What happens in Yishun, a district of Singapore? a classic - - PowerPoint PPT Presentation

What happens in Yishun, a district of Singapore?

a classic population pyramid 17.4 years 64.5 years 547,000 age median: life expectancy: age 60+

Total population: https://populationpyramid.net (United Nations)

What will happen to Malaysian population pyramid?

2010 28,334,000 26 years 74 years 2,250,000 100,000 The senior population was multiplied by 3 in 3 decades year population census age median: life expectancy seniors (60+) seniors (85+) 1980 13,136,000 17 years 72 years 745,000 67,000

Total population: https://populationpyramid.net (United Nations). Population census 1980, 2010

A huge population of seniors will have to be taken care of

60+ 0.7Millions

60+ 2.3Millions

60+ 6.3Millions

There is no timeless & universal rules of nutrition Nutritionists have to adapt to the local age pyramid

Nutrition

nutritionists have to adapt to the local age pyramid

nutritionists priority:

• Providing the young generation

with proper nutrients for healthy growth

nutritionists have to adapt to the local age pyramid

nutritionists priority:

• cardio-vascular diseases
• obesity
• diabetes

nutritionists have to adapt to the local age pyramid

nutritionists priority:

• age-related diseases

• cardio-vascular diseases
• obesity
• diabetes

statistically 1.4 senior 60+ out of 10 suffer from dementia

Simple question: is it going to be a proportional number in 2040? Simple Calculation: Senior population: 6.3 million Dementia: 0.88 million

Unfortunately: it does not work that way! It will be probably much more because we have two associated factors

• the population is aging

&

• the life expectancy is increasing

The prevalence of dementia increase exponentially with

• ldest ages

Dementia incidence increases exponentially with age

With a fast aging population, the Dementia will become epidemic: what will be the cost to society? There is no medical treatment to age-related dementia, the main cost is nursing This cost explodes with a fast aging population coupled with longer life expectancy.

the USA example,

as a modern nation

the cost for the US Government alone & only for Alzheimer cares: represents TODAY the whole 2015 GDP of one country like Portugal or New Zealand

the USA example,

as a modern nation

the cost for the US Government alone & only for Alzheimer cares: represents TODAY the whole 2015 GDP of one country like Portugal or New Zealand IN 2030 more than 2015 GDP of one country like Singapore or Malaysia

the USA example,

as a modern nation

the cost for the US Government alone & only for Alzheimer cares: represents TODAY the whole 2015 GDP of one country like Portugal or New Zealand IN 2030 more than 2015 GDP of one country like Singapore or Malaysia IN 2050 close to 2015 GDP of one country like Australia, Spain or Russia

• n top of that, you have to add the costs

funded by the families…

the USA example,

as a modern nation

The cost of dementia per patient today was estimated in Malaysia close to Rm 2,700/month (in 2005) with a fast aging population an increasing life expectancy Family could end up to support several parents & grand- parents at various periods of time, but also for many years.

Today, there is no medical treatment to age-related dementia but a proper lifestyle, especially a proper nutrition, can prevent, if not delay, but mitigate age-related diseases

What to Do?

3 important points

Public policies and nutritionists will play a key role in the prevention of age-related diseases it is necessary

• to get rid of misconceptions inherited from the 80’s
• to have « brain feeding » guidelines, not only for babies and

pregnant women, but also for general population and for seniors

• to rehabilitate fats and to declare « sugars » and « smoking »

public enemies

The U.S. government is poised to withdraw longstanding warnings about cholesterol The nation’s top nutrition advisory panel has decided to drop its caution about eating cholesterol-laden food, a move that could undo almost 40 years of government warnings about its consumption. The group’s finding that cholesterol in the diet need no longer be considered a “nutrient of concern” stands in contrast to the committee’s findings five years ago, the last time it convened. … Walter Willett, chair of the nutrition department at the Harvard School of Public Health, also called the turnaround on cholesterol a “reasonable move.” “There’s been a shift of thinking,” he said. … January 2015

What was the consequences of this misconception that dated 1961?

Based on the archaic belief that the fats we store in our body are the fats we eat (ignoring the complex chemistry of digestion), the americans turned away for decades

• n eggs: a great source of nutrients.

And the rest of the world followed.

Cholesterol in foods is just a clear and stunning example. but the biggest misconception,

• riginated in the 80’s, is probably the

food pyramid.

in June 2011, USDA announced the end of the Food Pyramid, created in the 80’s. but many countries never received the notification of replacement.

What were the consequences of the Food Pyramid on many nutrition guidelines? Promoted an excess intake of carbohydrates Demonized all types of fats for many years, despite the latest scientific findings Promoted inefficient, if not damaging, no-fat diets and low-fat diets Push the whole industry to substitute fats by sugars Heavily used refined carbohydrates

In Singapore, you can find industrial bread with 30% sugar to give more taste, while French bread recipe adds no sugar to the bread. The Food Pyramid created a habit of carbs and a world addiction to sugar. the bad consequences of the application

• f the food pyramid on public health are

incalculable.

Food Pyramid & Public heath in USA. Since the application of the guidelines, US citizens have reduced the percentage of fats from 43% to 33%. Ironically, what happened was contrary to what was expected. in 1960, only 1 in 100 Americans had type 2 diabetes, now it is 1 in 10 people. In 1960, 1 in 7 Americans were obese, now it is 1 in 3 people. Three decades ago, type 2 diabetes was generally limited to adults. Now, 1 out of 3 new diabetes cases is among patients under 18 with type 2 diabetes. More than 1 in 10 kids are pre-diabetic or have diabetes.

Figure 2. Number (in Millions) of Civilian, Non-Institutionalized Persons with Diagnosed Diabetes, United States, 1980-20144

the Food Pyramid was inefficient the no-fat and low-fat diets were damaging. so what were the inconveniences of low-fats diets? inefficient: the weight lost is often temporary unsatisfying: during the diet, the patient is starving and may suffer from fatigue and mood disorder damaging: no-fat and low-fat diets are not innocuous > Low-fats diets decrease brain cell function > Low-fats diets damage the body cells > Low-fats diets may impair the digestive system > Low-fats diets imbalance the immune system repeated and uncontrolled low-fat diets could eventually make you fat or sick, or both.

During this 3 decades of Food Pyramid, numerous scientific findings were published and demonstrated. the various types of fats and the incredible benefits on many of them, like Omega 3 the complexity of the chemistry of digestion and the role of bacteria the role of fruits and vegetables, for antioxidants and fibers the needs of non-refined and more complex carbohydrates, like wholemeal or brown rice the devastating effects of sugar and tobacco the benefits of high-fats diet versus low fat diet To add on this new scientific knowledge, the population shape also changes from pyramid to kite, making the misconceptions of the 80’s even more problematic on an aging population.

Our body is designed for higher-fat diet.

In the Paleolithic Period, the macronutrient ratio of a day’s diet was about 75% fat, 20% proteins, and 5% carbohydrates. Before the development of agriculture, our ancestors ate fish, wild meat and nuts on a daily basis. Our body systems have not changed substantially since then. In 2009, researchers led by Dr. Hession and Dr. Rolland from the Centre for Obesity Research and Epidemiology (CORE) in the UK, have conducted a meta-analysis on metabolic syndrome and proved that high-fat diets outperformed low-fat diets when it comes to weight loss, as well as when it comes to lowering heart disease risks, diabetes, inflammation and hypertension. It now becomes quite clear for scientists that general population who decrease the ratio of carbs, cut on sugars, eat more fruits and vegetable and increase the ratio of fats, within the limit of their daily calorie needs, are healthier and tends to lose weight easily and without efforts.

Among all nutrients explored by scientists on the last two decades a combination of 3 elements is very promising to prevent, delay or mitigate age-related diseases, especially dementia

• mega-3, especially DHA and EPA

Medium-Chain Fatty Acids (MCFAs or MCTs) antioxidants in fruits, vegetables and spices

Omega-3

it is an essential nutrient. For omega-3 fatty acids, it has two meanings:

• ur body can not produce them: we have to get them from our diet.

to make things worse, we do not get enough in our diet. it is difficult for our body to transform ALA into the most interesting forms of DHA and EPA. to make things worse, our enzymes have the strong competition of omega-6 Omega 3, especially DHA/EPA, are the last general nutrient deficiency in the modern world

It have been largely demonstrated that omega-3 is protective on heart and cardio-vascular system. As such, omega-3 plays a key role in the prevention, delay and mitigation of age-related disease It is now a large consensus amongst scientific community.

it is now obvious that omega-3 fatty acids, especially DHA/EPA, play a key role, not

• nly in the development of the

brain and the nerves system, but also in their protection and their proper functioning during all the life.

Omega-3 fatty acids are incorporated into neuronal membrane, making membrane fluidity and lipid raft domain.

the benefits of DHA/EPA in the formation and development of brain is not a surprise: there are many recommandations in all public policies for pregnant women and babies. breast milk is the best natural source of DHA for babies. but scientists are still discovering how far these benefits can go, even to school performances

because of all these proven and undebatable benefits, many advanced countries have published during the last 6 years, recommended intakes for general population for omega-3 ALA, DHA and EPA, with functional and even health claims. the recommendations clearly specify the level for ALA and the level for DHA-EPA. the level of DHA-EPA is certainly the most important as the conversion from ALA is not easy. Codex is also on the verge of publishing recommended intakes for general population for omega-3 DHA and EPA ( CX/NFSDU 15/37/7). in the next few years, it will be inconceivable for a modern country not to implement recommended daily intakes for DHA-EPA

where to get your omega-3 from? As the general population is so much in deficiency, I could recommend Omega-3 from any sources: supplements, supplement food (eggs),… but the best source is fatty fish as it contains already our needs in DHA-EPA besides, the natural source is always the best choice for human as we are not yet fully aware how the nutrients work together in the complex chemistry of digestion. As a proof, fish lovers tends to live longer.

Besides omega-3, a clear anti-aging best practice is to use proper oils and fats in the local general population diet the first move is to reduce significantly omega-6 consumption the second step is to use local oils and fats with anti-aging properties

Omega 6 has two problems: it competes with omega-3 as the enzymes needed for the digestion of omega-3 prefer omega-6

• mega-6 has proven inflammatory properties

general population gets too much omega-6 in their diet, especially with cooking oils & fried foods

Once we have removed omega-6 sources, we have to replace them by the local proper good fats rich in anti-aging nutrients.

coconut oil is 55% MCFAs and coconut milk fats 45% MCFAs it is now clearly demonstrated that Medium Chain Fatty Acids are « good » saturated fats MCFAs rapidly metabolize into energy in the liver. It is thought that unlike other saturated fats. The shortcuts that MCFAs take through our digestive system means that it is able to fight diseases, especially inflammatory conditions. MCFAs are transported across the intestinal wall and into the portal vein where they are sent directly to the liver. In the liver, MCFAs are used to produce energy in the form of ketone bodies.

• n top of that MCFAs in coconut is dairy free, an advantage for most of asian who

are lactose intolerant

the recents findings about MFCAs benefits are their role in delaying or mitigating neurodegenerative diseases, especially Alzheimer’s disease.

Alzheimer’s Brain cannot utilize the glucose

52

Alzheimer’s Disease is brain type Diabetes (Type 3 Diabetes)

Amyloid Beta

Glucose Ketone

53

Ketone Body improves Cognitive Function of Alzheimer’s Disease

0.5 .5 mM mM Ke Keto tone

54

What are the intake recommendations for omega-3 and MCTs?

for omega-3 DHA-EPA, it is easy to find levels with all public policies 250 to 500 mg/day

for MCT, There is not yet undebatable figures like for omega-3 DHA-EPA Europeans are encouraged to find them in coconut milk and Asians in coconut oil. Based on my medical experience, I would recommend for general population: 60ml of coconut oil or coconut milk daily for Alzheimer and dementia patients: 120ml daily

Thank you,

Feel free to contact:

Takuji Shirasawa, M.D., Ph.D. Director Professor Shirasawa Anti-Aging Physiology Medical Institute School of Medicine Tokyo, Japan Dokkyo Medical University

shirasawa@Shirasawa-acl.net