM therapy; this proportion had risen to 37.7% by 2008.[102]

An expert panel at a conference hosted in 1995 by the US Office for Alternative Medicine (OAM),[103][n 15] devised a theoretical definition[103] of alternative medicine as "a broad domain of healing resources... other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period."[104] This definition has been widely adopted by CAM researchers,[103] cited by official government bodies such as the UK Department of Health,[105] attributed as the definition used by the Cochrane Collaboration,[106] and, with some modification,[dubious discuss] was preferred in the 2005 consensus report of the US Institute of Medicine, Complementary and Alternative Medicine in the United States.[n 4]

The 1995 OAM conference definition, an expansion of Eisenberg's 1993 formulation, is silent regarding questions of the medical effectiveness of alternative therapies.[107] Its proponents hold that it thus avoids relativism about differing forms of medical knowledge and, while it is an essentially political definition, this should not imply that the dominance of mainstream biomedicine is solely due to political forces.[107] According to this definition, alternative and mainstream medicine can only be differentiated with reference to what is "intrinsic to the politically dominant health system of a particular society of culture".[108] However, there is neither a reliable method to distinguish between cultures and subcultures, nor to attribute them as dominant or subordinate, nor any accepted criteria to determine the dominance of a cultural entity.[108] If the culture of a politically dominant healthcare system is held to be equivalent to the perspectives of those charged with the medical management of leading healthcare institutions and programs, the definition fails to recognize the potential for division either within such an elite or between a healthcare elite and the wider population.[108]

Normative definitions distinguish alternative medicine from the biomedical mainstream in its provision of therapies that are unproven, unvalidated, or ineffective and support of theories with no recognized scientific basis. These definitions characterize practices as constituting alternative medicine when, used independently or in place of evidence-based medicine, they are put forward as having the healing effects of medicine, but are not based on evidence gathered with the scientific method.[6][13][22][76][77][110] Exemplifying this perspective, a 1998 editorial co-authored by Marcia Angell, a former editor of the New England Journal of Medicine, argued that:

This line of division has been subject to criticism, however, as not all forms of standard medical practice have adequately demonstrated evidence of benefit, [n 1][81] and it is also unlikely in most instances that conventional therapies, if proven to be ineffective, would ever be classified as CAM.[103]

Public information websites maintained by the governments of the US and of the UK make a distinction between "alternative medicine" and "complementary medicine", but mention that these two overlap. The National Center for Complementary and Integrative Health (NCCIH) of the National Institutes of Health (NIH) (a part of the US Department of Health and Human Services) states that "alternative medicine" refers to using a non-mainstream approach in place of conventional medicine and that "complementary medicine" generally refers to using a non-mainstream approach together with conventional medicine, and comments that the boundaries between complementary and conventional medicine overlap and change with time.[6]

The National Health Service (NHS) website NHS Choices (owned by the UK Department of Health), adopting the terminology of NCCIH, states that when a treatment is used alongside conventional treatments, to help a patient cope with a health condition, and not as an alternative to conventional treatment, this use of treatments can be called "complementary medicine"; but when a treatment is used instead of conventional medicine, with the intention of treating or curing a health condition, the use can be called "alternative medicine".[112]

Similarly, the public information website maintained by the National Health and Medical Research Council (NHMRC) of the Commonwealth of Australia uses the acronym "CAM" for a wide range of health care practices, therapies, procedures and devices not within the domain of conventional medicine. In the Australian context this is stated to include acupuncture; aromatherapy; chiropractic; homeopathy; massage; meditation and relaxation therapies; naturopathy; osteopathy; reflexology, traditional Chinese medicine; and the use of vitamin supplements.[113]

The Danish National Board of Health's "Council for Alternative Medicine" (Sundhedsstyrelsens Rd for Alternativ Behandling (SRAB)), an independent institution under the National Board of Health (Danish: Sundhedsstyrelsen), uses the term "alternative medicine" for:

In General Guidelines for Methodologies on Research and Evaluation of Traditional Medicine, published in 2000 by the World Health Organization (WHO), complementary and alternative medicine were defined as a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system.[115] Some herbal therapies are mainstream in Europe but are alternative in the US.[117]

The history of alternative medicine may refer to the history of a group of diverse medical practices that were collectively promoted as "alternative medicine" beginning in the 1970s, to the collection of individual histories of members of that group, or to the history of western medical practices that were labeled "irregular practices" by the western medical establishment.[1][118][119][120][121] It includes the histories of complementary medicine and of integrative medicine. Before the 1970s, western practitioners that were not part of the increasingly science-based medical establishment were referred to "irregular practitioners", and were dismissed by the medical establishment as unscientific and as practicing quackery.[118][119] Until the 1970's, irregular practice became increasingly marginalized as quackery and fraud, as western medicine increasingly incorporated scientific methods and discoveries, and had a corresponding increase in success of its treatments.[120] In the 1970s, irregular practices were grouped with traditional practices of nonwestern cultures and with other unproven or disproven practices that were not part of biomedicine, with the entire group collectively marketed and promoted under the single expression "alternative medicine".[1][118][119][120][122]

Use of alternative medicine in the west began to rise following the counterculture movement of the 1960s, as part of the rising new age movement of the 1970s.[1][123][124] This was due to misleading mass marketing of "alternative medicine" being an effective "alternative" to biomedicine, changing social attitudes about not using chemicals and challenging the establishment and authority of any kind, sensitivity to giving equal measure to beliefs and practices of other cultures (cultural relativism), and growing frustration and desperation by patients about limitations and side effects of science-based medicine.[1][119][120][121][122][124][125] At the same time, in 1975, the American Medical Association, which played the central role in fighting quackery in the United States, abolished its quackery committee and closed down its Department of Investigation.[118]:xxi[125] By the early to mid 1970s the expression "alternative medicine" came into widespread use, and the expression became mass marketed as a collection of "natural" and effective treatment "alternatives" to science-based biomedicine.[1][125][126][127] By 1983, mass marketing of "alternative medicine" was so pervasive that the British Medical Journal (BMJ) pointed to "an apparently endless stream of books, articles, and radio and television programmes urge on the public the virtues of (alternative medicine) treatments ranging from meditation to drilling a hole in the skull to let in more oxygen".[125] In this 1983 article, the BMJ wrote, "one of the few growth industries in contemporary Britain is alternative medicine", noting that by 1983, "33% of patients with rheumatoid arthritis and 39% of those with backache admitted to having consulted an alternative practitioner".[125]

By about 1990, the American alternative medicine industry had grown to a $27 Billion per year, with polls showing 30% of Americans were using it.[124][128] Moreover, polls showed that Americans made more visits for alternative therapies than the total number of visits to primary care doctors, and American out-of-pocket spending (non-insurance spending) on alternative medicine was about equal to spending on biomedical doctors.[118]:172 In 1991, Time magazine ran a cover story, "The New Age of Alternative Medicine: Why New Age Medicine Is Catching On".[124][128] In 1993, the New England Journal of Medicine reported one in three Americans as using alternative medicine.[124] In 1993, the Public Broadcasting System ran a Bill Moyers special, Healing and the Mind, with Moyers commenting that "...people by the tens of millions are using alternative medicine. If established medicine does not understand that, they are going to lose their clients."[124]

Another explosive growth began in the 1990s, when senior level political figures began promoting alternative medicine, investing large sums of government medical research funds into testing alternative medicine, including testing of scientifically implausible treatments, and relaxing government regulation of alternative medicine products as compared to biomedical products.[1][118]:xxi[119][120][121][122][129][130] Beginning with a 1991 appropriation of $2 million for funding research of alternative medicine research, federal spending grew to a cumulative total of about $2.5 billion by 2009, with 50% of Americans using alternative medicine by 2013.[10][131]

In 1991, pointing to a need for testing because of the widespread use of alternative medicine without authoritative information on its efficacy, United States Senator Tom Harkin used $2 million of his discretionary funds to create the Office for the Study of Unconventional Medical Practices (OSUMP), later renamed to be the Office of Alternative Medicine (OAM).[118]:170[132][133] The OAM was created to be within the National Institute of Health (NIH), the scientifically prestigious primary agency of the United States government responsible for biomedical and health-related research.[118]:170[132][133] The mandate was to investigate, evaluate, and validate effective alternative medicine treatments, and alert the public as the results of testing its efficacy.[128][132][133][134]

Sen. Harkin had become convinced his allergies were cured by taking bee pollen pills, and was urged to make the spending by two of his influential constituents.[128][132][133] Bedell, a longtime friend of Sen. Harkin, was a former member of the United States House of Representatives who believed that alternative medicine had twice cured him of diseases after mainstream medicine had failed, claiming that cow's milk colostrum cured his Lyme disease, and an herbal derivative from camphor had prevented post surgical recurrence of his prostate cancer.[118][128] Wiewel was a promoter of unproven cancer treatments involving a mixture of blood sera that the Food and Drug Administration had banned from being imported.[128] Both Bedell and Wiewel became members of the advisory panel for the OAM. The company that sold the bee pollen was later fined by the Federal Trade Commission for making false health claims about their bee-pollen products reversing the aging process, curing allergies, and helping with weight loss.[135]

In 1993, Britain's Prince Charles, who claimed that homeopathy and other alternative medicine was an effective alternative to biomedicine, established the Foundation for Integrated Health (FIH), as a charity to explore "how safe, proven complementary therapies can work in conjunction with mainstream medicine".[136] The FIH received government funding through grants from Britain's Department of Health.[136]

In 1994, Sen. Harkin (D) and Senator Orrin Hatch (R) introduced the Dietary Supplement Health and Education Act (DSHEA).[137][138] The act reduced authority of the FDA to monitor products sold as "natural" treatments.[137] Labeling standards were reduced to allow health claims for supplements based only on unconfirmed preliminary studies that were not subjected to scientific peer review, and the act made it more difficult for the FDA to promptly seize products or demand proof of safety where there was evidence of a product being dangerous.[138] The Act became known as the "The 1993 Snake Oil Protection Act" following a New York Times editorial under that name.[137]

Senator Harkin complained about the "unbendable rules of randomized clinical trials", citing his use of bee pollen to treat his allergies, which he claimed to be effective even though it was biologically implausible and efficacy was not established using scientific methods.[132][139] Sen. Harkin asserted that claims for alternative medicine efficacy be allowed not only without conventional scientific testing, even when they are biologically implausible, "It is not necessary for the scientific community to understand the process before the American public can benefit from these therapies."[137] Following passage of the act, sales rose from about $4 billion in 1994, to $20 billion by the end of 2000, at the same time as evidence of their lack of efficacy or harmful effects grew.[137] Senator Harkin came into open public conflict with the first OAM Director Joseph M. Jacobs and OAM board members from the scientific and biomedical community.[133] Jacobs' insistence on rigorous scientific methodology caused friction with Senator Harkin.[132][139][140] Increasing political resistance to the use of scientific methodology was publicly criticized by Dr. Jacobs and another OAM board member complained that "nonsense has trickled down to every aspect of this office".[132][139] In 1994, Senator Harkin appeared on television with cancer patients who blamed Dr. Jacobs for blocking their access to untested cancer treatment, leading Jacobs to resign in frustration.[132][139]

In 1995, Wayne Jonas, a promoter of homeopathy and political ally of Senator Harkin, became the director of the OAM, and continued in that role until 1999.[141] In 1997, the NCCAM budget was increased from $12 million to $20 million annually.[142] From 1990 to 1997, use of alternative medicine in the US increased by 25%, with a corresponding 50% increase in expenditures.[143] The OAM drew increasing criticism from eminent members of the scientific community with letters to the Senate Appropriations Committee when discussion of renewal of funding OAM came up.[118]:175 Nobel laureate Paul Berg wrote that prestigious NIH should not be degraded to act as a cover for quackery, calling the OAM "an embarrassment to serious scientists."[118]:175[142] The president of the American Physical Society wrote complaining that the government was spending money on testing products and practices that "violate basic laws of physics and more clearly resemble witchcraft".[118]:175[142] In 1998, the President of the North Carolina Medical Association publicly called for shutting down the OAM.[144]

In 1998, NIH director and Nobel laureate Harold Varmus came into conflict with Senator Harkin by pushing to have more NIH control of alternative medicine research.[145] The NIH Director placed the OAM under more strict scientific NIH control.[142][145] Senator Harkin responded by elevating OAM into an independent NIH "center", just short of being its own "institute", and renamed to be the National Center for Complementary and Alternative Medicine (NCCAM). NCCAM had a mandate to promote a more rigorous and scientific approach to the study of alternative medicine, research training and career development, outreach, and "integration". In 1999, the NCCAM budget was increased from $20 million to $50 million.[144][145] The United States Congress approved the appropriations without dissent. In 2000, the budget was increased to about $68 million, in 2001 to $90 million, in 2002 to $104 million, and in 2003, to $113 million.[144]

In 2004, modifications of the European Parliament's 2001 Directive 2001/83/EC, regulating all medicine products, were made with the expectation of influencing development of the European market for alternative medicine products.[146] Regulation of alternative medicine in Europe was loosened with "a simplified registration procedure" for traditional herbal medicinal products.[146][147] Plausible "efficacy" for traditional medicine was redefined to be based on long term popularity and testimonials ("the pharmacological effects or efficacy of the medicinal product are plausible on the basis of long-standing use and experience."), without scientific testing.[146][147] The Committee on Herbal Medicinal Products (HMPC) was created within the European Medicines Agency in London (EMEA). A special working group was established for homeopathic remedies under the Heads of Medicines Agencies.[146]

Through 2004, alternative medicine that was traditional to Germany continued to be a regular part of the health care system, including homeopathy and anthroposophic medicine.[146] The German Medicines Act mandated that science-based medical authorities consider the "particular characteristics" of complementary and alternative medicines.[146] By 2004, homeopathy had grown to be the most used alternative therapy in France, growing from 16% of the population using homeopathic medicine in 1982, to 29% by 1987, 36% percent by 1992, and 62% of French mothers using homeopathic medicines by 2004, with 94.5% of French pharmacists advising pregnant women to use homeopathic remedies.[148] As of 2004[update], 100 million people in India depended solely on traditional German homeopathic remedies for their medical care.[149] As of 2010[update], homeopathic remedies continued to be the leading alternative treatment used by European physicians.[148] By 2005, sales of homeopathic remedies and anthroposophical medicine had grown to $930 million Euros, a 60% increase from 1995.[148][150]

In 2008, London's The Times published a letter from Edzard Ernst that asked the FIH to recall two guides promoting alternative medicine, saying: "the majority of alternative therapies appear to be clinically ineffective, and many are downright dangerous." In 2010, Brittan's FIH closed after allegations of fraud and money laundering led to arrests of its officials.[136]

In 2009, after a history of 17 years of government testing and spending of nearly $2.5 billion on research had produced almost no clearly proven efficacy of alternative therapies, Senator Harkin complained, "One of the purposes of this center was to investigate and validate alternative approaches. Quite frankly, I must say publicly that it has fallen short. It think quite frankly that in this center and in the office previously before it, most of its focus has been on disproving things rather than seeking out and approving."[145][151][152] Members of the scientific community criticized this comment as showing Senator Harkin did not understand the basics of scientific inquiry, which tests hypotheses, but never intentionally attempts to "validate approaches".[145] Members of the scientific and biomedical communities complained that after a history of 17 years of being tested, at a cost of over $2.5 Billion on testing scientifically and biologically implausible practices, almost no alternative therapy showed clear efficacy.[10] In 2009, the NCCAM's budget was increased to about $122 million.[145] Overall NIH funding for CAM research increased to $300 Million by 2009.[145] By 2009, Americans were spending $34 Billion annually on CAM.[153]

Since 2009, according to Art. 118a of the Swiss Federal Constitution, the Swiss Confederation and the Cantons of Switzerland shall within the scope of their powers ensure that consideration is given to complementary medicine.[154]

In 2012, the Journal of the American Medical Association (JAMA) published a criticism that study after study had been funded by NCCAM, but "failed to prove that complementary or alternative therapies are anything more than placebos".[155] The JAMA criticism pointed to large wasting of research money on testing scientifically implausible treatments, citing "NCCAM officials spending $374,000 to find that inhaling lemon and lavender scents does not promote wound healing; $750,000 to find that prayer does not cure AIDS or hasten recovery from breast-reconstruction surgery; $390,000 to find that ancient Indian remedies do not control type 2 diabetes; $700,000 to find that magnets do not treat arthritis, carpal tunnel syndrome, or migraine headaches; and $406,000 to find that coffee enemas do not cure pancreatic cancer."[155] It was pointed out that negative results from testing were generally ignored by the public, that people continue to "believe what they want to believe, arguing that it does not matter what the data show: They know what works for them".[155] Continued increasing use of CAM products was also blamed on the lack of FDA ability to regulate alternative products, where negative studies do not result in FDA warnings or FDA-mandated changes on labeling, whereby few consumers are aware that many claims of many supplements were found not to have not to be supported.[155]

By 2013, 50% of Americans were using CAM.[131] As of 2013[update], CAM medicinal products in Europe continued to be exempted from documented efficacy standards required of other medicinal products.[156]

In 2014 the NCCAM was renamed to the National Center for Complementary and Integrative Health (NCCIH) with a new charter requiring that 12 of the 18 council members shall be selected with a preference to selecting leading representatives of complementary and alternative medicine, 9 of the members must be licensed practitioners of alternative medicine, 6 members must be general public leaders in the fields of public policy, law, health policy, economics, and management, and 3 members must represent the interests of individual consumers of complementary and alternative medicine.[157]

Much of what is now categorized as alternative medicine was developed as independent, complete medical systems. These were developed long before biomedicine and use of scientific methods. Each system was developed in relatively isolated regions of the world where there was little or no medical contact with pre-scientific western medicine, or with each other's systems. Examples are traditional Chinese medicine and the Ayurvedic medicine of India.

Other alternative medicine practices, such as homeopathy, were developed in western Europe and in opposition to western medicine, at a time when western medicine was based on unscientific theories that were dogmatically imposed by western religious authorities. Homeopathy was developed prior to discovery of the basic principles of chemistry, which proved homeopathic remedies contained nothing but water. But homeopathy, with its remedies made of water, was harmless compared to the unscientific and dangerous orthodox western medicine practiced at that time, which included use of toxins and draining of blood, often resulting in permanent disfigurement or death.[119]

Other alternative practices such as chiropractic and osteopathic manipulative medicine were developed in the United States at a time that western medicine was beginning to incorporate scientific methods and theories, but the biomedical model was not yet totally dominant. Practices such as chiropractic and osteopathic, each considered to be irregular practices by the western medical establishment, also opposed each other, both rhetorically and politically with licensing legislation. Osteopathic practitioners added the courses and training of biomedicine to their licensing, and licensed Doctor of Osteopathic Medicine holders began diminishing use of the unscientific origins of the field. Without the original nonscientific practices and theories, osteopathic medicine is now considered the same as biomedicine.

Further information: Rise of modern medicine

Until the 1970s, western practitioners that were not part of the medical establishment were referred to "irregular practitioners", and were dismissed by the medical establishment as unscientific, as practicing quackery.[119] Irregular practice became increasingly marginalized as quackery and fraud, as western medicine increasingly incorporated scientific methods and discoveries, and had a corresponding increase in success of its treatments.

Dating from the 1970s, medical professionals, sociologists, anthropologists and other commentators noted the increasing visibility of a wide variety of health practices that had neither derived directly from nor been verified by biomedical science.[158] Since that time, those who have analyzed this trend have deliberated over the most apt language with which to describe this emergent health field.[158] A variety of terms have been used, including heterodox, irregular, fringe and alternative medicine while others, particularly medical commentators, have been satisfied to label them as instances of quackery.[158] The most persistent term has been alternative medicine but its use is problematic as it assumes a value-laden dichotomy between a medical fringe, implicitly of borderline acceptability at best, and a privileged medical orthodoxy, associated with validated medico-scientific norms.[159] The use of the category of alternative medicine has also been criticized as it cannot be studied as an independent entity but must be understood in terms of a regionally and temporally specific medical orthodoxy.[160] Its use can also be misleading as it may erroneously imply that a real medical alternative exists.[161] As with near-synonymous expressions, such as unorthodox, complementary, marginal, or quackery, these linguistic devices have served, in the context of processes of professionalisation and market competition, to establish the authority of official medicine and police the boundary between it and its unconventional rivals.[159]

An early instance of the influence of this modern, or western, scientific medicine outside Europe and North America is Peking Union Medical College.[162][n 16][n 17]

From a historical perspective, the emergence of alternative medicine, if not the term itself, is typically dated to the 19th century.[163] This is despite the fact that there are variants of Western non-conventional medicine that arose in the late-eighteenth century or earlier and some non-Western medical traditions, currently considered alternative in the West and elsewhere, which boast extended historical pedigrees.[159] Alternative medical systems, however, can only be said to exist when there is an identifiable, regularized and authoritative standard medical practice, such as arose in the West during the nineteenth century, to which they can function as an alternative.

During the late eighteenth and nineteenth centuries regular and irregular medical practitioners became more clearly differentiated throughout much of Europe and,[165] as the nineteenth century progressed, most Western states converged in the creation of legally delimited and semi-protected medical markets.[166] It is at this point that an "official" medicine, created in cooperation with the state and employing a scientific rhetoric of legitimacy, emerges as a recognizable entity and that the concept of alternative medicine as a historical category becomes tenable.[167]

As part of this process, professional adherents of mainstream medicine in countries such as Germany, France, and Britain increasingly invoked the scientific basis of their discipline as a means of engendering internal professional unity and of external differentiation in the face of sustained market competition from homeopaths, naturopaths, mesmerists and other nonconventional medical practitioners, finally achieving a degree of imperfect dominance through alliance with the state and the passage of regulatory legislation.[159][161] In the US the Johns Hopkins University School of Medicine, based in Baltimore, Maryland, opened in 1893, with William H. Welch and William Osler among the founding physicians, and was the first medical school devoted to teaching "German scientific medicine".[168]

Buttressed by increased authority arising from significant advances in the medical sciences of the late 19th century onwardsincluding development and application of the germ theory of disease by the chemist Louis Pasteur and the surgeon Joseph Lister, of microbiology co-founded by Robert Koch (in 1885 appointed professor of hygiene at the University of Berlin), and of the use of X-rays (Rntgen rays)the 1910 Flexner Report called upon American medical schools to follow the model of the Johns Hopkins School of Medicine, and adhere to mainstream science in their teaching and research. This was in a belief, mentioned in the Report's introduction, that the preliminary and professional training then prevailing in medical schools should be reformed, in view of the new means for diagnosing and combating disease made available the sciences on which medicine depended.[n 18][170]

Putative medical practices at the time that later became known as "alternative medicine" included homeopathy (founded in Germany in the early 19c.) and chiropractic (founded in North America in the late 19c.). These conflicted in principle with the developments in medical science upon which the Flexner reforms were based, and they have not become compatible with further advances of medical science such as listed in Timeline of medicine and medical technology, 19001999 and 2000present, nor have Ayurveda, acupuncture or other kinds of alternative medicine.[citation needed]

At the same time "Tropical medicine" was being developed as a specialist branch of western medicine in research establishments such as Liverpool School of Tropical Medicine founded in 1898 by Alfred Lewis Jones, London School of Hygiene & Tropical Medicine, founded in 1899 by Patrick Manson and Tulane University School of Public Health and Tropical Medicine, instituted in 1912. A distinction was being made between western scientific medicine and indigenous systems. An example is given by an official report about indigenous systems of medicine in India, including Ayurveda, submitted by Mohammad Usman of Madras and others in 1923. This stated that the first question the Committee considered was "to decide whether the indigenous systems of medicine were scientific or not".[171][172]

By the later twentieth century the term 'alternative medicine' entered public discourse,[n 19][175] but it was not always being used with the same meaning by all parties. Arnold S. Relman remarked in 1998 that in the best kind of medical practice, all proposed treatments must be tested objectively, and that in the end there will only be treatments that pass and those that do not, those that are proven worthwhile and those that are not. He asked 'Can there be any reasonable "alternative"?'[176] But also in 1998 the then Surgeon General of the United States, David Satcher,[177] issued public information about eight common alternative treatments (including acupuncture, holistic and massage), together with information about common diseases and conditions, on nutrition, diet, and lifestyle changes, and about helping consumers to decipher fraud and quackery, and to find healthcare centers and doctors who practiced alternative medicine.[178]

By 1990, approximately 60 million Americans had used one or more complementary or alternative therapies to address health issues, according to a nationwide survey in the US published in 1993 by David Eisenberg.[179] A study published in the November 11, 1998 issue of the Journal of the American Medical Association reported that 42% of Americans had used complementary and alternative therapies, up from 34% in 1990.[143] However, despite the growth in patient demand for complementary medicine, most of the early alternative/complementary medical centers failed.[180]

Mainly as a result of reforms following the Flexner Report of 1910[181]medical education in established medical schools in the US has generally not included alternative medicine as a teaching topic.[n 20] Typically, their teaching is based on current practice and scientific knowledge about: anatomy, physiology, histology, embryology, neuroanatomy, pathology, pharmacology, microbiology and immunology.[183] Medical schools' teaching includes such topics as doctor-patient communication, ethics, the art of medicine,[184] and engaging in complex clinical reasoning (medical decision-making).[185] Writing in 2002, Snyderman and Weil remarked that by the early twentieth century the Flexner model had helped to create the 20th-century academic health center, in which education, research, and practice were inseparable. While this had much improved medical practice by defining with increasing certainty the pathophysiological basis of disease, a single-minded focus on the pathophysiological had diverted much of mainstream American medicine from clinical conditions that were not well understood in mechanistic terms, and were not effectively treated by conventional therapies.[186]

By 2001 some form of CAM training was being offered by at least 75 out of 125 medical schools in the US.[187] Exceptionally, the School of Medicine of the University of Maryland, Baltimore includes a research institute for integrative medicine (a member entity of the Cochrane Collaboration).[188][189] Medical schools are responsible for conferring medical degrees, but a physician typically may not legally practice medicine until licensed by the local government authority. Licensed physicians in the US who have attended one of the established medical schools there have usually graduated Doctor of Medicine (MD).[190] All states require that applicants for MD licensure be graduates of an approved medical school and complete the United States Medical Licensing Exam (USMLE).[190]

The British Medical Association, in its publication Complementary Medicine, New Approach to Good Practice (1993), gave as a working definition of non-conventional therapies (including acupuncture, chiropractic and homeopathy): "...those forms of treatment which are not widely used by the orthodox health-care professions, and the skills of which are not part of the undergraduate curriculum of orthodox medical and paramedical health-care courses." By 2000 some medical schools in the UK were offering CAM familiarisation courses to undergraduate medical students while some were also offering modules specifically on CAM.[192]

The Cochrane Collaboration Complementary Medicine Field explains its "Scope and Topics" by giving a broad and general definition for complementary medicine as including practices and ideas outside the domain of conventional medicine in several countriesand defined by its users as preventing or treating illness, or promoting health and well being, and which complement mainstream medicine in three ways: by contributing to a common whole, by satisfying a demand not met by conventional practices, and by diversifying the conceptual framework of medicine.[193]

Proponents of an evidence-base for medicine[n 21][195][196][197][198] such as the Cochrane Collaboration (founded in 1993 and from 2011 providing input for WHO resolutions) take a position that all systematic reviews of treatments, whether "mainstream" or "alternative", ought to be held to the current standards of scientific method.[189] In a study titled Development and classification of an operational definition of complementary and alternative medicine for the Cochrane Collaboration (2011) it was proposed that indicators that a therapy is accepted include government licensing of practitioners, coverage by health insurance, statements of approval by government agencies, and recommendation as part of a practice guideline; and that if something is currently a standard, accepted therapy, then it is not likely to be widely considered as CAM.[103]

That alternative medicine has been on the rise "in countries where Western science and scientific method generally are accepted as the major foundations for healthcare, and 'evidence-based' practice is the dominant paradigm" was described as an "enigma" in the Medical Journal of Australia.[199]

Critics in the US say the expression is deceptive because it implies there is an effective alternative to science-based medicine, and that complementary is deceptive because it implies that the treatment increases the effectiveness of (complements) science-based medicine, while alternative medicines that have been tested nearly always have no measurable positive effect compared to a placebo.[1][200][201][202]

Some opponents, focused upon health fraud, misinformation, and quackery as public health problems in the US, are highly critical of alternative medicine, notably Wallace Sampson and Paul Kurtz founders of Scientific Review of Alternative Medicine and Stephen Barrett, co-founder of The National Council Against Health Fraud and webmaster of Quackwatch.[203] Grounds for opposing alternative medicine stated in the US and elsewhere include that:

Paul Offit proposed that "alternative medicine becomes quackery" in four ways, by:[82]

A United States government agency, the National Center on Complementary and Integrative Health (NCCIH), created its own classification system for branches of complementary and alternative medicine that divides them into five major groups. These groups have some overlap, and distinguish two types of energy medicine: veritable which involves scientifically observable energy (including magnet therapy, colorpuncture and light therapy) and putative, which invokes physically undetectable or unverifiable energy.[212]

Alternative medicine practices and beliefs are diverse in their foundations and methodologies. The wide range of treatments and practices referred to as alternative medicine includes some stemming from nineteenth century North America, such as chiropractic and naturopathy, others, mentioned by Jtte, that originated in eighteenth- and nineteenth-century Germany, such as homeopathy and hydropathy,[161] and some that have originated in China or India, while African, Caribbean, Pacific Island, Native American, and other regional cultures have traditional medical systems as diverse as their diversity of cultures.[6]

Examples of CAM as a broader term for unorthodox treatment and diagnosis of illnesses, disease, infections, etc.,[213] include yoga, acupuncture, aromatherapy, chiropractic, herbalism, homeopathy, hypnotherapy, massage, osteopathy, reflexology, relaxation therapies, spiritual healing and tai chi.[213] CAM differs from conventional medicine. It is normally private medicine and not covered by health insurance.[213] It is paid out of pocket by the patient and is an expensive treatment.[213] CAM tends to be a treatment for upper class or more educated people.[143]

The NCCIH classification system is -

Alternative therapies based on electricity or magnetism use verifiable electromagnetic fields, such as pulsed fields, alternating-current, or direct-current fields in an unconventional manner rather than claiming the existence of imponderable or supernatural energies.[6]

Substance based practices use substances found in nature such as herbs, foods, non-vitamin supplements and megavitamins, and minerals, and includes traditional herbal remedies with herbs specific to regions where the cultural practices.[6] Nonvitamin supplements include fish oil, Omega-3 fatty acid, glucosamine, echinacea, flaxseed oil or pills, and ginseng, when used under a claim to have healing effects.[63]

Mind-body interventions, working under the premise that the mind can affect "bodily functions and symptoms",[6] include healing claims made in hypnotherapy,[214] and in guided imagery, meditation, progressive relaxation, qi gong, tai chi and yoga.[6] Meditation practices including mantra meditation, mindfulness meditation, yoga, tai chi, and qi gong have many uncertainties. According to an AHRQ review, the available evidence on meditation practices through September 2005 is of poor methodological quality and definite conclusions on the effects of meditation in healthcare cannot be made using existing research.[215][216]

Naturopathy is based on a belief in vitalism, which posits that a special energy called vital energy or vital force guides bodily processes such as metabolism, reproduction, growth, and adaptation.[38] The term was coined in 1895[217] by John Scheel and popularized by Benedict Lust, the "father of U.S. naturopathy".[218] Today, naturopathy is primarily practiced in the United States and Canada.[219] Naturopaths in unregulated jurisdictions may use the Naturopathic Doctor designation or other titles regardless of level of education.[220]

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Longevity and aging

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1Department of Pathology, University of Washington, Seattle, WA 98195, USA

2Institute of Aging Research, Guangdong Medical College, Dongguan 523808, China

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. You may not use this work for commercial purposes

Research into the biology of aging seeks to understand the basic mechanisms of aging, with the goal of extending the period of life spent free from chronic disease and disability. Aging results from molecular processes that are modulated by genetic and environmental parameters. At least some of these mechanisms of aging are broadly shared across eukaryotic species from yeast to mice, and likely humans, as well. Recent breakthroughs in aging-related research have identified conserved longevity factors, such as components of the insulin-like signaling pathway and the mechanistic target of rapamycin, and have suggested potential paths toward developing the first interventions to slow aging in humans.

Aging drives disease. Nearly every major killer in developed countries shares a common feature: your risk of getting the disease increases dramatically as you get older. For example, the likelihood of being diagnosed with Alzheimers disease doubles every five years after the age of 65. A similar kind of relationship can be seen for most types of cancer, heart disease, diabetes, kidney disease, and many others (). What is it about getting older that simultaneously increases risk for all of these disorders? Are there common molecular changes that cause an organism to switch from youthful and healthy to aged and infirm? Can we intervene in this process to do something about it? These are some of the big questions that scientists who study the biology of aging are interested in answering.

The perspective that most age-related disorders share a common underlying biology is a departure from traditional biomedical science, one that potentially offers a more powerful approach towards improving human health. Rather than focus on curing the individual disease, interventions that target the molecular processes of aging can simultaneously delay the onset and progression of most age-related disorders. Such an intervention is predicted to have a much larger effect on life expectancy than can be attained by treating individual diseases [1-3]. This is because even if one disease is cured, the relationship between age and all the other disorders of aging still holds. For example, it has been estimated that curing cancer will lead to only a 3-5 year increase in survival for an average 50 year-old woman, while slowing aging to an extent that is routine in laboratory organisms has about a 5-10-fold greater impact on life expectancy [1-3]. Importantly, these added years from slowing aging are spent largely free from chronic disease and disability, while the relatively small gains in survival by curing cancer (or any other individual disease of aging) are still associated with the inevitable age-related declines in function of every other bodily system. This concept of extending the period of life spent free from chronic disability and disease, referred to as healthspan, is a critically important idea in the field of aging-related research.

Although the average human lifespan in developed nations has increased dramatically over the past century, there is little evidence that the rate of aging has been slowed [4]. As a consequence, nearly every developed nation in the world is experiencing a growth in the number of elderly living longer, but they are living longer with multiple age-associated disorders [5]. The ability to provide care for this expanding population of elderly is predicted to have dramatic social and economic consequences over the next few decades, a so-called silver tsunami [6]. From a public health perspective, successful intervention into human aging must be accompanied by compression of morbidity, where the majority of lifetime illness is compressed into a shorter period of time near the end of life [7]. Advances in aging-related research have the potential to alleviate these stresses by delaying the onset of age-related morbidity and allowing elderly people to retain high functionality and productivity for a greater proportion of their lives.

The first molecular theory of human aging to gain prominence was the free radical theory of aging, proposed by Denham Harman more than 50 years ago [8]. This theory posited that oxidative damage from free radicals, produced as a by-product of metabolism and environmental insults, results in damage that, over time, ultimately causes the pathological consequences of aging at the cellular, tissue, and organismal level. Although this theory is now recognized as insufficient to explain all aspects of aging, and the relevance of oxidative stress as a general cause of aging is currently debated [9], the idea that the biological process of aging can be defined by a relatively small number of specific molecular processes has become generally accepted. Here, I will discuss how recent work in humans and model organisms has begun to elucidate these molecular processes, has demonstrated the existence of broadly conserved longevity pathways, and, for the first time, offers real hope of intervening to enhance healthy aging.

The relatively long lifespans of humans make direct mechanistic studies of aging in people particularly challenging. There are currently no reliable biomarkers for quantifying the rate of aging, making it impossible to validate claims that specific genetic polymorphisms, lifestyle choices, or pharmacological interventions impact the aging process itself. Although it is possible through correlative studies to establish the effects of specific factors on mortality, it is important to understand that such effects may or may not be relevant for the basic mechanisms of aging. This is particularly true when increased risk of death is correlated with a specific factor, because there are many ways to enhance your risk of dying without accelerating the normal aging process.

A few molecular and hormonal changes that occur during aging have been proposed as potential predictors of individual longevity. Among these are declines in serum dehydro-epiandrosterone sulfate (DHEAS), growth hormone, and telomere length [10-12], the latter two of which have achieved popular notoriety as causes of human aging. Growth hormone therapy is even recommended by some anti-aging doctors as a treatment for aging in otherwise healthy individuals, and several companies are actively developing telomerase activators to help maintain telomere length during aging. Unfortunately, the actual benefits, if any, of such treatments are currently unclear, and the potential risks, particularly increased risk of cancer, warrant caution [11,13]. Importantly, none of these, or other correlative markers, can currently be used reliably to predict either individual life expectancy or biological (as opposed to chronological) age.

Due to the challenges of defining basic mechanisms of aging in humans directly, rodent models served for many decades as the organisms of choice for these kinds of studies; however, even mice and rats tend to live 2-3 years, making the pace of progress slow relative to other areas of research. This all changed in the mid-1990s as simpler eukaryotic systems became widely used in the field. Along with rodent models, the budding yeast Saccharomyces cerevisiae, the nematode Caenorhabditis elegans, and the fruit fly Drosophila melanogaster have served as the primary model organisms for developing a biochemical and genetic framework for understanding aging [9,14,15]. In each of these model systems, multiple single gene mutations have been identified that substantially extend both median and maximum lifespan, and in both yeast and nematodes the number of such mutations is now in the hundreds. These discoveries have further supported the idea that aging is a defined biological process with a strong genetic component. They have also provided insight into molecular mechanisms of aging, as well as possible targets for interventions that could slow aging.

A particularly important outcome from the use of yeast and invertebrate species in aging research is the discovery of conserved genetic pathways that modulate longevity across broad evolutionary distance [15-17]. Insulin-like signaling and the mechanistic target of rapamycin (mTOR), in particular, are now known to modulate the pace of aging from simple eukaryotes through to mammals. In general, insulin-like signaling and mTOR activity are highest under conditions favoring growth, where reproduction is maximized and aging occurs most rapidly. When nutrients and growth cues are scarce, signaling through these pathways is reduced, fecundity is reduced or absent altogether, and longevity is maximized. This is consistent with the idea that aging and reproduction are evolutionarily coupled, such that both processes are simultaneously slowed in order to allow organisms to withstand periods of resource scarcity, then resume faster reproduction (and faster aging) when times are good again.

The best-characterized intervention for modulating aging is dietary restriction (also referred to as caloric restriction or calorie restriction). Dietary restriction, which can be defined as a reduction in nutrient availability in the absence of malnutrition, was first found to extend lifespan in rats more than 70 years ago [18]. Since then, hundreds of studies have shown that a reduced calorie regimen can increase lifespan and delay the onset of multiple age-related phenotypes in a diverse range of organisms, including all of the major model systems used in biomedical research [19,20].

Studies of dietary restriction in non-mammalian systems have led to important advances in our understanding of the fundamental relationship between diet and aging. One example is the observation in both C. elegans and D. melanogaster that, in addition to food consumption, food sensing can also reduce longevity. Simply being exposed to food odorants can attenuate the beneficial effects of dietary restriction in both organisms [21,22]. A second example is that dietary restriction appears to be effective at reducing mortality even when initiated late in life [21,23]. Demographic analysis of several thousand flies indicates that dietary restriction causes a nearly instantaneous shift in the mortality trajectory, as if the risk of death is immediately reduced, without molecular memory of the prior fed state [23]. Return to a control diet again shifts the mortality trajectory back to the original state, or nearly so, and similar effects are also seen in C. elegans [21]. One interpretation of these data is that dietary restriction, at least in invertebrates, is not really slowing the rate of aging, but is instead causing individuals to become more resistant to the damage associated with aging. Whether a similar phenomenon occurs in mammals is currently unclear; however, limited studies seem to indicate that there is a diminishing longevity benefit when dietary restriction is initiated in older animals relative to younger animals, but that late-onset dietary restriction still induces a robust anti-cancer effect in mice [24].

The molecular mechanisms by which dietary restriction achieve such remarkable effects across a diverse range of organisms is an area of active research. Not surprisingly, dietary restriction modulates the activity of multiple cellular factors, several of which have been implicated in longevity and healthspan. These include sirtuins, key metabolic regulators such as AMP kinase, antioxidant enzymes, DNA damage response enzymes, and others [25]. Among these, however, the mTOR pathway, in particular, has repeatedly emerged as a central player in the pro-longevity effects of dietary restriction in yeast, nematodes, and fruit flies [26,27]. In response to nutrient depletion, mTOR activity is reduced and this results in a cascade of downstream events that have been shown to promote longevity and enhance resistance to stress. In particular, reduced synthesis of new proteins via inhibition of mRNA translation, enhanced degradation of damaged proteins and other macromolecules via autophagy, and altered carbon metabolism and mitochondrial function all contribute to lifespan extension from dietary restriction in simple eukaryotes [28] (). Similar responses also occur in mammals in response to dietary restriction or mTOR inhibition; however, there is less direct evidence for their involvement in lifespan extension. In addition to these cellular adaptations, it is likely that several broad physiological responses to dietary restriction also play an important role in promoting longevity and health in mammals. Reduced inflammation, decreased levels of growth-promoting hormones, enhanced glucose homeostasis, decreased adiposity, protection from a variety of cancers, and preservation of stem cell function have each been proposed to be an important part of the dietary restriction effect.

Reduced mTOR signaling extends lifespan in response to dietary restriction

Other than dietary restriction, the only non-genetic intervention that has been similarly found to extend lifespan in yeast [29,30], nematodes [31], fruit flies [32], and mice [33] is treatment with the drug rapamycin. Rapamycin is a specific inhibitor of mTOR [34], and has been proposed to act as a dietary restriction mimetic by inducing the pro-longevity response to dietary restriction under high nutrient conditions [35]. Recently the pro-longevity effects of mTOR inhibition by rapamycin were also extended to the plant kingdom, with a study showing that rapamycin slows aging in an Arabidopsis strain engineered to be sensitive to the drug [36]. The first study showing that rapamycin could extend lifespan in mice was particularly noteworthy for at least two reasons. First, it was carried out in a genetically heterogeneous strain background, alleviating a common concern that many longevity studies are performed in laboratory-adapted inbred mouse lines. Second, the drug was not given to the mice until they had reached 600 days of age, roughly equivalent to 60 years of age in a person [37]. Since then, the pro-longevity effect of rapamycin in mice has been replicated, including initiating the treatment early in life, which yields a slightly greater extension of median longevity than late-life treatment alone [38-40]. Interestingly, initial analysis of end-of-life pathology indicates that rapamycin does not significantly alter the spectrum of causes of death in mice, but instead delays the age-related declines in a variety of parameters including alterations in heart, liver, adrenal glands, endometrium, tendon, and spontaneous activity [38,41]. These data are consistent with the idea that rapamycin is slowing the aging process in mice such that many normal causes of morbidity and death are delayed. It is important to note that these studies have largely been performed using a single dose of rapamycin and the observed effects on longevity and healthspan may be different at higher or lower doses of the drug.

In addition to rapamycin, several other compounds are being actively studied for their potential to delay age-related disease by targeting key aging-related pathways. The most publicized of these is undoubtedly resveratrol, a chemical found in red wine that, like rapamycin, was first reported to increase lifespan in yeast and has also been proposed to act as a dietary restriction mimetic [42]. Unlike rapamycin, however, the initial studies reporting robust lifespan extension from resveratrol in yeast and invertebrate species have proven controversial [43,44], and attempts to extend lifespan of mice with resveratrol have not been successful [38]. Interestingly, resveratrol does appear to enhance at least some measures of healthspan in mice, in particular improving metabolic function in the context of a high fat diet [45]. Resveratrol also extends survival of mice fed a specific high fat diet formulation [46], although the relevance of this to normal aging is unclear. Dozens of additional compounds are also currently being, or have already been, tested for effects on lifespan by the National Institute on Agings Interventions Testing Program [47] and individual research groups. Any compound that significantly extends lifespan or healthspan in mice will be of particular interest for future studies in people.

A major unanswered question is whether the longevity interventions identified in model organisms will have similar effects on longevity and healthspan in humans. There are at least three different schools of thought on this issue. The first argues that human aging is fundamentally different from aging in short-lived, laboratory-bred organisms, including rodents. This is based largely on theoretical arguments and cannot be ruled out, but experimental evidence is mounting against this idea (discussed further below). The second viewpoint argues that humans have evolved to have exceptional longevity, and that any additional gains in maximum lifespan are likely to be minimal; however, interventions that significantly extend lifespan in model organisms have the potential to extend healthspan in humans, resulting in a compression in morbidity. The third viewpoint recognizes that the evolutionary distance between yeast and mice is much greater than the distance between mice and humans, and, since longevity interventions have already been identified that span the larger evolutionary distance, there is a good chance these same interventions will have a similar effect on longevity in people. Clearly, the jury is still out on this question, but there is accumulating evidence that interventions, such as dietary restriction, that affect aging in model organisms can also impact age-related diseases in people.

One major limitation of most aging-related studies in model organisms is that they have been performed on inbred or laboratory-bred strains of animals. This creates at least two potential complications: (1) lab strains generally have minimal genetic heterogeneity and (2) lab strains have generally been artificially selected for life in the lab, which usually means rapid reproduction under minimally stressful conditions and an over-abundance of food. While this latter condition (too much food) may in fact better reflect life in most developed countries, it has been speculated that laboratory selection may cause laboratory strains to show a robust response to some interventions, such as dietary restriction, that would not be seen in natural populations. In partial support of this idea, one study in mice found that a wild strain was longer-lived than a standard inbred lab strain under laboratory conditions and failed to show significant median lifespan extension from dietary restriction [48]. Dietary restriction did reduce late life mortality in the wild strain, suggesting at least a partial benefit from dietary restriction [48]. In another study, the question of genetic heterogeneity was addressed by examining the effect of dietary restriction across 41 inbred lines of mice. Surprisingly, although some lines showed the expected lifespan extension from dietary restriction, many showed either no effect or a substantial lifespan reduction [49]. Taken together, these studies suggest that genotype will play a large role in determining individual response to dietary restriction and other interventions that impact aging in people.

Several groups have attempted to begin to address the question of whether dietary restriction is likely to slow human aging experimentally, either through direct studies of dietary restriction in humans or by studying dietary restriction in non-human primates. As discussed above, such studies in humans are limited to correlative measures due to the lack of validated biomarkers of human aging; however, many of the physiological changes associated with dietary restriction in rodents occur similarly in people practicing a reduced-calorie diet. These include reduced adiposity, enhanced glucose homeostasis, decreased blood pressure, and improved cardiac function [50,51], many of which are predictors of improved health and reduced disease risk. Thus, there is evidence that dietary restriction is likely to extend healthspan in people, although it will be many years before this question is answered definitively, and we may never know whether dietary restriction substantially extends lifespan in people.

The first published study of the effects of dietary restriction on longevity in primates was performed in rhesus monkeys and showed a significant reduction in deaths due to age-related causes in the restricted group relative to the control fed group [52]. More importantly, this study and others also showed that dietary restriction dramatically reduced the incidence of age-related disorders including, sarcopenia, cancer, diabetes, cardiovascular disease, as well as changes in brain structure and function [52-55]. In a more recent report, a second rhesus monkey study performed at the United States National Institute on Aging failed to detect a significant increase in survival from dietary restriction, although this study did find that dietary restriction appeared to improve some measures of healthspan [56]. The reason for the different outcomes from these two studies remains an active area of investigation, and there are several differences in experimental design that may be involved, including the use of different diet formulations, animals taken from different geographic locations, genetic heterogeneity among the populations, and the age at which dietary restriction was initiated.

Additional support for the idea that human aging shares features with aging in other species comes from direct studies of DNA polymorphisms associated with longevity in people. The best example of this is the Foxo3a gene, which encodes a transcription factor that modulates a variety of cellular processes, including cell death, growth, and stress resistance. Multiple independent studies have identified a variant of Foxo3a that is over-represented in the longest-lived individuals, including cohorts from Germany, Italy, China, and the United States [57-61]. Foxo3a orthologs in both worms and flies are known to play a central role in modulating lifespan in both species in response to reduced insulin-like signaling [15,62,63]. Thus, although the relationship in people between Foxo3a and aging remains correlative, the finding that this highly conserved longevity factor is associated with human longevity is quite suggestive.

There is also accumulating evidence that, as in other species, mTOR signaling may play a central role in human aging. Activation of mTOR has long been associated with a variety of human cancers, and rapamycin is already clinically approved for treating certain rare forms of cancer [64]. In addition to cancer, aberrant activation of mTOR has also been linked to several additional age-related disorders, including cardiovascular disease, peripheral insulin resistance and diabetes associated with obesity, and kidney disease [34,65]. Thus far, there is little direct evidence in humans that mTOR modulates neurological changes with age in people; however, there is a large body of such literature in rodent models, including recent studies showing that rapamycin improves function in two different Alzheimers disease models [66,67], as well as delays normal age-association cognitive decline [68,69]. Currently, the NIH clinical trials database (http://clinicaltrials.gov/) lists more than 1,300 clinical trials associated with the search term rapamycin. The information gained from these trials, along with the continued development and testing of newer and more potent inhibitors of mTOR and other components of the mTOR pathway, may allow for the first effective interventions against human aging.

Aging research has progressed to the point where interventions that modulate human aging are a realistic possibility. In fact, they may already exist among the candidate molecules currently being explored. The potential benefits of such interventions dwarf those that can be attained by traditional disease-centered approaches and are necessary to confront the looming silver tsunami. Before such benefits can be realized, however, there are challenges that must be overcome. Among these are the need for better methods to confirm and validate putative longevity- and healthspan-promoting interventions, and an improved understanding of the complexities associated with genetically and environmentally heterogeneous populations. Despite these difficulties, there is growing confidence that the next decade will see significant advances in aging research making a profound impact on age-related disability and disease. Such advances cant come too soon. After all, were not getting any younger.

Research related to this topic in MKs laboratory is supported by the NIH grants R01AG031108, R01AG033598, R01AG038518, R01AG039390 to MK and by the University of Washington Nathan Shock Center of Excellence in the Basic Biology of Aging (P30AG013280).

The author declares that they have no disclosures.

Articles from F1000Prime Reports are provided here courtesy of Faculty of 1000 Ltd

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Longevity and aging

Careers Human Longevity, Inc.

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Human Longevity, Inc. (HLI) is a genomics and cell therapy company focused on extending the healthy, high performance human lifespan. Led by a world-class team of scientific and medical visionaries, HLIs mission is to identify the therapeutically targetable mechanisms responsible for age-related human biological decline and to apply this intelligence to develop innovative solutions to interrupt or block those processes, meaningfully extending the human lifespan.

We are building a database of genotype and phenotype information together with data mining infrastructure, on a scale that has not ever been done before. We are trying to tackle some of the most vexing diseases like cancer, heart disease and diabetes. We are blazing a new trail in science, medicine and research and we need people who, like us, want to change the world. Our founders, along with our scientific and medical teams are impatient for the healthcare of the future. That is why we are working to change the way medicine is practiced through our genomic-focused, preventive model.

We are seeking world-class people who share our passion and want to play an integral role in executing the companys vision. If you are dynamic, innovative, creative, intelligent, and resourceful, consider joining our quest to improve the state of healthcare in the world today.

HLIParticipates in E-Verify

HLIwill provide the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS), with information from each new employees Form I-9 to confirm work authorization. Human Longevity, Inc. is an equal opportunity employer.

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20 tips to increase your longevity | Canadian Living

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Frenchwoman Jeanne Calment, the world's oldest person, died in 1997 at the age of 122. Her longevity probably had a lot to do with her zest for life at 85 she took up fencing and at 100 she was still riding a bike.

According to the 2006 Census, there are about 4,600 people over the age of 100 in Canada, and number that's grown 22 per cent from 2001. And by 2031, there will be some 14,000 Canadian centenarians. What you can do to live longer Having the right genes certainly boosts your chances of making it to the century mark, since longevity runs in families. At least 50 per cent of centenarians have first-degree relatives or grandparents who reach a ripe age, according to Boston University's New England Centenarian Study (NECS), the most comprehensive study of seniors in the world.

You can't control genetics, but there are plenty of things you can do to increase the probability of living to a ripe old age. "At the end of the day The New England study showed that lifestyle, diet, mental attitude and spiritual disposition play the biggest roles in longevity," says Farid Wassef, a pharmacist in Stouffville, Ontario, and co-author of Breaking the Age Barrier (Viking Canada, 2003).

Hope to live to 100? Heed the following 20 tips and you just might make it.

1. Stay trim: Extra weight puts you at risk for heart attack, diabetes, cancer and other diseases that can shave years off your life.

2. Eat well and prosper: You know the drill 10 servings of fruits and veggies a day (the more colourful the better), lots of whole grains and cut down on salt, fat and sugar.

3. Don't smoke: Need we say more?

4. Have kids later: A woman who bears a child after age 40 has four times of a greater chance of living to 100 than women who give birth earlier in life, according to NECS. Page 1 of 3 - Find 9 more great tips that will help you live longer on page 2

5. Feed your head: Do crosswords, learn a new language, take up a hobby, attend a lecture and figure out how to Twitter and Skype. All these things will keep your mind engaged.

6. Stay fit: Regular exercise keeps your body strong and is the best insurance against disease and injury.

7. Be the life of the party: Or at least maintain social connections by having close ties with friends and family. Such connections can help ward off depression, boost your body's immune system and help you live longer.

8. Develop stress-busting habits: Walk, meditate, talk to a friend or play music. Learn stress management, as it's one of the keys to disease prevention.

9. Lend a helping hand: Volunteering makes you happier, healthier and live a longer life. Studies from the U.S. Corporation for National and Community Service show a strong link between volunteering and longevity.

10. Get married: Plenty of studies show that married folks live longer than their unmarried counterparts. And marriage is especially beneficial for men a 2010 study from Germany's Ruhr Graduate School in Economics found married men were 6 per cent more likely to go to the doctor probably because their wives encouraged them to have a regular checkup.

11. Have more sex: An active sex life is closely connected with a longer life. A 2010 report in the American Journal of Cardiology shows that men who have sex two or three times a week have a lower risk of heart disease by 45 per cent. 12. Laughter really is the best medicine: A University of Maryland study found that 15 minutes of laughter a day can improve blood flow to the heart by 50 per cent, which helps reduce heart disease.

13. Keep your cool: "He that can have patience, can have what he will," said Benjamin Franklin. That may include a longer life. Men who frequently express anger are more than twice as likely to have a stroke than those who control their tempers, according to a 1999 study reported in the journal Stroke. Page 2 of 3 - Read more tips on improving your longevity on page 3

14. Get the right amount of shut-eye: A 2002 study conducted by the Scripps Clinic Sleep Center in California on the sleep habits of one million Americans found people who sleep between six and a half and seven and a half hours a night live the longest. It also found that people who sleep eight hours or more, or less than six and a half hours, don't live quite as long.

15. Take a daily multivitamin: A report from Harvard Medical School advises a regular dose of supplements, including calcium and vitamin D, can help lengthen life. 16. Daily flossing can add years to your life: Poor oral health is related to a higher risk of heart disease and stroke. Studies done at Emory University in Atlanta, Georgia, with the Centers for Disease Control, indicated that people with gingivitis and periodontitis have a mortality rate that is 23 to 46 per cent higher than those who don't.

17. Play fetch with Fido: People who have pets are less lonely and depressed and also get more exercise, all of which can add years to their lives. 18. Be part of a spiritual community: Many large-scale studies show that people who regularly attend religious services live longer, happier and healthier lives. 19. Have a regular medical checkup: Many diseases such as diabetes, high blood pressure and heart disease can be treated or even prevented if caught early enough.

20. Look for blue skies: One quality most centenarians share is optimism. If you want to live a long life, your attitude counts.

How long will you live? Check out the Life Expectancy Calculator at livingto100.com. Based on findings from the NECS project, it asks 40 simple questions and takes 10 minutes to complete. Page 3 of 3

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20 tips to increase your longevity | Canadian Living

LA Fitness – Secaucus, NJ – yelp.com

Posted: October 9, 2016 at 3:44 pm


Specialties

At LA Fitness, we encourage club members to live an active lifestyle, practice good health and Exercise Your Options'_!

The exercise classes typically offered at a LA Fitness location include: aerobic basics, aqua fit, belly dancing, body works plus abs, boot camp conditioning, cardio jam, club boxing circuit, core training, cycle, cycle zone, hip hop, kickbox cardio, latin heat, mat pilates, sampler, senior fit, step circuit, step II plus abs, step sculpt, striding, sunrise yoga, tai chi, total body conditioning, yoga, yogabeat, and/or Zumba.

Please visit the LA Fitness site for a listing of current class offerings.

Facilities and amenities may vary by location

Established in 1984.

LA Fitness offers several amenities, including an aerobics room, weight lifting equipment, cardio equipment, steam room, sauna, group fitness classes, sports leagues, personal training and much, much more! Facilities and amenities may vary by location.

LA Fitness seeks innovative ways to enhance the physical and emotional wellbeing of our increasingly diverse membership base. Today, our state-of-the-art clubs span the continent and we're still expanding. Our strong and successful growth stems from our commitment to understanding and meeting the distinct needs of each community we serve. With our wide range of amenities and a highly trained staff, we can provide fun and effective workout options to family members of all ages and interests. Because we know that a healthy society depends on the well-being of all those who comprise it, our emphasis is on giving our members the most for their dollars to make the LA Fitness experience accessible to more segments of the community.

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LA Fitness - Secaucus, NJ - yelp.com

Lansdale Hospital – Abington – Jefferson Health

Posted: October 7, 2016 at 12:41 pm


Abington Lansdale Hospital is a 135-bed, acute care general hospital providing a comprehensive range of inpatient and outpatient healthcare services. The facility includes a 24-hour emergency department, an 18 bed Orthopaedic and Spine Institute, a 6 bed Acute Rehabilitation Unit, a Sleep Center and a Wound Care Center.

Home to over 700 employees, Abington Lansdale Hospital has a staff of more than 300 active physicians. Physicians are supported by a dedicated team of professional nurses who draw from years of clinical experience and training.

Abington Lansdale Hospital offers a sophisticated array of clinical programs, including: interventional radiology, comprehensive diabetes treatment, orthopaedics, physical rehabilitation, outpatient surgery, cardiology, ophthalmology, podiatry, oral surgery and 24-hour emergency services.

As a trusted healthcare provider, Abington Lansdale Hospital handles nearly 6,000 inpatient admissions per year - while outpatient visits number close to 60,000. In addition, over 27,000 people are treated each year in the hospital's emergency department.

Abington Lansdale Hospital is located just outside of Lansdale, Pennsylvania, approximately 24 miles northwest of Philadelphia. Nestled in the heart of Montgomery County, Lansdale is one of the six boroughs that make up the area known as North Penn, one of the region's most prosperous and desirable locations.

According to recent demographic information, Lansdale is home to an estimated 51,000 residents. However, Lansdale Hospital serves all of the North Penn communities, as well as parts of neighboring Bucks County, for a total patient base nearing 200,000.

From small local enterprises to large multi-national corporations, business is booming in the North Penn area. Montgomery County has the highest per capita income in the state of Pennsylvania, and the second highest median income.

Lansdale is served by the North Penn School District, with thirteen elementary schools, three middle schools and one high school. The area is also home to numerous private and parochial schools, technical career centers, four-year colleges and two-year colleges.

The Lansdale/North Penn area offers an exceptional quality of life, with quaint suburban towns, quality schools, a healthy economy, good jobs, abundant recreation and convenient access to Philadelphia, New York, the Poconos and the New Jersey Shore. And with Abington Lansdale Hospital, quality healthcare is right in your community.

100 Medical Campus Dr. Lansdale, PA 19446 215-368-2100

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Lansdale Hospital - Abington - Jefferson Health

Gaiam TV is now Gaia

Posted: at 12:41 pm


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Sarah Carpenter, Gaia Member

I got involved with Gaia because of Corey Goode. He fascinates me and I find him to be remarkably authentic and very straightforward... I love Gaia and have respect for the mission and purpose of the company that brings so much good information to all of us. Thank you, Gaia.

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My Yoga on Gaia has been an integral part of my yoga journey. No matter what I'm working on, either in my body or in my heart, there is a program to help with it... My Yoga is a great complement to my practice in the studio...

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Zane Basak, Gaia Member

Stream yoga, meditation, and mind-expanding programs that provide a true alternative to mainstream media. Explore what's on Gaia below, then sign up to gain full access and continue your path towards a more conscious life.

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Gaia is an exceptional resource for exploring different styles of yoga with the world's top instructors. The convenience of having guided classes at home makes yoga more accessible and promotes a daily routine. My home practice was transformed within my first month of membership. I continue to do yoga everyday and feel great.

Sarah Carpenter, Gaia Member

I got involved with Gaia because of Corey Goode. He fascinates me and I find him to be remarkably authentic and very straightforward... I love Gaia and have respect for the mission and purpose of the company that brings so much good information to all of us. Thank you, Gaia.

James Daniel MacManis, Gaia Member

My Yoga on Gaia has been an integral part of my yoga journey. No matter what I'm working on, either in my body or in my heart, there is a program to help with it... My Yoga is a great complement to my practice in the studio...

Kristen Dill, Gaia Member

Gaia is totally based, without a doubt, on TRUTH, and each and every video has opened many doors for my inquisitive mind. I Love watching David Wilcock,Corey Goode, George Noory and Regina Meredith and hundreds more...

Glenda Jasper, Gaia Member

Gaia is an incredible portal into the realms of the esoteric. Everything from meditation and astrology to ancient civilizations and the paranormal, it's all in one place. I'm able to expand my perspectives everyday at home, plus it makes for great conversation with my friends. Thanks Gaia, keep fighting the good fight!

Zane Basak, Gaia Member

Gaia helps you achieve your highest potential at your convenience. Stream our unique programming on the screen of your choice. Currently available on the new Apple TV, Roku, IOS, Chromecast, and on the web.

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Gaiam TV is now Gaia

Alzheimer’s Disease: Understand the Symptoms – WebMD

Posted: October 6, 2016 at 5:41 am


The symptoms of Alzheimer's disease often come on slowly. It might start when someone has trouble recalling things that just happened or putting thoughts into words. But over time, the problems get worse. People in the later stages of the disease usually cant live alone or care for themselves.

There are three main phases of Alzheimer's: mild, moderate, and severe. Each stage has its own set of symptoms.

How to Manage "Sundowning"

When you are with someone who has Alzheimer's disease, you may notice big changes in how they act in the late afternoon or early evening. Doctors call it sundowning, or sundown syndrome. Fading light seems to be the trigger. The symptoms can get worse as the night goes on and usually get better by morning. Although you may not be able to stop it completely, you can take steps to help manage this challenging time of day so you both sleep better and are less tired during the day. Let your loved ones...

Read the How to Manage "Sundowning" article > >

The first stage usually lasts from 2 to 4 years. The symptoms include:

When a person has one or a few of these issues, it doesnt necessarily mean he has Alzheimer's. There are other medical conditions that can cause the same problems, such as:

A doctor can check on these symptoms and do tests to know if a person has Alzheimers or something else.

This is when memory loss gets worse and starts to cause problems in daily life. This stage can last from 2 to 10 years.

Someone with moderate Alzheimer's may start to forget details about his life, like where he went to high school or when he got married. He may not recognize or remember family members and friends. He might also forget where he leaves things and cant retrace his steps to find them.

Other symptoms at this stage can include:

Some people with moderate Alzheimers also become more aware that theyre losing control of their lives, which can make them even more frustrated or depressed.

More here:
Alzheimer's Disease: Understand the Symptoms - WebMD

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