Maintenance of Wellness

Dr. Kenneth Dickie Royal Centre of Plastic Surgery

Aging is destructive, progressive, intrinsic, and universal.

Aging is a gradual decline of optimum performance.

Age management is the attempt to restore and maintain optimum performance

Signs and Symptoms of Aging

• Loss of skin tone• Loss of muscle mass• Loss of bone density• Loss of libido• Loss of drive to excel• Loss of strength• Increased body fat

Aging and Dementia• 50% of patients over the age of 90 will have significant

dementia• Can we reduce the progression of cerebral aging as well?• After age 40, our cerebral function begins to deteriorate due

to damage to approximately half of the genes involved in learning, memory, and communication between cells.

• The remaining genes—particularly those involved in DNA repair, antioxidant defense, stress and inflammatory responses, are required to work harder.

Aging and Dementia

• Thus with aging, genetic changes can account for brain decline

• There is evidence that free radicals exposed to brain cells in vivo, result in damage to the same genes that demonstrate damage in vitro

• Damage that is due to environmental, lifestyle and other “extrinsic” factors may be preventable, or even reversible over time.

APOPTOSIS

• Programmed Cell Death– For every cell, there is a time to live and a

time to die– Death by injury (mechanical or biological)

• Free radical damage to DNA promotes cellular aging

– Death by “Suicide”• PCD required for normal development (tadpole)• PCD for cells that represent a threat to the integrity of the

system: infective, immunological

NOT ALL CELLS ARE PROGRAMMED TO DIE AT A PRE-

DETERMINED TIME

Age Management

• Combining plastic surgical rejuvenation with some or all of the methodology available today to enhance youthfulness, wellness, and preservation of physical features

What Does Age Management Address?

• Nutrition• Supplements• Exercise• Hormone replacement therapy• Stress Management • Skin care• Cosmetic Surgery

Age Management Will Address

• Weight gain• Poor nutrition• Exercise pattern• Supplements• Hormone replacement therapy• Stress management• Hair, cosmetics, etc.

Age Management Medicine

• Not only is it possible to avoid premature disability and death, but energy level, lean muscle mass, bone density and cognitive function can be increased.

• Immune system strength can be improved to help the patient remain as disease free as possible

Age Management Can

• Reduce heart risks• Reduce cancer risks• Decrease diabetes and stroke risks• Improve quality of life• and more specifically…… • Address Metabolic Syndrome

Metabolic Syndrome

• Metabolic syndrome exists if you have at least 3 of the following traits:– Waist>40” in men, >35” in women– Triglyceride levels >150– HDL (“good cholesterol”) <40 in men, < 50 in

women– BP > 130/85– Fasting Glucose > 100

Metabolic Syndrome

• On average, 20% of men and women over age 20 have metabolic syndrome

• As people approach their 60s and 70s, this figure jumps to over 40%

• Those with metabolic syndrome will have a greater risk of diabetes, heart disease, and stroke

Metabolic Syndrome

• The cause of metabolic syndrome has been linked to:

– Improper Nutrition–Lack of

Exercise

Traditional Medicine

• Symptom based medicine (eg: treatment of heart disease when angina develops) is often too late

• Early diagnosis/intervention using age management strategies will lessen the dependency on symptoms to warn of impending disease

American Journal of MedicineFeb 1, 2004

• The time has come to abandon disease as the focus of medical care. The changed spectrum of health, the complex interplay of biological and non-biological factors, the aging population, and the interindividual variability in health priorities render medical care that is centered on the diagnosis and treatment of individual diseases at best out of date and at worst harmful.

How do we decelerate the aging process?

• Regular Physical Exercise• Daily Mental Exercise• Proper Diet (with caloric restriction)• Nutriceuticals and Metabolic Pharmaceuticals• Therapeutic Intervention on Immune System

(Stem cells & supplemental growth factors)

Age Management Medical Assessment

• Endocrine assessment/hormone replacement• Anti-oxidant analysis/supplementation• Evaluation of bio-markers of aging• Cardiovascular/immune protection• Cognitive function assessment/repair• Metabolic & DNA repair• Aesthetic Surgery and skin care

Extrinsic Factors Which Influence Aging:

EXERCISE=60%

SUPPLEMENTS=10%DIET=30%

EXERCISE

VITAMINS & SUPPLEMENTS

PREVENTATIVE MEDICINE

STRESS REDUCTION

SURGERYSELF EDUCATION

HORMONAL MAINTENANCE

SKIN CARE

EDUCATION

NUTRIENT INTAKE

IDEALBODY WT.GOALS

Exercise: 60% To ‘Wellness’

• Train Harder• Train Shorter• Train Regularly– Doing ‘wind sprints’ at

1 minute intervals on a treadmill, for 12 minutes a day

• DO NOT Overtrain• Resistance Training

DIET

• CONTRIBUTES ~ 30% TO ‘WELLNESS’• UNDERSTAND C/P/F RATIO• ‘GOOD’ FATS • PROTEINS ARE ESSENTIAL / VEGETARIANS ARE AT RISK• CALORIC RESTRICTION

.

The Zone Diet

• Calorie Restriction……….1500cal/day• 2/3 meal portion vegetables/fruit• 1/3 meal portion high quality protein (portion

size = palm of your hand)• Limit carbohydrates, hydrogenated fats• Add supplements

FISH OIL: Natures wonder drug

• Omega-3 Fatty Acids• Naturally found in

Salmon, Tuna, Anchovies, Bluefish

• 4 capsules (1000mg) per day

• Use highly purified brand

Supplements--OTC

Vitamin A Vitamin D Vitamin E Vitamin K

Vitamin C B Vitamins

Co EnzymeQ10

Selenium

EssentialFatty Acids

Iron Calcium MagnesiuM

Garlic GinkgoBiloba

Ginseng Zinc

Supplements-Physician Supervision

DHEA Melatonin Bromelain

Arnica Montana

Human GrowthHormone

Testosterone

Thyroid Estrogen Progesterone

Supplements: HGH

• Human Growth Hormone Supplementation– Improved body

composition– Increased physical

performance, stamina, libido

– Improved mood and mental acuity

Supplements: HGH

• Human Growth Hormone is Statutorily Not a Dietary Supplement but a Drug. Prescribing, Administering, Marketing or Distributing of Human Growth Hormone for Age Related Problems is Illegal: U.S. F.D.A.

• HGH is approved for:– Children with growth hormone deficiency– Patients with treated pituitary tumors– Wasting syndrome of AIDS

Supplements: HGH

• Is the use of HGH an effective and SAFE anti-aging strategy?

• Could low dose, intermittent HGH therapy be beneficial in counteracting the natural decrease of HGH associated with aging?

• Is it possible that this may strengthen the weak link in the chain of longevity?

Dr. John Clement: I.A.T.

• Western Medicine maintains that cancer must be cured before a patient can resume a “normal” life

• If we can CONTROL cancer in the same manner which we control diabetes or hypertension, patients may live a relatively normal life with their cancers while maintaining appropriate immunologic surveillance

Dr. John Clement

• Advances in wellness medicine and cancer treatment must incorporate a combined approach involving surgery, immunotherapy, stem cell manipulation, gene therapy as well as the use of supplements that provide the raw materials essential to the repair of cellular components that regulate our health

Tissue Engineering

• Stem Cells– Umbilical cord Stem Cells– No Antigenicity– Stem Cells from Fat

Grafting

• Supplemental Growth Factors

• Genetic Manipulation

What Is A Stem Cell

• …a cell from the embryo, fetus, or adult that can undergo extensive proliferation before senescence and can be differentiated to specialized cells of body tissues and organs

• Extrinsic and intrinsic tissue factors keep stem cells in their undifferentiated state until stimulated.

Embryonic Stem Cells vs.Umbilical Cord Stem Cells

Adult Stem Cells

• Adult Stem Cells are undifferentiated cells that occur in differentiated tissue

• Are more differentiated than embryonic stem cells

• Are easier to obtain than embryonic stem cells (eg: Liposuctioned Fat )

• Can be harvested and stored for later use

Adult Stem Cells:Promise of an Improved Life

• “Given the enormous potential of stem cells to the development of new therapies for the most devastating diseases, when a readily available source of stem cells is identified, it is not too unrealistic to say that this research will revolutionize the practice of medicine and improve the quality and length of life.” --National Institutes of Health, May, 2002

EDUCATIONAL EMPHASIS

40’S

ANTICIPATE HORMONAL CHANGES

IMPROVE NUTRITION

CAUTION – ALCOHOL INTAKE

INTENSIVE SKIN CARE

SURGERY (EYES, FACE, BODY)

50’S PLUS

EMPHASIZE ‘TURN BACK THE CLOCK’

EMPHASIZE ‘SLOW THE AGING PROCESS’

HORMONE REPLACEMENT

NUTRITION/EXERCISE/ACTIVITY PLAN

MEDICAL FITNESS/IDEAL BODY WEIGHT

SURGERY

EDUCATIONAL EMPHASIS

20’s

SKIN PROTECTION

IDEAL BODY WEIGHT

NUTRITION/SUPPLEMENTS

SKIN NUTRIENTS

30’S

INTENSIVE SKIN CARE

MONITOR BMI CLOSELY

NUTRITION/SUPPLEMENTS

We Should Focus First on Extending our Health

Expectancy, then we can contemplate our Life Expectancy

If you have any questions, feel free to contact Dr. Kenneth Dickie at royalcentreofplasticsurgery.com

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