Optimum Health at Every Age

Regardless of age, four pillars to focus on to achieve optimal health include,

  • Diet

  • Exercise

  • Sleep

  • Stress

Below is some information on lifestyle recommendations for these 4 pillars. In addition, appropriate screening tests and laboratory evaluation for early detection and prevention of various diseases are described. Click on the links on individual topics to learn more about recommendations to stay healthy.

Ages 20-29 Years

 

Diet:

Exercise:

  • Incorporate > 150 minutes/week of exercise including cardio, yoga, strength training etc. 

Screening and Age Based Evaluation:

  The following must be considered,

  • Age appropriate cancer risk screen. This includes cervical cancer screen (pap smear) in women every 3 years starting age at 21.

  • Age appropriate immunizations.

  • Metabolic, hormone and additional evaluation based upon individual symptoms.

    • Thyroid disease is fairly common affecting over 10% of the general population. 

    • The most common female hormone imbalance in this age group includes disorders such as PCOS, endometriosis, and hyperandrogenism. 

    • The most common cardiac risk factors in this age group are hyperlipidemia and obesity. 

    • The most common and under recognized metabolic conditions include metabolic syndrome, pre-diabetes, and non-alcoholic fatty liver disease.

    • The most common marker of inflammation is elevated CRP.

    • A common nutrient deficiency is Vitamin D. 

Work evaluation:

  • Identify and modify work / school related stress on physical and mental health. High risk jobs include,

    • Sit down desk jobs​ 

    • Strenuous and repetitive physical work

    • Jobs and crafts with toxin exposure such as dental hygienist, factory and farm workers, building rehabilitators etc. 

    • Night shifts which can disrupt circadian rhythm

    • Work which involves potential conflict related to human interactions such as human resources and/or customer service​​

    • Any work with profession-passion dissonance

Sleep:

  • Seven to eight hours of good quality sleep is necessary for optimal function.

Genetic testing:

  • Genetic testing is indicated based upon family history and/or specific clinical markers.

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Ages 30-39 years

Diet:

Several healthy options can work. Among these, whole foods, mostly a plant based diet is highly recommended. Personalize with food sensitivity testing if necessary. Additional considerations include,

  • Consider removing meat and animal based products from diet based upon individual needs and preferences. This is because at this point, most skeletal structure is fully formed and the brain volume has reached it's highest potential. At this age, a whole foods plant based diet can fulfill the body's nutrition requirements while at the same time safeguarding against detrimental effects of animal based products. Some of these include,

    • Cardiovascular disease​ such as atherosclerosis, high cholesterol

    • Metabolic derangements such as obesity, prediabetes. 

    • Onset of autoimmune diseases as animal based proteins are identified as a trigger for the immune system. 

Exercise:

Incorporate > 150 minutes/week of exercise including cardio, strength training, yoga etc.

Screening and Age Based Evaluation:

  • Age appropriate cancer screening includes pap smear in women every 3-5 years. 

  • Age appropriate immunizations.

  • Metabolic, hormone and additional evaluation based upon individual symptoms. Following must be considered, 

    • Thyroid disease is fairly common in general population and affects women disproportionately.

    • Most common female hormone imbalance at this age include progression of endometriosis, estrogen dominance and inability to lose weight as a results, PCOS, hyperandrogenism etc. 

    • Approximately 15-20% men start to lose testosterone levels in this age group. 

    • Most common cardiac risk factors at this age are high blood pressure and hyperlipidemia leading to early onset of cardiac dysfunction. 

    • Common metabolic conditions include metabolic syndrome, diabetes, gout and non-alcoholic fatty liver disease. Excessive alcohol intake in preceding years further exacerbates this condition. 

    • Most common markers of inflammation are CRP and homocysteine. 

    • Common nutrient deficiency is Vitamin D. 

Work evaluation:

  • By this age, years of physical stress from high risk jobs accumulates and leads to medical conditions such as arthritis, mood disorder and overall deconditioning. Identify and modify work related stress on physical and mental health. High risk jobs include,

    • Sit down desk jobs​ 

    • Strenuous and repetitive physical work

    • Work with toxin exposure such as dental hygienist, factory and farm workers, building rehabilitators etc. 

    • Night shifts which can disrupt circadian rhythm

    • Work which involves potential conflict related to human interactions such as human resources, customer service​​

    • Any work with profession-passion dissonance

Sleep:

  • Get 7-8 hours of good quality sleep. Mild or early onset of obstructive sleep apnea may start to develop in this age group and when suspected must be evaluated for. 

Genetic testing:

  • Genetic testing is indicated based upon family history and/or specific clinical markers.

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Ages 40-49 years

Diet:

Personalize diet from several healthy options. Among these a whole foods mostly plant based diet with focus to detoxify and achieve hormone balance is highly recommended. At this age, hormone imbalance starts to set in. Women may start to go through peri-menopause phase and men start to see a decline in testosterone levels. Following diet related strategies can help with some of these imbalances, 

  • A whole foods plan based diet helps promote phase 1, 2 and 3 detoxification pathways in the liver and helps achieve hormone balance.

  • In addition, micronutrients such as zinc, magnesium, folate and several vitamins which support hormone balance can be obtained from green leafy vegetables.

  • Avoidance of processed foods such as packaged meats prevents metabolic and endocrine derangements. 

Exercise:

At this age, we start to lose flexibility and accumulate disproportionate distribution of fat or adipose tissue. This is often seen as belly bulge, neck hump, and loss of core strength. Therefore, a diverse exercise plan must be followed consisting of > 150 minutes/week of exercise including  strength training, toning, cardio, yoga etc.

Screening and Age Based Evaluation:

  • Age appropriate cancer screening includes

    • In women, mammogram every year and pap smear every 3-5 years.

    • Prostate cancer screen in men when indicated.

    • Colon cancer screen in men and women starting at age 45. 

  • Age appropriate immunizations.

  • Metabolic, cardiac, hormone and additional evaluation based upon individual symptoms: Following must be considered when developing strategies to test and prevent several of these disorders, 

    • Common metabolic conditions include onset or worsening of metabolic syndrome, diabetes, gout and non-alcoholic fatty liver disease. Excessive alcohol intake in preceding years further exacerbates this condition. 

    • Most common marker of inflammation are elevated CRP and elevated homocysteine. In addition, autoimmune diseases start to manifest due to epigenetic expression of a variety of genes. 

    • Digestive and absorptive capacity can start to decline in this age leading to a variety of nutritional deficiencies including vitamin D, B vitamins, and minerals such as magnesium etc. This leads to fatigue and inability to lose weight. In addition, loss of smooth muscle tone and mucosal damage from age related changes leads to a variety of common disorders such as GERD and functional bowel disorders such as SIBO, leaky gut and IBS. Gut evaluation, therefore can help identify some of these problems. 

    • Most common cardiac risk and disease in this age group includes atherosclerosis from years of accumulated high cholesterol and consumption of inflammatory diet. In addition V02max, which is a marker of cardiorespiratory fitness declines. 

    • Most common hormone disorder is thyroid disorder, which if present, usually starts to manifest related complications. Female hormone imbalance at this age includes decline in estrogen, progesterone and testosterone with a parallel rise in cortisol levels. Approximately 40-60% men experience low testosterone levels in this age group. Hormone evaluation in the form of lab testing helps identify need for hormone based treatment. 

Work evaluation:

  • By this age, years of physical stress from high risk jobs accumulates and leads to medical conditions such as arthritis, mood disorder and overall deconditioning. In addition, this age group is at highest risk for burn out which further compromises quality of life. One strategy is to identify and modify work related stress on physical and mental health. High risk jobs include,

    • Sit down desk jobs​ 

    • Strenuous and repetitive physical work

    • Work with toxin exposure such as dental hygienist, factory and farm workers, building rehabilitators etc. 

    • Night shifts which can disrupt circadian rhythm

    • Work which involves potential conflict related to human interactions such as human resources, customer service​​

    • Any work with profession-passion dissonance

Sleep:

  • Good quality 7-8 hours of sleep is important. Obstructive sleep apnea affects approximately 25-30% population in this age group. Being overweight or obese further increases the risk. Therefore, when suspected, this condition must be evaluated and treated. 

  • In addition, circadian rhythm disorder starts to develop and at risk individuals report difficulty falling or staying a asleep. Fluctuations in melatonin levels and decrease in body's ability to metabolize caffeine and other products leads to further sleep disruption specially when these products are consumed to stay awake. Thus a vicious cycle of non-restorative sleep and fatigue develops leading to a variety of metabolic derangements and even cognitive decline. 

Genetic testing:

  • Genetic testing is indicated based upon family history and/or specific clinical markers. Specifically, genetic tests for the following may be of value,

    • Alzheimer disease ​

    • Cardiovascular disease

    • Cancer screen 

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Ages 50-65 years

Diet:

A personalized diet plan is recommended. Among several, a whole foods mostly Plant based diet, Cardiometabolic diet or Mito diet provide the most benefits in terms of reducing inflammation, detoxification and achieving hormone balance. At this age, hormone imbalance usually progresses to advance level. Women go through menopause phase and men see a decline in testosterone levels. Following diet related strategies can help achieve balance,

  • A whole foods plan based diet helps promote phase 1, 2 and 3 detoxification pathways in the liver and helps achieve hormone balance.

  • Micronutrients such as zinc, magnesium, folate and several vitamins which support hormone balance can be obtained from green leafy vegetables.

  • Avoidance of processed foods such as packaged meats prevents metabolic and endocrine derangements. 

Exercise:

At this age, we start to lose flexibility and accumulate disproportionate distribution of fat or adipose tissue. This is often seen as belly bulge, neck hump, and loss of core strength. Therefore, an exercise plan must be followed consisting of > 150 minutes/week of exercise including  focus on toning, strength training, cardio, yoga etc.

Screening and Age Based Evaluation:

  • Age appropriate cancer screening includes yearly mammogram and a pap smear in women every 3-5 years. Prostate cancer screen when indicated in men and colon cancer screen in men and women starting at age 45. In addition, bone density scan (DEXA) is indicated in women. 

  • Age appropriate immunizations.

  • Metabolic, cardiac, hormone and additional evaluation based upon individual symptoms: When evaluating for the above, following must be considered, 

    • Most common cardiac risk and disease in this age group includes atherosclerosis from years of accumulated high cholesterol and consumption of inflammatory diet. Cardiac function starts to decline and this leads to symptoms of heart failure such as fatigue, shortness of breath, leg swelling and chest heaviness. In addition V02max, which is a marker of cardiorespiratory fitness declines. Lung function testing in the form of spirometry and additional testing may be of value when this is suspected. 

    • Common metabolic conditions include diabetes and related complications start to develop because typically by now, people have lived with high blood sugar for several years. Some of these include,

      • Neuropathy 

      • Eye disease and

      • Decline in kidney function 

    • Additional common problems include gout and non-alcoholic fatty liver disease. Excessive alcohol intake in preceding years further exacerbates this condition. 

    • Most common marker of inflammation are elevated CRP and elevated homocysteine. In addition, autoimmune diseases start to manifest themselves due to epigenetic expression of a variety of genes. 

    • Immune system starts to lose its robustness and ability to fight infections. This leads to resurgence of chronic viral infections. Common viruses which tend to persist in body include herpes zoster or shingles, herpes simplex etc. 

    • Digestive and absorptive capacity can start to decline in this age leading to a variety of nutritional deficiencies including vitamin D,B vitamins, and minerals such as magnesium etc. This leads to fatigue and inability to lose weight. In addition, loss of smooth muscle tone and mucosal damage from age related changes leads to a variety of common disorders such as GERD and functional bowel disorders such as SIBO, leaky gut and IBS. Gut evaluation, therefore can help identify some of these problems. 

    • Most common female hormone imbalance at this age includes decline in estrogen and progesterone and testosterone with a parallel rise in cortisol levels. Approximately 40-60% men experience low testosterone levels in this age group. Hormone evaluation in the form of lab testing helps identify needs for hormone based treatment. 

Work evaluation:

  • By this age, years of physical stress from high risk jobs usually has accumulated and leads to medical conditions such as arthritis, mood disorder and overall deconditioning. Usually people have reached peak of their careers by now which comes with added responsibilities. Many people work outside their work hour windows which leads to stress, sleep disturbances and a compromise in quality of life. Identify and modify work related stress on physical and mental health. High risk jobs include,

    • Sit down desk jobs​ 

    • Strenuous and repetitive physical work

    • Work with toxin exposure such as dental hygienist, factory and farm workers, building rehabilitators etc. 

    • Night shifts which can disrupt circadian rhythm

    • Work which involves potential conflict related to human interactions such as human resources, customer service​​

    • Any work with profession-passion dissonance

Sleep:

  • A good quality 6-8 hours of sleep is important. Obstructive sleep apnea affects approximately 25-30% population in this age group. Being overweight or obese further increases the risk. Therefore, when suspected, this condition must be evaluated and treated.

  • Disturbances in initiating and maintaining sleep and circadian rhythm disorder starts to develop and at risk individuals report difficulty falling or staying a asleep. Decrease in body's ability to metabolize caffeine and other stimulating products leads to further sleep disruption specially when these products are consumed to stay awake and to function. Thus a vicious cycle of non-restorative sleep and fatigue develops leading to a variety of metabolic derangements and even cognitive decline. 

Genetic testing:

  • Genetic testing is indicated based upon family history and/or specific clinical markers. Specifically, genetic tests for the following may be of value,

    • Alzheimer disease ​

    • Cardiovascular disease

    • Cancer screen 

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Ages > 65 years

Diet:

A personalized diet plan is recommended. Among several, a whole foods mostly Plant based diet, Cardiometabolic diet or Mito diet provide the most benefits in terms of achieving optimal nutrition, maintaining cognitive function and preventing muscle and bone loss. Several tissues in the body go through degenerative changes and require supplements for optimal function. People see about 20-30% decline in appetite by age 65 along with decreased digestion and absorption. This further leads to nutritional deficiencies. Commonly needed supplements include vitamins, minerals, anti-oxidants, omega 3 fatty acids, probiotics, digestive enzymes and in some situations, collagen peptides. 

Exercise:

At this age, loss of balance becomes challenging. This occurs due to loss of core strength, neuropathy and bone weakness. Exercises to improve core strength and improve balance, bone mass and coordination are therefore beneficial. Specific exercises which help in this regard are,

  • Pilates, yoga and stretching

  • Strength training

  • Balance ball 

  • Tai Chi 

  • Whole body vibration

Screening and Age Based Evaluation:

  • Age appropriate cancer screening includes yearly mammogram until age 75. Prostate cancer screen when indicated in men and colon cancer screen in men and women starting at age 45 until age 75. In addition, bone density scan (DEXA) is indicated in women and high risk men.

  • Age appropriate immunizations. 

  • Metabolic, cardiac, hormone and additional evaluation based upon individual symptoms: When evaluating for the above, following must be considered, 

    • Most common female hormone imbalance at this age includes decline in estrogen, progesterone and testosterone with a parallel rise in cortisol levels. Over 80% men experience low testosterone levels in this age group. Hormone evaluation in the form of lab testing helps identify needs for hormone based treatment. 

    • Most common cardiac risk and disease in this age group includes atherosclerosis from years of accumulated high cholesterol and consumption of inflammatory diet. Cardiac function starts to decline and this leads to symptoms of heart failure such as fatigue, shortness of breath, leg swelling and chest heaviness. In addition V02max, which is a marker of cardiorespiratory fitness declines. Therefore, comprehensive cardiac and respiratory evaluation is often indicated. Some of these tests include

      • Vascular age determination​

      • Echocardiogram

      • Coronary artery calcium score

      • Carotid imaging

      • Spirometry

    • Additional cardiovascular complications with ensuing impact on quality of life include the following and must be avoided

      • Stroke - leads to neurological deficits and inability to care for oneself.

      • Peripheral vascular disease - leads to pain, delayed healing and loss of function.

      • Vascular dementia - leads to cognitive decline.

    • Common metabolic conditions include diabetes and related complications such as neuropathy, eye disease and decline in kidney function, gout and non-alcoholic fatty liver disease. Excessive alcohol intake in preceding years further exacerbates this condition. 

    • Kidney function starts to decline leading to decreased ability to clear toxins and medications from the system. This often results in high risk of developing medication related complications. Most people in this age group are on a few or several prescription medications and/or non-prescription supplements. It is therefore important to start low and go slow in this age group when it comes to medications and supplements.

    • Most common marker of inflammation are elevated CRP and elevated homocysteine. In addition, complications associated with chronic conditions such as autoimmune diseases, specific organ dysfunction etc. start to develop. Therefore, routine monitoring and management of these diseases is highly recommended.  

    • Immune system starts to lose its robustness and ability to fight infections. This leads to resurgence of chronic viral infections. Common viruses which tend to persist in body include herpes zoster or shingles, herpes simplex etc. In addition, several bacterial infections such as pneumonia, urinary tract infections and bacteremia become frequent. 

    • Digestive and absorptive capacity can start to decline in this age leading to a variety of nutritional deficiencies including vitamin D,B vitamins, and minerals such as magnesium etc. This leads to fatigue and inability to lose weight. In addition, loss of smooth muscle tone and mucosal damage from age related changes leads to a variety of common disorders such as GERD and functional bowel disorders such as SIBO, leaky gut and IBS. Gut evaluation, therefore can help identify some of these problems. 

    • Autonomic dysfunction in this age group increases susceptibility to falls and fractures. Monitoring and maintaining fluid balance and optimizing blood pressure is therefore recommended. 

    • Age related changes in vision, hearing and skin changes lead to a decline in function and quality of life in several areas; 

      • Vision loss as a result of cataract, glaucoma and macular degeneration ​leads to loss in function.

      • Hearing loss leads not only difficulties in communication but cognitive decline as well.

      • Skin related changes lead to a variety of uncomfortable conditions such as excessive dryness, loss of elasticity, slow healing, and risk for skin cancer.

      • Loss of healthy secretions lead to dry mouth, dry eyes and dryness in airway passages. All of these changes increase risk of infection in several areas in addition to causing discomfort. 

    • Cognitive decline starts to manifest in high risk individuals. Comprehensive cognitive assessment and treatment can help manage subtle and advanced cognitive decline. Risk factors include years of 

      • Cardiovascular disease

      • Metabolic disturbances,

      • Hormone imbalance,

      • Chronic infections,

      • Genetic factors.

Work evaluation: Usually by this age, people have look to prepare for retirement. Some people cut back on work hours but unfortunately, years of physical stress from high risk jobs accumulates and leads to medical conditions such as arthritis, mood disorder and overall deconditioning.

    Sleep:

  • Sleep tends to become an increasingly problematic issue by this age. People who already have insomnia or circadian rhythm disorder, see a worsening of their symptoms. This occurs due to

    • Loss of sleep center's ability to regulate orexin is quite common in this age group.

    • Fluctuations in melatonin levels.

    • Decrease in body's ability to metabolize caffeine and other products leads to further sleep disruption specially when these products are consumed to stay awake and functional. Thus a vicious cycle of non-restorative sleep, fatigue develops leading to a variety of metabolic derangements and cognitive decline. 

  • Obstructive sleep apnea, if already preset, continues to cause problems in this age group. Therefore, when suspected, this condition must be evaluated and treated

Genetic testing

  • Genetic testing is indicated based upon family history and/or specific clinical markers.

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