Healthy Aging: Western and Oriental Approaches Compared

Introduction

The twenty-first century is characterized by the successes of modern science, which have brought about apparently unlimited materialistic achievements. While people enjoy better health and remarkable means of healing that allow them to live to a much longer age, longevity and the increasing number of elderly people have produced new social problems (Buckwalter et al., 2003).

The current expected age of survival for men and women all over the world is ever increasing, and it has become clear that many people surviving to higher ages are in fact not in good shape, either socio-economically or physically (Lipsitz, 2004). In Hong Kong, for instance, expected ages of survival had already increased to 79.3 years for men and 85.4 years for women, according to 2007 vital events data from the Census and Statistics Department. If these elderly citizens are in good health, they enjoy being senior and wise. On the contrary, if they are suffering from ill health, they become a burden to themselves, and their families and communities must reserve huge resources to support them. The question arises: do we have healthy environments in which aging people can remain healthy?

The answer appears to be unfavorable. The physically observable environment being presented to everyone is gloomy, particularly in Asia. The overly rapid economic growth in most regions has polluted the atmosphere, water sources, vegetation, living organisms, crops, and livestock. The direct effects may be a cause of the general rise in the incidence of cancers. Economic growth has also brought along socio-psychological tensions in the living environments of most inhabitants. The ever-increasing stress has rightly been taken as a culprit in the ever-declining mental health of all people, young and elderly alike.

Advances made in molecular biology have brought about the discovery and mapping of the complete genomic picture, followed by the identification of specific genes responsible for rare, congenitally related disease entities. Optimists hurried to assume that sooner or later, all diseases and pathologies could be traced to a genomic origin and ultimately eliminated. They predicted that individualized treatment according to different identified targets would not be a remote practice. The different genomic make-up of different individuals could certainly explain the commonly observed differences in responses to similar treatment regimes among patients labeled with similar pathologies (Vaillancourt, 2002).

All appeared well, and another major medical advance in the direction of definitive cure seemed expected — until further advances in molecular biology revealed much more complicated pictures. Pathologies and diseases at the molecular level — beyond tissues, cellular, and finer histomorphometric levels — exist at what can be termed the proteomic level, and they are under the influence and control of very complicated systems. These systems interact and remain in an unstable equilibrium. Once that unstable equilibrium is disturbed, the individual is beset by pathological changes which may or may not be linked with symptoms and signs.

The mechanisms affecting the different systems of proteomic reactions are influenced not only by the genomic make-up of the individual but also by the environment the individual faces. The environment is both external and internal. The external environment has been discussed above. The internal environment refers to the alimentary tract and the respiratory and excretory tracts, all in tubular forms of various shapes. The living organisms inside these tubular cavities are ever-changing, and personal habits, lifestyles, and individual activities initiate environmental changes all the time. One might argue that whenever changes occur, counter-changes to bring stability and equilibrium are always possible. Be that as it may, where is the concerted motivation and dynamic that is expected to be essential for positive stability (Vaillancourt, 2002)? With aging, one expects a much higher chance of losing that stability. Keeping healthy while aging is therefore of utmost importance.

Aging is a normal life process involving a complexity of objective changes in the pathological deterioration of cells and tissues — a phenomenon known as degeneration. Normally, cells undergo repair and regeneration in response to wearing out. With aging, their proliferative capacity declines, their differentiation into specialized functions slows down, and their normal responses to growth factors become hazardous. Laboratory investigations have suggested that these degenerative changes may result from free radical accumulations or abnormal protein production.

Aging: Changes at Different Levels

Cellular degenerations lead directly to tissue and organ damage, either directly through declines in circulation and loss of muscle and bone mass, or indirectly through inactive hormonal activities, inefficient immunological reactions, or loss of stem cell supplementation.

Among the widespread, generalized phenomena that leave no cells, tissues, or organs unaffected, there are areas that are either more severely affected or, when affected, lead to readily expressed pathological changes and immediate manifestations of health deterioration, followed shortly by the occurrence of disease. The critical areas include: cardiovascular degenerations resulting from abnormal cholesterol deposits leading to coronary and cerebral artery obstructions; abnormal cellular proliferations leading to cancer development; and musculoskeletal deteriorations leading to physical weakness, pain, and proneness to injury. One area becoming more prominent in recent years, due to the further increases in survival age, relates to the loss of neurological regenerative power, leading to a variety of dementias.

Beyond the tissues and cells, at the molecular level, proteomic activities normally maintain a balanced signaling that keeps generation and degeneration, anabolism and catabolism, in equilibrium. Aging refers to a stage when deterioration becomes more rapid, producing manifestations of different degrees of frailty. Opposing couples of cell signaling are found — though not yet completely understood — in all the structural and functional balance of the body's tissues.

Given the serious challenges posed by aging, there is a natural enthusiasm to respond positively to this urgent need of the new century. That enthusiasm comes not only from elderly people themselves and professional healers, but also from health service providers at the government level.

Assessing Patient Needs and Providing Treatment

In the affluent world, the market-driven economy has initiated the formation of special professional groups to provide services to aging populations. One remarkable group has arisen from Europe — the Anti-aging Medicine Specialization (AAMS). Within a few years, this organization became the most influential such body, first in Europe and then spreading to the United States. It holds frequent training courses for physicians and paramedical professionals and has facilitated the establishment of specific clinics offering healthy aging advice, clinical investigations, and treatment. The major areas of concern from the AAMS are Nutrition, Hormonal Deficiencies, Psychological Health, Environment, and Physical Activities.

On the nutrition side, healthy foods and drinks are redefined, as are "bad" foods and drinks. Followers are advised not to consume milk products, sugar, unsprouted grains, and alcoholic and caffeinated drinks (Werbach, 2003). A new concept of food digestion has been established, which emphasizes subclinical food allergy related to specific food items that initiate a major change of intestinal flora (Gibson, 2006). To substantiate these postulations, specific tests have been created. The "toxicity" of food items has also come under scrutiny. A new disease syndrome — "Chronic Fatigue Syndrome" — has emerged, with its cause attributed to an imbalance produced by an insufficiency of essential food substances alongside an excess of "toxic" chemicals (Yoshimura, 1985; McKenna, 2006).

The rationale for labeling certain foods as bad is based on this new concept of food digestion, which takes into consideration the possible occurrence of sub-clinical food allergy. A food item traditionally regarded as beneficial — such as milk products — may be the cause of sub-clinical allergy and therefore become bad for health. Such items are thought to induce allergy through a complicated mechanism involving changes in intestinal flora (Gibson, 2006). "Toxicity" is thus redefined as not only a state that produces direct adverse effects on normal physiology, but the cumulative result of sub-clinical allergy initiated through the consumption of "bad" food. An analysis of these toxic effects can be accomplished through careful history-taking on nutritional intake, while new laboratory tests have been developed to confirm the existence of allergy and toxicity.

The hormonal insufficiency school commands even greater respect, since the scientific basis of the imbalance between opposing internal secretions appears a sound theory. When serological tests are used to detect imbalances, titre values of opposing internal secretions are observed as manifestations of hormonal imbalances. Normally, only gross imbalances are considered significant in clinical situations. Now that sophisticated tests to measure minute deficiencies are available, ailments like "chronic fatigue syndrome" and "subclinical allergy" — which still lack perfect objective definitions — appear to have reliable pathological explanations (Lindstedt, 2001; Krabbe, 2004). Before the establishment of such evidence, aging people were advised to rely on exercise and a variety of harmless measures such as meditation and spiritual involvement. These measures can now be combined with sophisticated hormonal control, either supplementation or suppression, administered under medical attention.

These current developments are genuinely popular. However, if one applies the principles of evidence-based medicine to critically evaluate the efficacy of these treatments, one might be disappointed, because the parameters are yet to be properly defined.

There is yet another important consideration in attempting to uncover the underlying causes of fatigue and aging. Pollution in the atmosphere and in environmental water in seas and rivers is deteriorating so rapidly that one has little hesitation in associating physiological distress with pollution. Unclean air and contaminated water certainly do nothing to help degenerating tissues. In contrast to the mounting interest in pursuing deductive practices to maintain health during the aging process in the affluent world, the Oriental concept of anti-aging has kept its popularity.

The Oriental concept of longevity emphasizes less on external influences and concentrates more on an internal balance. The Yin-Yang forces need to be kept in harmonious balance; without this harmony, the living individual suffers either an over-active or under-active state. The balanced state relies on a holistic equilibrium that is primarily internal, but must also be harmonious with the environment — respecting climatic and geographic changes. One's position in the family and community needs to be kept in harmony too, without which one's internal balance will be lost (Leung, 2001). The means and efforts to achieve a reasonable state of holistic equilibrium have not been medication-oriented.

One of the essential requirements towards achieving internal harmony is balanced nutrition. Balanced nutrition refers to regular food consumption according to individual need, a balanced diet that avoids the choice of excessively rich foods, a careful selection of fresh and hygienic items, and sometimes the use of herbal choices to help maintain a good balance (Liang, 2006). For the Chinese people, gourmet recipes often contain herbs that are commonly known as vegetables, although the same items might be medicinal choices for special uses. Indulgence in rich food and drink is strictly not recommended. Some nutritional items favored in Chinese medicine include Radix Ginseng, Radix Codonopsis, Radix Astragali, Rhizoma Dioscoreae, Fructus Crataegi, Fructus Lycii, Adenophora stricta Miq., Rhizoma Polygonati Odorati, Bulbus Lilii, Cordyceps, Semen Coicis, and Semen Nelumbinis.