Welcome, my name is Dr. Warrick Bishop. I'm a cardiologist, an author and a keynote speaker. I'm CEO of the Healthy Heart Network. I'm all about trying to help people live as well as possible for as long as possible. Heart disease is huge in Australia. Every 20 minutes someone suffers a heart attack. Most of these could probably have been avoided if only we knew what to do. This podcast is all about helping you understand blood pressure, weight, cholesterol for better health. If you enjoy this podcast, I would be honored for a five-star review. You can share it with your family and friends. It may well save someone you love. Hi, my name is Dr. Warrick Bishop and welcome to my podcast and videocast station. I really do appreciate you tuning in and I really do hope that I'm able to share information that you find valuable. informative and that helps you on your own health journey. Look, I've found two papers that I'd like to touch on and share today. The first of those papers is in regard to slowing down, ageing and understanding ageing a little bit better. The other one is about red wine. Well, it turns out both these topics are close to my heart. perhaps for selfish reasons, in ways that we might understand ageing better, improve our health span and improve our quality of life for as long as possible. The other, of course, is I do enjoy a glass of wine and do, in fact, have a cellar. So let's start off with the ageing article. By way of background, probably the most significant paper to start this process off came out in 2013 and was published in Cell, a journal, a scientific journal, in that space. And that article in 2013 really notated some of the molecular indicators that are important in trying to assess ageing in mammals. Well, it is interesting to realise that Since that time, approximately 300,000 articles on ageing have been published. And that is somewhat incomprehensible in terms of a total number. And interestingly, as you might guess, is as many as were published in the entire previous century. So lots of work has been done. Some of it on humans, but the vast bulk on mice. What has been pointed to is a number of primary causes of aging. And they centre around such things as genomic instability. So this is breakdown of your DNA. Shortening of telomeres. These are the proteins that extend from the end of your DNA. Epigenetic alterations, these are things that happen around or outside of the DNA. And an imbalance between protein synthesis and degradation. Really sort of suggesting that synthesis or creation production of protein, things to keep our body together, is offset against the breakdown. This particular article really makes mention that at the moment, in our current state, dietary intervention is probably the easiest way for us to be looking at trying to impact people when it comes to slowing down aging. And believe it or not, the Mediterranean diet gets a flag in this particular article. Eating nuts, particularly walnuts, almonds, is associated with less dyslipidemia. Diet rich in fiber, less colonic digestive pathologies. And eating a diet that's low in fatty meats and rich in fruits and sugars is associated with less prostate, breast and colon disease. So these associations are clear, but still there's no clear cut. diet tie to longevity, although it makes sense if you can reduce some of these chronic conditions and improve the management of these chronic conditions than there would, by virtue of common sense, be an impact on age and health span. One of the things that is interesting, and we're going to hear these sort of terms more often in the future, is the age indicators now i mentioned genomic instability i mentioned telomere wear epigenetic alterations loss of proteostasis that's just not keeping enough proteins being produced and therefore literally seeing a breakdown one of the other things is macro autophagy or inactivated macro autophagy and autophagy is in reference to the body gobbling up cells that are pretty well no longer functional. So we think of cells as they start to die as sometimes getting caught in that death cycle. And imagine a cell sitting somewhere in an organ, perhaps even on the skin. It's past its... At best, it's well into its use-by date, and it should be switching off into programmed cell death. Well, if it doesn't, it can hang around for a while, and this sort of dysfunctional life cycle, extended life cycle of these cells, can end up being problematic. Other indicators can be dysregulation of nutrient sensing, mitochondrial dysfunction. We know that mitochondria are the enginal. energy source within cells, cellular senescence, a little bit like macro autophagy, depletion of hemipoietic progenitor cells. Now that is pretty important because we will end up tracking these sort of markers as an indication of age, almost certainly because these progenitor cells are the cells that can subsequently be used to be guided. to become different tissues and regenerate organs potentially. There are alterations in intracellular communication as we age, chronic inflammation, and importantly, imbalances in the microbiome. Well, all this stuff is absolutely fascinating. It is completely and utterly at this stage a tease. There is a reasonable reason to try and eat sensibly. And Mediterranean diets and a focus on antioxidants together with fiber makes perfect sense. And keeping away from sugar as well makes perfect sense. I will keep you updated in the space of assessment of aging, health span, and the potential of even reversing aging in the longer term. 300 000 articles being produced in the span of a decade or two we will see at least that many and more in the next period of time so watch this space the other article i was pretty keen to share with you was about red wine now i need to remind you that from all the stuff that i've been sharing in recent time regarding alcohol consumption there just isn't a healthy amount of alcohol so we don't know if there's a lower amount which you can consume and be okay however we know that there is no amount of alcohol that will clearly offer you some sort of benefit well interestingly a research group in brazil were trying to find out if we could find an argument for recommending that people do enjoy a glass of wine. So in recent time, around about the beginning of this year, in the American Journal of Clinical Nutrition, there was a paper published called the Wine Flora Study. And the flora in this particular situation was not about flowers that you'd purchase at a shop. gut flora. Well, this particular study took 42 men, average age of about 60 years of age, all of them with documented coronary artery disease, and they were subject to two three-week interventions. In one of those interventions, the participants consumed 250 ml of red wine per day. The red wine sample had an alcohol content of 12.75%. It turns out that the Brazilian Wine Institute produced and supplied the red wine, a 2014 Merlot bottled in August 2016, specifically for the study, which is nice, isn't it? The second intervention involved alcohol abstention. So each intervention was preceded by... two weeks washout. And because certain foods could interfere with the results, the participants were instructed not to consume, obviously, alcoholic beverages, but such things as fermented foods like yogurt, kombucha, soy, kefir, sauerkraut, and so on. And this is so it didn't muck around with the gut flora. Synthetic prebiotics like inulin, fiber, dairy, polyphenols like Grapes, grape juice, etc. Cranberries, strawberries and probiotics were also all kept out of the diet so that there weren't any confounders. At each intervention, the gut microbiota, so the bugs within the gut, were analysed using an RNA sequencing technique. So that meant that the actual bug and the number of those bugs could be determined using RNA. RNA markers which is pretty clever and allowed identification of the species. They also not just checked the gut so stool samples for that RNA sequencing but they also checked the blood looking at the metabolome the plasma metabolome so that was a way of looking at the proteins that were within the blood of these individuals and they used liquid chromatography to evaluate what was in the serum together with mass spectrometry together with the mass spectrometer to analyze this information now one of the things they were trying to evaluate obviously were the bugs but they were also looking for a particular compound and that compound was is a compound called or referred to as TMAO, trimethylalanine N-oxide. And they're pretty interested in that because this particular metabolite seems to be linked to gut flora and seems to be linked to increased likelihood of oxidation within the vasculature and therefore linked to increased risk of stroke and heart attack. When they did their evaluation, they did not demonstrate any difference in the TMAO levels, which was sort of a little bit of a surprise. They did find from their plasma metabolic analysis that there were significant changes in metabolites after red wine consumption, consistent with an improved redox homeostasis, dealing with antioxidant stressors within the bloodstream. So importantly, the researchers didn't demonstrate that red wine was beneficial in reducing trimethylamine N-oxide, TMOA. They did demonstrate that it possibly improved antioxidant levels in the blood. But these were very short studies and may not have been long enough to really represent significant change. Importantly, though, and the researchers make this point, there is no clear evidence at this stage that consumption of alcohol is beneficial in this space and that excess alcohol consumption, of course, carries with it its own risks. Anyway, watch this space. I probably will have a glass of wine with dinner tonight and keep an eye out on the literature as it continues to appear. For now, I hope you found that interesting and informative. If you've got any queries or questions, drop us a note at info at drbaricbishop.online. For now, I'm going to wish you the very best. Please live as well as possible for as long as possible. Take care and bye for now. Did you know that coronary artery disease kills one in four people? So most of us are likely to carry some risk or know someone who does. If you're interested in finding out more about how to evaluate that risk, check out www.virtualheartcheck.com.au. It'll give you information about risk and what else can be done to be even more precise.
