Amber Donaldson Nutrition 302: Lifespan Nutrition March 26, 2011 Research Paper Dr.

Katie Kavanagh Leafy Vegetables as Aging Prevention Mechanisms Along with other factors, the consumption of leafy vegetables has the possibility to enhance life quality by helping to prevent and/or lessen certain effects associated with aging. Habits, such as eating healthfully, implemented early and continued throughout life, can be determining factors for longevity. According to the Centers for Disease Control and Prevention, not meeting physical activity recommendations, having a poor diet, using tobacco, and over consuming alcohol can result in greater instances of chronic diseases and their effects (1). Choosing a balanced diet that incorporates leafy vegetables is a positive step towards improving the aging process.

Aging and associated affects:

To begin, it is important to define aging and old age. In more technical terms, a person is often classified as old when they reach sixty-five years of age (2), but markers of age extend beyond the number of years one has lived. For instance, a persons level of mobility, energy, and mental intactness can also serve as indicators of aging progression. As the size of the United Statess older population continues to grow along with the average life expectancy (3), it is important that people take preventative steps to ensure a good quality of life into their older years. Some of ages most common detrimental effects and chronic diseases can be lessened by the presence of a healthy lifestyle, which includes having a proper diet that incorporates leafy vegetables. For instance, heart disease, cancer, and stroke, the top three causes of death for individuals

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over sixty, and diabetes mellitus, the sixth top cause of death for individuals over sixty, all possess risk factors associated with nutrition (4). Coronary heart disease occurs when the small blood vessels responsible for oxygen supply to the heart become more constricted, which can impair blood flow (5). Coronary heart disease becomes less of a risk for those who maintain a balance of good HDL cholesterol in comparison to less desirable LDL cholesterol, who have a healthy weight, and who control their insulin levels. All of these recommendations are enhanced by the presence of a healthy diet (5). The risk of cancer, which is the instance of uncontrolled abnormal cell growth, can also be improved by warding off obesity and adopting a healthy diet that is rich in antioxidants (6, 7). Additionally, stroke, which occurs when the brains blood supply is cut off, is less of a threat for individuals who manage their cholesterol and blood pressure (8). Diabetes mellitus is characterized by the bodys inability to properly use or make insulin and by having a minimum fasting blood glucose of 126 milligrams per deciliter (9). In congruence with the previous three diseases, individuals suffering from diabetes mellitus can benefit from controlling their weight and cholesterol levels through a healthy diet and exercise (9). Additionally, diet can impact other serious but in some cases less severe disorders that accompany the aging process. Osteoporosis is defined as a continuing decrease in bone density (10). The disease affects about one in five American women, typically from the older population (10). Osteoporosis treatment and prevention plans have a strong focus on diets that include adequate amounts of calcium (10). Age-related macular degeneration results in the degradation of ones central vision (11). This disease is also typically more prominent in older adults. Those who are over seventy-five have about a thirty percent chance of contracting the disease in comparison with the two percent risk for the middle-age population (11). It is recommended that those suffering from age-related macular degeneration consume a large quantity of green, leafy

Donaldson vegetables and avoid obesity (11). Additionally, Alzheimers disease prevention benefits from

controlled blood pressure and antioxidant rich diets (12). Alzheimers disease is a type of dementia that worsens over time (12). The disease impacts the mind by impairing brain function in terms of memory, thinking, and behavior (12).

How leafy vegetables combat the effects of aging:

Now, the question in need of answering is: why choose leafy vegetables as a means of age prevention? The answer has to do with the fact that this diverse plant group possesses at least one attribute that combats each of the above disorders as well as others. Leaf vegetables are vegetables found in the form of leaves on plants as opposed to stalks, roots, and flowers. They include: beet greens, collards, kale, radicchio, salad greens, spinach, turnip greens, watercress, and more (13). While these vegetables are by no means a cure all for old age effects, leafy vegetables are certainly significant when it comes to the widespread beneficial effects they have on the human body. Revisiting weight management, evidence suggests that leafy vegetables may be valuable tools when it comes to preventing obesity. For one thing, these vegetables are significantly nutrient dense, but they are low in terms of energy density. For instance, one cup of chopped, raw kale contains 547.4 mcg of vitamin K, 80.4 mg of vitamin C, 10,302 IU of vitamin A, and 3 grams of fiber, among other nutrients, for only thirty-six calories (14). The fact that leafy vegetables are low in calories while providing adequate nutrition is important because, as mentioned previously, recommendations for combating coronary heart disease, cancer, stroke, diabetes, and age-related macular degeneration include having a healthy weight (5, 6, 7, 8, 9, 11). Alzheimers disease is also affected because blood pressure, which should not be high, negatively correlates with weight (15). Also, because they are so low in calories and carbohydrates, [diabetics] cant eat too much. (16) Because they are low glycemic index foods, they are useful tools for diabetics trying to

Donaldson control their blood sugar in addition to their weight. From the perspective of cholesterol, leafy vegetables can serve as a means of control. In a study done at Yonsei University in Korea, thirty-two, male, human subjects were divided into groups based on past habits such as alcohol consumption, intake of certain lipid-lowering medications six months before the study, and disease history. Each day the participants were

instructed to follow their usual habits in terms of diet and lifestyle. What they were instructed to do differently was to consume the 150 mL of kale juice, which equates to 167 mg of fresh kale, that was delivered to them every morning. After twelve weeks, HDL cholesterol concentrations increased by twenty-seven percent, while LDL cholesterol concentrations decreased by ten percent (17). These findings help to support the notion that foods like leafy vegetables, rather than single nutrients, may have further implications on our heart health than previously believed (17). Having healthy cholesterol levels, which equates to total cholesterol levels less than 200 mg/dL(18), improves the severity and instances of coronary heart disease, stroke, and diabetes (5, 8, 9). When it comes to controlling blood pressure, choosing leafy vegetables is a positive choice for a variety of reasons, such as their mineral content. As stated above, these plants can help maintain a healthy weight, which directly relates to maintaining blood pressure (15). Additionally many of the leafy vegetables, such as kale, collards, spinach, turnip greens, beet greens, turnip greens, mustard greens, dandelion greens, and more, are some of the highest forms of vitamin K available through diet (19). A study done at St. Georges Hospital Medical School in London demonstrated the significance of vitamin K as means to lower blood pressure. The effects of potassium citrate, the primary form of potassium found in food (20), on fourteen subjects suffering from essential hypertension were measured after one week. The only change implemented in their diet and lifestyle habits was the addition of potassium citrate. The results showed a decrease from

Donaldson the beginning blood pressure of 15116/937 mm Hg with a 24-hour urinary potassium of 8124 mmol to an ending blood pressure of 13812/886 mm Hg with a 24-hour urinary potassium: 16033 mmol with potassium citrate, serving as evidence that leafy vegetables are important for blood pressure control (20). Furthermore, these vegetables are naturally low in sodium, and

according to the CDC, Eating less sodium can help prevent, or control, high blood pressure. (21). Another mineral these vegetables contain, particularly spinach, is magnesium (22). Magnesium, the fourth top occurring mineral in the body, controls many homeostatic processes in the body, including blood pressure (22). A healthy blood pressure is important for lowering the risk of coronary heart disease (5), stroke (8), diabetes (9), age-related macular degeneration (11), and Alzheimers disease (12). Additionally, leafy vegetables are high in antioxidants. These include antioxidants such as beta-carotene, lutein, and vitamin C (7). Antioxidants help to protect individuals from free radicals, which are thought to cause various diseases through fostering oxidative stress in the body (23). Diets rich in antioxidants are recommended to ward off cancer (6) and Alzheimers disease (12). Also, because the eye is susceptible to oxidative stress, diets rich in phytochemicals, especially from leafy, green vegetable sources, are recommended to help prevent age-related macular degeneration, although research is not fully conclusive. Research has been concentrated around antioxidants lutein and zeaxanthin (24). Finally, leafy vegetables help protect against old age through their calcium content, (25) although spinach is less absorbable because it has a high oxalate concentration. Consuming adequate amounts of calcium in the early years of life is important because it helps to build and protect bone mass into the later years (26). Around age seventeen, about ninety percent of adult bone mass has already been established (26). Adequate bone mass is important for osteoporosis

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because one of the two main factors that influence its presence is [p]eak bone mass attained in the first two to three decades of life (26). In order to ensure maximum calcium absorption, maintaining vitamin D stores is recommended because vitamin D facilitates calcium absorption and can therefore help protect the bones. For example, hip fractures share a strong positive association with vitamin D deficiency (27).

Conclusions and recommendations:

Overall, it is evident that leafy green vegetables as part of a healthy lifestyle have positive benefits when it comes to aging in a healthful manner (17, 20, 24). This diverse plant group can help to prevent and improve common, life threatening conditions associated with old age, such as coronary heart disease, cancer, stroke, and diabetes (5, 6, 7, 9). They can also aid in osteoporosis, age-related macular degeneration, and Alzheimers disease relief efforts (10, 11, 12). The dense nutrient profile, low energy profile, and high antioxidant levels of these vegetables are the primary factors attributed to their success in these cases (1, 14, 19). How these vegetables are incorporated into ones diet is important. Eating a variety of foods is the recommended practice to ensure adequate intake of as many important nutrients as achievable (28). Green, leafy vegetables should be incorporated into this healthy eating practice because of their wide range of benefits. Consuming these foods in conjunction with other foods can improve their nutritional quality further. For instance, pairing them with vitamin D rich foods like salmon enriches calcium absorption. Also, adding additional vitamin C to these vegetables, such as including orange juice in a sauce or salad dressing, increases the bioavailability of their iron (29). When it comes to cooking methods, it is wise to consume the vegetables in lightly cooked forms in order to preserve the nutrients (30). Eating these vegetables raw or lightly steamed is an encouraged choice (30). People are encouraged to eat two and a half servings of vegetables

Donaldson per day (31). Remembering to make a few of the servings leafy vegetables is important. Because

these foods are naturally occurring substances that have been eaten throughout history, it is safe to assume that they can be incorporated without health threats in most normal cases.

References:
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Donaldson http://www.aoa.gov/aoaroot/aging_statistics/index.aspx. Accessed March 30, 2011. 3.Administration on Aging. A Profile of Older Americans: 2010 page. Available at: http://www.aoa.gov/AoARoot/Aging_Statistics/Profile/2010/3.aspx. Accessed March 30, 2011. 4.Brown JE, Isaacs JS, Krinke UB, Lechtenberg E, Murtaugh MA, Sharbaugh C, Splett PL,

Stang J, Wooldridge NH. Nutrition Through the Life Cycle. 4th ed. Belmont, California: Wadsworth, Cengage Learning; 2011: 455. 5.National Center for Biotechnology Information, U.S. National Library of Medicine. Coronary Heart Disease page. Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004449/. Accessed March 30, 2011. 6.National Center for Biotechnology Information, U.S. National Library of Medicine. Cancer page. Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002267/. Accessed March 30, 2011. 7.National Cancer Institute. Antioxidants and Cancer Prevention: Fact Sheet page. Available at: http://www.cancer.gov/cancertopics/factsheet/prevention/antioxidants. Accessed March 30, 2011. 8.National Center for Biotechnology Information, U.S. National Library of Medicine. Stroke page. Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001740/. Accessed March 30, 2011. 9.American Heart Association. Diabetes Mellitus page. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4546. Accessed March 30, 2011. 10. National Center for Biotechnology Information, U.S. National Library of Medicine.

Donaldson Osteoporosis page. Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001400/. Accessed March 30, 2011.

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http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/What-YourCholesterol-Levels-Mean_UCM_305562_Article.jsp. Accessed March 30, 2011. 19. USDA National Nutrient Database for Standard Reference, Release 17.(g) Content of Selected Foods per Common Measure, sorted by nutrient content Vitamin K (phylloquinone). Accessed March 30, 2011. 20. Feng JH, Markandu ND, Coltart R, Barron J, MacGregor GA. Effect of Short-Term Supplementation of Potassium Chloride and Potassium Citrate on Blood Pressure in Hypertensives. Hypertension. 2005;45:571. 21. Center for Chronic Disease Prevention. Alzheimer's Disease page. Available at: http://www.cdc.gov/bloodpressure/sodium.html. Accessed March 30, 2011. 22. Office of Dietary Supplements. Magnesium page. Available at: http://ods.od.nih.gov/factsheets/magnesium/. Accessed March 30, 2011. 23. Medline Plus. Antioxidants page. Available at: http://www.nlm.nih.gov/medlineplus/antioxidants.html. Accessed March 30, 2011. 24. Basu A, Rhone M. Phytochemicals and age-related eye diseases. Nutrition Reviews. 2008;66:465472. 25. Medline Plus. Calcium page. Available at: http://www.nlm.nih.gov/medlineplus/calcium.html. Accessed March 30, 2011. 26. National Institute of Child Health & Human Development. Building Strong Bones: Calcium Information for Health Care Providers. 2006; 2. 27. Nordin BEC. Calcium and osteoporosis. Nutrition. 1997; 13: 664. 28. American Dietetic Association. The Importance of Variety page. Available at: http://www.eatright.org/Public/content.aspx?id=3181&terms=variety. Accessed March

Donaldson 30, 2011. 29. Brune M, Hallberg L, Rossander L. The role of vitamin C in iron absorption. Int J Vitam Nutr Res Suppl. 1989;30:103-1088. 30. Belelli F, Natella F, Ramberti A, Scaccini C. Microwave and Traditional Cooking

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Methods: Effect of Cooking on Antioxidant Capacity and Phenolic Compounds Content of Seven Vegetables. Journal of Food Biochemistry. 2010; 4: 796-810. 31. American Dietetic Association. Media Press Room page. Available at: http://www.eatright.org/nnm/blog.aspx? id=4294969949&blogid=6442450952&terms=cups+per+day. Accessed March 30, 2011.