The Good, the Bad, and the Ugly ... about Black

 (Published in ENRICH magazine, 2022)

IS IT TOTALLY in black-and-white if I say black is still the coolest color out there? Or is it simply an excuse used by slightly neurotic young adults to mask their low self-esteem?

Truth is, black is a color you love or hate. Or is it, love to hate? Wearing black either makes you feel a whole lot sexier or marks you as a person less than generous.

The ambivalence about the color black isn't new. Even the previous statement about black being a color is a misnomer. Technically, black isn't a color at all. It's a hue, or the pure form of any color.

Black is black because it absorbs all the wavelengths of light and converts these wavelengths into heat. So, don’t go out wearing black on a hot day, which seems like most days in the Philippines. White is also a hue and also isn't a color (for the opposite reason compared to black).

Black, however, commands an almost slavish loyalty as a wardrobe color among a segment of young Pinoy adults. Call them Goths, hip-hoppers, Millennials or something else. Black is a bewildering choice given how hot and humid this country gets during the hottest dry season months from March to May. Now why is that?

Hollywood goddess Audrey Hepburn in the classic Little Black Dress from Givenchy.

The good about black

Black is a prominent color among a goodly number of young Filipinos as you can see on our streets. It also retains its cachet as a color of sophistication. Black is an attractive color after all, especially if worn with panache.

In color psychology, black is the color chosen by persons that want to impress others while steeling their self-confidence at the same time.

If a man wants to dress to impress, he confidently dons the classic Black Suit with tie (which Filipinos still refer to as the "Americana"). Or, he sports a head-turning, all-black rig to astonish all and sundry. “He’s so hot!” has both a figurative and literal meaning in this case.

Women with verve slip on the elegant little black dress (LBD) made immortal by Hollywood goddess, Audrey Hepburn, and flaunt their sexy allure with extravagant bling. The few Goth girls among us will naturally choose black for their predictably monochromatic and boring wardrobe.

About half of the women and 64% of men in a study agreed that black exudes confidence. This study on the psychology of black published in the United States also saw respondents rank black either first or second in having the most "good" attributes among colors.

Black was perceived as a "serious" and "reliable" color that boosts one's self-esteem. It was rarely seen or rated as a "bad" color.

A survey on how people perceived others based on the color of clothes they wore was taken in 2021 and involved 1,000 people. It found six in 10 respondents favored black as a color of confidence (or 48% of women and 64% of men).

It concluded that people in black were regarded by others as serious and reliable. Black dressers were also perceived as solid team players ideal for job interviews -- and also for first dates.

Among many Millennials (those born from 1981 to 1996) and some Zoomers aka Generation Z (1997 to 2012), dressing in black appears to be a symbol of confidence, credibility and self-expression. Black reveals their drive for recognition and power.

Goth girls in their favorite color -- black, of course.

People that prefer wearing black take themselves very seriously and expect others to treat them accordingly. Millennials and Zoomers are quite alike in a lot of ways, and seem to share a preference for black as a fashion and emotional statement.

It seems black also reflects the drive of these people to persevere in the struggle for a better future. And who can blame them given the series of economic and emotional disasters inflicted on them by the Great Recession of 2008, COVID-19 in 2020 and Putin's War of 2022?

This trio of tragedies has stunted their education; left them with low paying jobs and denied many of them a shot at a more prosperous future. Black seems to have become the symbol of the youth's war against despair and failure.

On the other hand, the realization they might not be as prosperous as their parents has led to a jump in depression and other mental health concerns among Millennials and Zoomers.

Some of the young, especially those in the West, see black as the color of an activist liberalism that literally fights for justice, social equality and climate protection. Black is the uniform color of this global army of left-wing liberal activists -- even in the Philippines.

It is the de rigueur hue for the anti-fascist and anti-racist political movement in the United States called "Antifa" (a portmanteau of the German “antifaschistisch” or anti-fascist). Antifa men and women clad head-to-foot in black like Japanese "ninja" have gained fame (or notoriety) because of their violent street battles against neo-Nazis, white supremacists and alt-right racists in many American cities since 2017.

Antifa fighters choose to don black to create a bond of equality and camaraderie. This color choice has led to their other nickname: the "Black Bloc".

Black's association with heroism goes back to Medieval Europe, an era that lasted from about 500 to 1500 CE, when bards wrote of "Black Knights" and their exploits. The most famous Black Knight was King Richard the Lionheart of England who assayed the role in the immortal historical novel, Ivanhoe, by Sir Walter Scott published in 1819.

Hollywood is one huge reason why a ton of Millennials and Zoomers still see black as the color of cool. And who doesn’t want to be a cool superhero in a stunning black costume? But today’s onscreen superheroes such as Batman and the X-Men began their crime-fighting careers as comic-book characters sporting bright and colorful livery. This riot of colors changed on the big screen to plain and boring black.

Batman, as played by Adam West in the hit 1966 TV series, “BAMed!”,  “BIFFed!” and “SOCKed!” his way to fame dressed in a gray body suit and a dark blue mask, cape, gloves and boots. Not a tinge of black on him. When the first issue of The X-Men hit the stands in 1963, all five teen heroes (Cyclops, Marvel Girl, Beast, Iceman and Angel) went into action in blue and yellow uniforms.

Today, actors in the movie versions of Batman (like Robert Pattinson) and The X-Men preen onscreen in total badass black, as do other superheroes and super villains in the Marvel Comic Universe and the DC Universe. There is no sign Hollywood’s enduring infatuation with superhero black is waning. And fan kids will keep on strutting in badass black.

The Antifa Black Army

The "bad"

The current dalliance with fashionable black, however, flies in the face of the Filipino historical narrative. Black is the traditional color of death and villainy in our culture, shaped as it is by folk Catholicism and centuries-old indigenous paganistic folklore at odds with Christianity.

Associating black with death goes back to before Spain embarked on its enslavement of the Philippines in the 16th century. It began with Islam, which was introduced to Philippine tribes in the late 13th century by Arab and Muslim Gujarati (people from the Indian state of Gujarat) missionaries and merchants.

Islamic belief holds that black is the color of "Jahannam", Islam's version of the Christian Hell. Jahannam, also called "the abyss" or "the fire", is an enormous land with seven levels located below heaven or "Jannah" ("paradise").

In the Islamic tradition, widows must wear black during the 40-day period of mourning for their husbands. They must also remain in their late husband’s home and are forbidden from entertaining suitors during this sad time.

On the other hand, Muslims regard white, the color of the flag of the Prophet Muḥammad, as the purest and cleanest color in Islam. It is for this same reason white is the color of Muslim burial shrouds.

Under the influence of Roman Catholicism, Catholic Filipinos during the 377 years of Spanish tyranny were taught black was the color of Satan, evil, Hell and death.

Then and now, most Christian Filipino funerals prefer black as the color of mourning. In an old but dying Filipino tradition, grieving family members will wear black in some way or the other to manifest their sorrow.

Men used to wear a black ribbon around their arms; women dressed completely in black while children pinned black ribbons on their clothing. This tradition is dying.

The embodiment of Death in Western culture is usually portrayed as a ghastly living skeleton garbed in a long and hooded black robe. The “Grim Reaper” wields a long and crooked scythe to reap the souls of sinners by the thousands and consign them to Hell. Filipinos have imbibed this concept, as well.

Clearly, black was never a favorite color of Filipino Muslims and Filipino Christians.

One might expect black to be associated with Filipino wars and warriors. Not so. Red (and not black) was the dominant color of the Philippine Revolution against Spain ignited on August 19, 1896 by the Katipunan (Kataastaasang Kagalanggalang Katipunan ng mga Anak ng Bayan).

Most of the Katipunan war flags -- which were the first war flags of the Filipino nation -- had red as their dominant color. Red symbolized the blood of the Katipuneros who swore to fight to the death for Philippine independence in what the Spaniards called the "Guerra Tagala" or the Tagalog War.

One notable exception to red's dominance was the black flag of Gen. Mariano Llanera of Nueva Ecija. His flag consisted of a black field emblazoned with a white letter "K", beneath which lay a skull and crossbones device, both in white.

The ugly

Starting next summer and all the summers thereafter, Filipinos should consider the Sun their Eternal Enemy -- a clear and ever-present threat to their health -- and banish heat absorbing black clothes as a favorite summer wear for the same reason. Think heat stroke and sunburn among the ugly health problems associated with overheated human bodies.

Black is not the healthy color to constantly wear in a warm tropical country like the Philippine. Most of us have known this since we were kids, which is why many school uniforms are in white. Science also proves black absorbs more heat than any other color.

Black clothes and other black materials efficiently absorb most of the sun's light and infrared radiation, causing the material to get hotter as it absorbs radiant energy. It isn’t a color because it doesn’t have a specific wavelength. Black is, therefore, the absence of visible light, which is a type of radiation that travels in electromagnetic waves.

On the other hand, white clothes are very poor absorbers of incident visible sunlight and infrared light. Most of these wavelengths are reflected away and don't increase the heat content of white clothes. White clothes are the better choice in hot climes.

Black roses

 

"Malas" causes cancer -- or does it?

 (Published in ENRICH magazine, 2022)

THE CONTENTIOUS CLAIM most adult cancers are due to "bad luck" or "malas" shouldn't be seen as a death sentence. Neither should it be regarded as a Gospel truth that deters us from doing all the good stuff proven to prevent cancer and extending our healthspans.

This unending hue and cry over the allegedly huge role chance (or is it Fate) plays in the development of cancer was triggered by a research paper published January 2015 in the peer-reviewed journal, Science. The paper suggested that cancer as a whole occurs by chance and can't be attributed mostly to heredity or lifestyle risk factors such as smoking and alcohol use.

The study asserts that two-thirds of adult cancers across different tissues are simply the result of sheer “bad luck”. Bad luck in this case refers to random DNA mutations occurring in genes that later progress into cancer.  You're lucky if these mutations don't trigger cancer. If not, it's your bad luck.

These random and potentially harmful DNA mutations accumulate in our bodies when stem cells (cells that generate all other cells with specialized functions) divide into various tissues, explained Dr. Cristian Tomasetti, an eminent cancer biologist and an associate professor of oncology and biostatistics at Johns Hopkins University who is one of the study's two authors.

Dr. Bert Vogelstein, a professor of oncology and Howard Hughes Medical Institute investigator at The Johns Hopkins Medical School, is co-author of the paper, "Variation in cancer risk among tissues can be explained by the number of stem cell divisions".

The study is a technical description of how cancer rates vary in different tissues and is based on data from the United States. It did not focus on cancer prevention or on lifestyle changes that deter cancer.

The study suggests our inherited genes, environmental factors and risky lifestyle choices such as smoking, alcoholism or eating too much red meat play a small role in cancer development.

"Here, we show that the lifetime risk of cancers of many different types is strongly correlated (0.81) with the total number of divisions of the normal self-renewing cells maintaining that tissue's homeostasis," wrote Tomasetti and Vogelstein.

"These results suggest that only a third of the variation in cancer risk among tissues is attributable to environmental factors or inherited predispositions.

"The majority is due to 'bad luck,' that is, random mutations arising during DNA replication in normal, noncancerous stem cells. This is important not only for understanding the disease but also for designing strategies to limit the mortality it causes".

Tomasetti and Vogelstein found a strong relationship between how often certain cells divide in different kinds of human tissue and the lifetime chance cancer will develop in those tissues. They confirmed the more often cells divide, the more likely this tissue will develop cancer since duplicating DNA can lead to mistakes, and DNA mistakes can cause cancer.

Tissues with stem cells that divide a lot tend to develop higher rates of cancer. That's why colon cancer is more common than brain cancer. On the other hand, stem cells that rarely divide are likely to have lower cancer rates.

Vogelstein explained that cancer occurs when tissue-specific stem cells mutate or make random mistakes. These mistakes occur when one chemical letter (Adenine, Thymine, Guanine or Cytosine) in our DNA is incorrectly exchanged for another during the replication process in cell division. The massive accumulation of these mistakes over time increases the risk cells will grow unchecked into cancer.

"All cancers are caused by a combination of bad luck, the environment and heredity, and we've created a model that may help quantify how much of these three factors contribute to cancer development," said Vogelstein.

Bad luck causes cancer

Unlucky 22

A layman’s knee-jerk reaction to the “bad luck” conclusion is to ask "What's the use of a healthy lifestyle if there's practically nothing you can do to prevent cancer"?

Does this mean we should abide by the Epicurean blandishment to "Eat, live and be merry for tomorrow we die"? It's a tempting course of action given the study, but one that's wrong on all counts.

"If two-thirds of cancer incidence across tissues is explained by random DNA mutations that occur when stem cells divide, then changing our lifestyle and habits will be a huge help in preventing certain cancers, but this may not be as effective for a variety of others," said Tomasetti.

Tomasetti and Vogelstein found that 22 of the 31 cancer types they studied could largely be explained by the "bad luck" of random DNA mutations during cell division. There are more than 100 types of cancer, of which carcinoma is the most common.

The 22 "bad luck" cancers identified by Tomasetti and Vogelstein are those in which “primary prevention measures are not likely to be as effective”. Primary prevention measures, which involve screening, seek limiting our exposure to carcinogens to prevent the start and spread of cancer.

They include lifestyle interventions (such as regular physical activity and not smoking) and medical interventions (vaccinations). Tomasetti and Vogelstein also said the early detection of cancer is a viable secondary prevention measure for some cancers that can't be overcome by prevention.

 he 22 "bad luck" cancers consist of head osteosarcoma, glioblastoma, medulloblastoma, head and neck, thyroid medullary, lung (for non-smokers), esophageal, osteosarcoma of the arms, hepatocellular carcinoma, pancreatic ductal adenocarcinoma, pancreatic islet tumors, gall bladder, duodenum, small intestine, pelvis osteosarcoma, ovarian germ cell, testicular germ cell, melanoma, osteosarcoma, leg osteosarcoma, chronic lymphocytic leukemia and acute myeloid leukemia.

The other nine cancer types are due to bad luck plus environmental or inherited factors. These include basal cell carcinoma, HPV-16 (human papillomavirus-16) head and neck, thyroid follicular, lung (smokers), HCV (hepatitis C virus) hepatocellular, colorectal adenocarcinoma, Lynch colorectal and familial adenomatous polyposis or FAP colorectal.

Extrinsic factors

The conclusions of the paper by Tomasetti and Vogelstein are still hotly debated. The study continues to draw withering criticism and outrage from its foes, especially cancer prevention doctors who see it as negating the message that most cancers can be prevented. The furor has escalated with the publication of new studies seeking to counteract the "bad luck" hypothesis.

Eleven months after Tomasetti and Vogelstein's study, a team of cancer biologists and statisticians published a study in Nature, the British weekly scientific journal, detailing the contrary opinion using mathematical, epidemiological and molecular evidence.

“A majority of cancers are due to extrinsic factors,” declared Dr. Yusuf Hannun, director of the cancer center at Stony Brook University in New York State and senior author of the paper in response to the contention most cancers are the result of random biological mistakes.

“External factors can influence the rate of stem-cell division and the number of mutations", Hannun added.

The rebuttal explained that cancers are more prevalent than can be explained by cell division alone. This can be seen by the huge geographical variation in rates of different cancers, which suggest cancers are triggered by much more than intrinsic factors like cell division.

For example, prostate cancer is 25 times more common in Australia than south-central Asia (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka) while breast cancer is five times more common in Western Europe compared to East Asia (China, Japan, Mongolia, North Korea, South Korea, and Taiwan).

The Stony Brook study also said the non-inclusion of common cancers such as prostate and stomach cancer might have skewed the conclusion about the importance of cell division in explaining which tissues likely develop cancers. It pointed out cancers due to cell-division errors form the base to which cancers due to other causes are added.

The paper concluded that “unavoidable intrinsic risk factors (such as cell division) contribute only modestly, less than 10-30 percent, to the development of many common cancers”.

Doubling down

Partly in response to the Stony Brook study, Tomasetti and Vogelstein in 2017 released another paper (also published in Science) that defended their original findings and also sought to correct what they saw were widespread misinterpretations about it.

Based on health records from 69 countries, the new study argues that 66% of cancer-causing genetic mutations arise from the “bad luck” of healthy, dividing cells making random mistakes when copying their own DNA. This time, the new study admitted the cause of many cancers might be environmental factors.

It analyzed cancer genomes in a United Kingdom database to classify if cancer-causing mutations are hereditary, if they originate from the environment or are random DNA-copying mistakes.

Tomasetti and Vogelstein now pointed out their new conclusion does not mean that two-thirds of cancers can't be prevented. Vogelstein said understanding the role of unforced errors “could provide comfort to the millions of patients who developed cancer but led near-perfect (healthy) lifestyles”.

“This is particularly true for parents of children who have cancer” and who might blame the tragedy on the genes they passed on to their child or the environment they provided.

Hannun, however, was skeptical of the new study and remarked he wasn’t “very impressed with the overall conclusion”.

Cancer can be prevented

Prevention still matters since some 42% of cancers are preventable. Tomasetti and Vogelstein admitted as much in their original study when they said "One of the most promising avenues for reducing cancer deaths is through prevention". They also said the early detection of cancer is a viable secondary prevention measure for cancers that can't be controlled by prevention.

We must take heart from the knowledge our chances of not developing cancer are affected by the lifestyle choices we make. We have to do the right thing. The Mayo Clinic, which has been consistently ranked among the best hospitals in the United States, offers these cancer-prevention tips.

* Don’t use any type of tobacco to avoid lung, throat, mouth, larynx, pancreas, bladder, cervix and kidney cancer.

* Maintaining a healthy weight and being physically active helps fight cancer. A healthy weight might lower the risk of breast, prostate, lung, colon and kidney cancer, among others. Physical activity might lower the risk of breast cancer and colon cancer.

* You've also got to go on a healthy diet by eating lots of fruits and vegetables. Also limit your intake of processed meats such as ham, bacon and frankfurters since eating lots of this stuff can slightly increase the risk of colorectal cancers and other chronic diseases.

* Regular medical examinations boost the chances of discovering skin, colon, cervix and breast cancer early on. Early discovery increases the likelihood of successful treatment of early stage cancer.

* Vaccinate yourself against Hepatitis B, which can increase the risk of developing liver cancer. Also vaccinate against the Human papillomavirus (HPV) that can lead to cervical cancer, squamous cell cancers of the head and neck and other genital cancers.

* Avoid risky behaviors such as unsafe sex with multiple partners to preclude acquiring sexually transmitted infections like HIV or HPV. People with HIV or AIDS are at a higher risk of cancer of the anus, liver and lungs. HPV increases the risk of cervical cancer, cancer of the anus, penis, throat, vulva and vagina.

* Protect yourself from skin cancer, one of the most common types, by avoiding the midday sun, staying in the shade and using sunscreen when needed.

Cancerous cells

About cancer

Cancer, which can begin in almost any of the more than 37 trillion cells in the human body, is basically uncontrolled cell growth. A growing mass of cancerous cells can later develop into a tumor.

In the Philippines, 189 of every 100,000 Filipinos were afflicted with cancer in 2012. Four Filipinos died of cancer every hour or 96 cancer patients per day, according to a study conducted by the University of the Philippines’ Institute of Human Genetics, National Institutes of Health.

Cancer is one of the five leading causes of death in the Philippines with lung cancer due to smoking causing the most cancer deaths. Lung cancer caused by tobacco remains the biggest single cause of cancer deaths worldwide (six million deaths annually).  There were an estimated 1.1 billion smokers on our planet in 2019.

The five most common cancers globally are carcinomas that attack organs and glands such as the lungs, breasts and skin. There's leukemia, which affects the body’s blood forming tissues. Sarcoma affects soft or connective tissues such as muscle, fat, bone and blood vessels.

Melanoma occurs in cells that pigment the skin. Lymphoma attacks the lymphatic system, which is part of the body's germ-fighting network.

Advancing age is the top risk factor for developing cancer with people over 65 running the greatest risk of acquiring the disease. The median age of a cancer diagnosis in the U.S. is 66 years-old.

For many of us, cancer will be in our future. One in two women and one in three men in the U.S. will develop cancer in their lifetime based on 2015 data. It’s equally grim in the United Kingdom where one in two men and women will be diagnosed with cancer. Cancer prevention starts now.

Height does matter, and in more ways than one

 (Published in ENRICH magazine, 2022)

IN THE PHILIPPINES, the phrase "stand tall" should be taken with a figurative, and not literal, meaning.

That's because Filipinos still retain the dubious honor of being one of the world's shortest people in average population height, average female height and average male height. On average, Filipino men and women are a mere 156.41 cm (5 feet 1.57 inches) tall, according to data released in 2019 by NCD Risk Factor Collaboration (NCD-RisC), a project linked to Imperial College London. This made Filipinos the fifth shortest people in the world based on NCD-RisC reckoning.

The same data also showed the average Filipino man with a height of 163.22 cm (5 feet 4.25 inches). That's as tall as Hollywood stars Michael J. Fox and Kevin Hart. The average Filipina is 149.60 cm (4 feet 10.89 inches) tall. Heightwise, that’s similar to former President Gloria Macapagal-Arroyo, superstar Nora Aunor and the late Hollywood legend Judy Garland.

Filipinos are only marginally taller than citizens of Timor-Leste, which topped the shortest stature list of NCD-RisC. The average height of both males and females from Timor-Leste was 155.47 cm (5 feet 1.28 inches). The average Timorese man stands 159.79 cm (5 feet 2.90 inches) tall while the average woman gets to 151.15 cm (4 feet 11.50 inches).

On the other hand, the average Timorese woman (151.15 cm) is taller than the average Filipina (149.60 cm). This makes Filipinas the second shortest in the world behind the women of Guatemala, who have an average height of 149.38 cm (4 feet 10.81 inches).

NCD-RisC is a global network of health scientists that provides timely data on major risk factors for non-communicable diseases for all countries.

The question now is why are we still of such short stature when this problem has been with us for generations? There are short and easy answers to this question.

Basically, it boils down mostly to genetics (or biological factors) coupled with the right food and adequate nutrition (or socioeconomic factors), especially in childhood.

Some scientists estimate that genetics accounts for more than 60% of a person's height. This being the case, a relatively well-to-do Filipino couple whose height is above average will likely sire taller than average children.  The reverse is also true.

The hereditary advantage conferred by tall parents who have enough money to regularly feed their children more protein (generally meat) than carbohydrates (rice) in their kids' growing years should see much taller children. Most Filipinos, however, are neither tall nor rich. The consequences of these realities are what we see daily on our streets: a sea of short and poor Filipinos.

Stunted, poor and malnourished

Height matters, and not only because of bragging rights. It turns out "height is a proxy indicator of how well the Philippines is doing as a society to reduce childhood poverty and improve access to nutrition," according to a report released in 2015 by Save the Children Philippines. It appears the Philippines is failing in this task.

"If the Philippines is to progress economically, we must not leave the poorest children behind," said the report with the title, "Sizing Up the Stunting and Malnutrition Problem in the Philippines".

World Atlas, an educational geography website online since 1996, publishes its own set of global stature statistics. In 2017, it estimated the average height of Filipinos at only 154.9 cm (5 feet 1.5 inches), a full 8.3 cm (3.3 inches) shorter than the estimate from NCD-RisC.

This made the Philippines the country with the third shortest population in the world. Instead of Timor-Leste, World Atlas said Bolivia had the world's shortest population. It placed the height of the average Bolivian at 151.1 cm (4 feet 11.5 inches).

What makes the estimate by World Atlas remarkable is that it attributed the short stature of Filipinos to "severe malnutrition problems ... especially prevalent in the event early age pregnancies, where the mother is not fully physically equipped for childbirth and childcare".

It noted the Department of Education (DepEd) admitting 1.8 million malnourished Filipino children are in danger from abnormalities such as stunting.

"The result is that the likelihood of this situation being repeated in the next generation is high. Although feeding programs have been launched, funds are not adequate enough," it reported.

It appears the DepEd estimate is off the mark. A report published by the Philippine Daily Inquirer in 2015 claimed 30% of all Filipino children under the age of five were stunted or short for their age. In numbers, this is an astonishing 3.6 million children, the ninth largest number of any country at the time.

"This is not a theoretical problem; this is a nutritional emergency," said the story.

At 63%, the Autonomous Region in Muslim Mindanao (ARMM) had the highest level of stunting among children in the entire country. Childhood stunting in Mindanao comes to 40%. This figure is equivalent to the average for all of sub-Saharan Africa consisting mostly of black African countries.

The report defined "stunted" as a child chronically malnourished during the first 1,000 days of its life, or from conception until the second birthday. This is the critical growth period for any child.

The World Health Organization (WHO) asserts stunting is the irreversible outcome of inadequate nutrition and repeated infections during the first 1,000 days of a child’s life.

The latest data about stunted Filipino children remains troubling and points to a neglect of the problem by both the national and local governments. The World Bank estimated 29% of Filipino children in 2019 age five and below were stunted.

It said the Philippines is still plagued by childhood stunting because of undernutrition, which it labeled "the silent pandemic". Stunting keeps most children in poverty for their entire lives while poverty creates the conditions leading to stunting.

In 2015, poverty meant 1.5 million Filipino children went through a day without a full meal. Some 2.7 million Filipino children missed a meal because their families don't have enough money for three meals a day. This situation has remained rampant.

In 2018, the Department of Health (DOH) estimated there were 4.2 million stunted Filipino children and more than 300,000 children under five years that are severely wasted, or thin for their height. Severely wasted children have at least nine to 12 times an increased risk of death.

The toll taken by malnutrition on Filipino children is gruesome and heartbreaking. UNICEF Philippines estimates 95 Filipino children die every day from malnutrition.

Another indignity: 27 out of 1,000 Filipino children do not live past their fifth birthday. And still another:  a third of Filipino children are stunted, and stunting after two years of age can be permanent, irreversible -- and even fatal. We must put a stop to this!

Bad for the brain

Malnutrition and poverty are also bad for the brain. A poor and stunted Filipino child will unlikely achieve his full cognitive and intellectual potential.

WHO and the United Nations Children's Fund (UNICEF) both agree stunting affects the cognitive development of children, which can be seen in their paltry academic results at school.

Nine out of 10 Filipino children at age 10 cannot read or understand a simple story by the age of 10. This translates into a record high "learning poverty" of 90.5%. The inability of Filipino children to read by 10 years-old will also mean they face huge obstacles to learning math, science and a host of other more difficult subjects.

 Learning poverty is defined by the World Bank as a child being unable to read and understand simple text by age 10. Also called "galloping illiteracy", learning poverty will later translate into economic poverty.

 It has gotten far worst over the past two years due to the cancellation of face-to-face classes in the aftermath of COVID-19. Before COVID-19 struck in early 2020, learning poverty in the Philippines was lower at 69.5%.

Malnourished Filipino children

First 1,000 days

During the presidential campaign 2016, candidates were asked to support the “First 1,000 Days Act,” a piece of legislation pending in Congress whose goal was to make reducing stunting and improving nutrition nationwide a presidential priority.

The man that won the presidential race, Rodrigo Duterte, did do something: he signed laws aiming to address the malnutrition problem. In the middle of his six-year long administration that bowed out on June 30, 2022, he signed Republic Act 11148 into law on November 29, 2018.

RA 11148, or the “Kalusugan at Nutrisyon ng Mag-Nanay Act," is more popularly known as the First 1,000 Days Law.  It seeks to boost national and local health and nutrition programs through an integrated strategy for maternal, neonatal, child health and nutrition in the first 1,000 days of a child's life.

"This law will complement the much-awaited Universal Health Care Law to further boost the country’s health status on our way to make Filipinos the healthiest in Southeast Asia by 2022 and in Asia in 2040,” boasted DOH Secretary Francisco Duque III.

Over three years later or in June 2022, the national government announced its intent to borrow $178.1 million from the World Bank to further support RA 11148.

It said the loan will “increase the utilization of a package of nutrition-specific and nutrition-sensitive interventions and improve key behaviors and practices known to reduce stunting in targeted local governments”. The project will be jointly implemented by the DOH and the Department of Social Welfare and Development (DSWD).

“It’s important that we focus on the health and nutrition of children starting in their mother's womb, especially because it has a big effect on their capacity to learn,” said Sen. Sherwin Gatchalian, who co-authored RA 11148.

“We should make sure that our communities have enough participation and capability, together with the local government, in order to ensure the good health of Filipino children”.

RA 11148 complements Republic Act No. 11037 (or the Masustansyang Pagkain Para sa Batang Pilipino Act) signed into law on June 2018. This is a law "Institutionalizing a National Feeding Program for Undernourished Children in Public Day Care, Kindergarten and Elementary Schools to Combat Hunger and Undernutrition among Filipino Children and Appropriating Funds Therefor".

Both laws are part of the national government's bid to eliminate hunger and reduce all forms of malnutrition. They also intend to secure healthy lives, promote the well-being of Filipinos, and end hunger and food insecurity.

Up and down

Up until his death in 2020, Junrey Balawing from Sindangan, Zamboanga del Norte was the shortest living man in the Philippines and the world. He stood tall at 56.0 cm (22.0 inches), as verified by Guinness World Records in 2012.

He became the world's shortest non-mobile person after the death of Chandra Bahadur Dangi from Nepal in September 2015. Chandra measured 54.6 cm (21.5 inches). Balawing was only 27 at the time of his death in the City of Dapitan.

On the opposite end of the scale, the tallest indigenous Pinoy on record is Raul Dillo standing at an eye-popping 221 cm (7 feet 3 inches), a height he hit when he was only 17 years-old. Now 30 years-old, this giant used to play basketball in college and in the defunct Metropolitan Basketball Association but never shone despite his height advantage.

Dillo later played bit roles in a number of Filipino movies where he was predictably typecast as a giant. Asked about the downside to being gigantic in 2012, he replied: “Sa transportation ang hirap. Kung bus, okay pa. Pero tulad ng tricycle, mahirap.”

The tallest home-grown Philippine Basketball Association (PBA) player is center Edward Joseph "E. J." Feihl, whose ceiling was 215.9 cm (7 feet 1 inch).  The second overall pick in the 1995 PBA draft, Feihl played for Ginebra San Miguel and six other teams until his retirement in 2007.

Feihl was born in Santa Barbara, Pangasinan to a Filipino mother and a German father. He’s 52 years-old.

The dearth of six-foot tall home-grown Filipino giants is a reason why the PBA is riddled with towering imports. In 2021, the PBA implemented a height limit of 198 cm (6 feet 6 inches) on imports to prevent the favorite Pinoy sport from being completely dominated by foreign skyscrapers.

 

Raul Dillo

Have you heard of this new disease called ageing?

 

(Published in ENRICH magazine, 2022)

A MOMENTOUS DEBATE raging in the global medical community will profoundly alter the way we perceive and treat the many diseases and infirmities that inevitably come with growing old.

At issue is the vexed question: "Is ageing a disease"?

It is a conundrum the informed Filipino layman will likely answer with, "Of course, not". In his world view, ageing is not a disease because he knows of no disease or medical condition called ageing. But he does realize chronic diseases like cancer, diabetes, stroke, arthritis, heart disease and Alzheimer's are prevalent among his old parents and even older grandparents.

The World Health Organization (WHO), however, no longer holds with certainty the view that ageing is not a disease. In January 2022, WHO effectively paved the way for defining ageing, specifically biological ageing or senescence, as a disease in the 11th revision of the International Classification of Diseases (ICD-11).

Its reasoning: old age gives rise to biological changes that make people more vulnerable to diseases that worsen with age like cancer and arthritis. Some experts contend ageing is the biggest risk factor for heart disease, cancer and dementia.

WHO, therefore, has apparently redefined ageing as a treatable condition that can be delayed and cured like a disease. It likely sees "ageing itself" as the principal cause of the myriad of illnesses linked to old age.

This redefinition of ageing as a disease should also lead doctors and scientists to address not only the effects of ageing but the underlying causes of the symptoms linked to ageing.

It's known that the processes underlying age-related diseases probably overlap. Therefore, if scientists can determine what biological processes make people more susceptible to age-related diseases such as heart disease and Alzheimer’s, a treatment might be found that can potentially treat multiple diseases at once instead of one at a time.

Age-related diseases are deadly. Of the 150,000 people that die every day across our planet, about two-thirds (close to 100,000) die from age-related causes. Even wars can't kill as many people. Some 27,000 people died daily in World War 2, the deadliest war in human history.

What exactly is ageing?

This festering dispute among the learned leads us to the question as to what ageing -- or the process of becoming older -- really is.

A medical definition describes chronological ageing as a time-dependent functional decline marked by a progressive loss of physiological integrity. This attenuation leads to the impairment of bodily functions and increases one's vulnerability to death. In other words, the older you get, the weaker and sicker you become. But is this due to the cumulative effects of individual age-related diseases, or to ageing as a disease? That is the question.

At the biological level, ageing is caused by the gradual accumulation of molecular and cellular damage over a person’s lifetime. These molecular level changes trigger a decline in mental and physical function and increase the risk of disease and death.

Then, there's the role cellular senescence plays in ageing. Ageing is also defined as the accumulation of senescent cells. Senescent cells cause many of the degenerative changes we perceive as ageing, as well as age-related diseases.

Cellular senescence is the process in which cells age and stop dividing permanently -- but don't die. Over time, massive numbers of old, or senescent, cells accumulate in our body tissues.

These "living-dead" cells or zombies release a range of inflammatory factors and enzymes that destroy the tissues in which they reside. As a result, our immune cells attack and kill senescent cells, thereby changing our tissues for better or worse.

In one fell swoop

ICD, the tool that ignited the ageing firestorm, is a globally used diagnostic tool published by WHO to help doctors and healthcare professionals identify diseases. It is a healthcare classification system providing diagnostic codes for classifying diseases.

The specific changes to ICD-11 about ageing involve general symptoms (code “MG2A”) and in the causality section of “XT9T”.  ICD-11 classifies "old age" as a specific disease in contrast to ICD-10 where old age is classified as a “general symptom”. Another contentious change was replacing the code for “senile debility” with the code MG2A, which originally stood for “old age”.

WHO also implemented an extension code (or a new category of codes) for "ageing related", or XT9T diseases. These are diseases “caused by pathological processes which persistently lead to the loss of organism’s adaptation and progress in older ages”. Extension codes provide additional information on a disease, injury or disorder.

The new code XT9T can be immediately applied to relevant conditions listed in ICD-11, as well as to future relevant medical conditions.

On the other hand, the implementation of the extension code XT9T in ICD-11 "is not tantamount to formal recognition of ageing as a disease," asserts an editorial in the peer-reviewed scientific journal, The Lancet. The advent of XT9T does, however, "signal acknowledgment by WHO of ageing as a major disease risk factor and of the considerable public health problem posed by ageing-related diseases".

The new proposals in ICD-11 intend to ensure ICD has a complete list of pathologies and disorders related to ageing. It also seeks to guarantee and account for the full spectrum of degenerative changes.

Accomplishing this means all ageing-related pathologies will have to be included in disease or disorder classifications, which wasn't the case previously. This omission meant an ageing diseases classified and assessed for the level of severity in one organ can be unclassified in another. It is a confusing situation at best.

More seriously, the absence of classifications and staging can result in less than ideal treatments since pathological ageing changes are not included in ICD.

The ageing-related changes to ICD-11 came from a joint proposal submitted to WHO’s ICD-11 Task Force by the Biogerontology Research Foundation, the International Longevity Alliance, and the Council for Public Health and the Problems of Demography.

Cellular senescence

Raging storm

The release of ICD-11 quickly ignited a storm of controversy, splitting medical professionals involved in gerontology, longevity science and other disciplines having to do with ageing into pro-disease and anti-disease factions.

Advocates for classifying ageing as a disease have long argued ageing is the biggest risk factor for chronic diseases, which are today treated individually as a matter of course. They contend ageing is not a deviation from the normal state as can be expected from a disease.

Treatments that focus on the underlying ageing process will “in one fell swoop, intervene in several or many chronic diseases of ageing,” claims Dr. Alexander Fleming, the founder of Kinexum (a company that develops drugs and biotech products).

Dr. David Sinclair, professor of genetics at Harvard Medical School and one of the better known longevity scientists, agrees that ageing is the main cause of all major diseases in society today.

"I'd argue that just because ageing happens to more than half of us, is no reason to not include it as a disease," he noted. "In fact, I would say it's even more important that we work on trying to combat it, because ageing is the main cause of all major diseases in society now.”

This line of thinking mirrors that made by Dr. Leonard Hayflick, professor of anatomy at the University of California San Francisco School of Medicine, back in 1962.

At the time, Dr. Hayflick argued that if old age is a risk factor for nearly all of the diseases likely to kill us, "why then are we not devoting significantly greater resources to understanding what … increase(s) vulnerability to all age-associated pathology?"

He said the lack of distinction between ageing and age-related diseases “is the most serious impediment to our understanding of the ageing process.”

Dr. Hayflick gained fame by discovering a limit to how many times human cells divide before they become senescent. His name is inextricably linked to the discovery of the key role telomeres play in the ageing process.

The declaration by WHO seems a belated acknowledgement of a landmark study about ageing published in February 1954 by Dr. Robert Perlman in which he described ageing as a “disease complex" while emphasizing the etiologic significance of both internal and external environmental stress.

Perlman's study, “The Ageing Syndrome”, published in the Journal of American Geriatrics Society has slowly gained adherents over the past half century.

In 2015, a team of international researchers published a study in the online biomedical and life sciences journal PubMed Central with the provocative title, “It is time to classify biological ageing as a disease.” It sees "the ageing process as the underlying cause for the chronic diseases affecting the elderly".

Alarm bells

The ageing-related revisions in ICD-11 were met with alarm by medical professionals holding the contrary but majority view. Current thinking contends ageing is a natural process and not a disease, and "should not be considered a disease in and of itself."

A paper published in The Lancet in October 2021 took WHO to task for supporting moves to classify ageing as a disease.

"We argue that simply equating old age as a disease in the ICD-11 is potentially detrimental and deleterious from clinical, research, and humanitarian points of view, and propose alternate productive solutions," wrote the study authors.

They argue chronological age has limited use in diagnosis, prognostication, and treatment guidance. In addition, “age by itself is of limited use for the assessment of population health, for the evaluation of initiatives designed to promote healthy ageing, and for health or social care planning. “

Instead on harping on ageing, the authors "propose that frailty should be included as a clinical disorder instead of old age." They ask WHO "develop the reporting of frailty in the ICD classification system" and argue that frailty "is a much more homogeneous and better-defined clinical entity" compared to old age.

They claim ICD-11 branding ageing as a disease will potentially magnify the socioenvironmental disadvantages in terms of equality in healthcare provision endured by the elderly.  Ageing as a disease will also reinforce commonly held ageistic beliefs in society and the medical community.  Validation of ageistic beliefs will also stand to worsen the societal marginalization and discrimination against the elderly.

The International Association of Gerontology and Geriatrics based in Belgium and comprising 84 national societies from 72 countries has also assailed the inclusion of old age as a pathological criterion in ICD-11. Others are urging WHO to revise the ICD-11 classification of old age.

What's at stake

Behind the fire and fury engulfing those for and against the proposition is a deep concern for the plight of the elderly. The implications of the WHO declaration that ageing is a disease -- which many medical professionals dispute or dismiss -- will massively affect the healthcare provided the elderly and the development of drugs needed to combat diseases of ageing.

The protagonists don't dispute ageing is a one-way street culminating in six feet of subterranean real estate. What they can't agree on is how to make this final journey more tolerable, which means an emphasis on healthy ageing or our healthspan.

Those that contend ageing should be classified as a disease want to goad governments and pharmaceutical firms into emphasizing the development of therapeutic interventions targeting ageing and ageing-related diseases.

They argue that new therapeutic interventions for ageing will lead to the acceptance of ageing as a disease. This acknowledgement will help ensure treatments are covered by health insurance providers, especially those in the West. It is also critical to boost funding from grant-awarding organizations for ageing research.

The poorest of Filipinos

The implications of this debate on ageing in the Philippines will be huge.

The country has an elderly population age 60 up of more than 12 million persons. This total comprises 11% of the total population of 110.8 million persons, estimated the Commission on Population and Development (PopCom).

In 2015, PopCom said the country’s population will begin to age by 2025 to 2030. It was because of this former PopCom executive director Juan Antonio Perez III said he was gravely concerned that “social protection systems have yet to catch up with social conditions”.

“People are living longer but in poorer health and socio-economic conditions," said Perez.  "They are only partially reaping the benefits of better health and social conditions."

He warned the government has only 10 years to craft programs for the elderly that address healthcare, rehabilitation, depression and daily activities, among others.

He emphasized senior citizens will need the government’s help as they will be “the poorest members of the population because usually their pensions are not enough for them”. Not much has occurred since 2015 to negate this warning.

In 2017, the Philippines was ranked 60th out of 191 countries in WHO’s Ranking of the World's Health System. The country with the world’s best healthcare was France; Singapore had Asia’s best healthcare system.

“Happy Beddian to you” and other birthday oddities

 (Published in ENRICH magazine, 2022)

WILL YOU LIVE  to see your "Beddian Birthday"? Are you a "leapling"? Is it true early Christians regarded birthdays as "celebrations of evil”?

The answers to these puzzling birthday questions: Likely not if you're a Millennial (people born from 1981 to 1996). You’re a leapling, or a "leaper", if you were born on February 29 in a Leap Year. This also doesn’t mean your true age is a fourth of what it really is.

Sad, but the answer is true: early Christians refused to celebrate birthdays. They believed birthday celebrations were pagan rituals honoring the birth of pagan gods such as the Egyptian Pharaoh. This proscription against birthdays is in the Bible, as interpreted by some hardcore Christians even today.

There are two mentions of birthdays in the Christian Bible. One has to do with the birthday of the Pharaoh that imprisoned Joseph (Genesis 40:20-22); the other the birthday of the Jewish king, Herod the Great, where he promises to give the daughter of Herodias anything she wanted. She asked for the head of John the Baptist. Herod granted her wish (Mark 6:21-29).

It was only some four centuries after Christ's crucifixion the Church Fathers did an about face about birthdays. These ancient scholars decided that Christians thanking God for adding one more year to their scandalously short lives was a good thing worthy of praise.

Short is all too apt: the average life span of an Israelite male in Palestine during Christ's lifetime was a mere 29 years. On the other hand, a Jewish male in Israel today can expect to live up to 75 years. Christ was 33 when he was put to death on April 3, 33 AD, allege some biblical scholars.

The belief birthdays are pagan was also the reason early Christians didn't celebrate Christmas, otherwise known as Jesus Christ's "birthday". Christ was probably born in either September or October between 6 BC and 4 BC but not on December 25. His exact birth date remains unknown.

Happy birthday, birthday

It's hard to believe a mainstream ritual as innocuous as a birthday could have had such a complex and convoluted history among Christians. From pagan ritual shunned by Christians to a custom celebrated worldwide by many faiths is a huge leap indeed.

It’s surprising to discover that only the birthdays of pagan gods were celebrated in the ancient world. The prosaic custom we fondly call the birthday can be traced back to the ancient Egyptians tradition of hailing the coronation, or "god birth”, of their god descended to Earth -- the Pharaoh.

The Egyptians believed their all-too-human Pharaoh was transformed into a god once he ascended the throne of Egypt and they celebrated his deification or "birthday" accordingly. Pharaohs also held lavish feasts to mark this grand event. Individual birthday celebrations were unknown to the common Egyptian of the time, however.

Historians say the first birthday in history was recorded around 3,000 BCE. This birthday was likely that of Pharaoh Narmer (or Menes), who founded the first pharaonic dynasty that united both upper and lower Egypt.

The Egyptians developed two calendars: a lunar calendar based on the phases of the moon and a civil calendar for administrative and accounting tasks. The Egyptian lunar calendar was the first known calendar to use a year consisting of 365 days. It also had 12 lunar months and three seasons. By the way, this year (2022) is the year 6263 on the Egyptian calendar.

On to Hellas

The road that takes us to the birthday as we know it today then passes through ancient Greece, or Hellas, the homeland of the Hellenes or Greeks.

The Hellenes adopted the Egyptian tradition of celebrating the birthdays of gods, of which they had a vast pantheon residing atop Mount Olympus. The Greeks also had no personal birthdays.

Greece, a confederation of city states, had no single calendar. Instead, many city states had their own calendars that were different from the calendars of other communities.

The Hellenes added to our birthday traditions by introducing the birthday cake and candles. They lit candles at the temples or statues of their Olympian gods to drive away evil spirits such as the Keres (female death-spirits that feast on the dead) and Erebus (the personification of Darkness).

Celebrating the birthdays of their gods was a plea to the Olympians for protection against evil. Friends and family would gather around a statue of the birthday god and ask him or her to shield them from harm. Hellenes cheered loudly to call the attention of the deity. Gifts were placed at the god's temple as symbols of love.

It seems a favorite god of the Hellenic masses was Artemis, the Olympian goddess of the Moon, chastity, childbirth, wild animals, the hunt and vegetation. Considered the greatest Greek goddess by some, she was also hailed as the goddess of “Asia and the whole world”.

Hellenes offered moon-shaped cakes made from flour and lit by small candles as an obeisance to Artemis. By lighting candles on a moon cake, Greeks saw themselves sending prayers to Artemis, as well as recreating the bright glow of her Moon. Blowing out the candles was also another kind of prayer to Artemis.

Artemis' birthday was celebrated on May 6 along with her twin brother, Apollo, the god of the Sun and Light, music and dance, archery, truth and prophecy, and healing and poetry, among many other appellations.

Birthdays for the people

The Julian calendar established by Julius Caesar, the first Roman emperor, and adopted by the Roman Empire on January 1, 45 BC gave Roman citizens an excuse to celebrate individual birthdays. Some historians argue this is the first time in history a civilization celebrated the birth of beings who weren't gods.

Because human birthdays were acknowledged, a Roman man turning 50 years would receive a special cake made from honey, wheat flour and grated cheese. The patriarchal Romans didn't celebrate the birthdays of women, however.

One can conclude from this that some Romans did count the years of their lives from birth using the Julian calendar that had 365-1/4 days in a year. A Julian year was divided into 12 months and began a year on January 1.

Except for February, all the Julian months had either 30 or 31 days. February had 28 days in common years (or those with 365 days) and 29 every fourth year (or a leap year with 366 days). There was no February 29 in the Julian calendar.

The universal calendar

That individual birthdays are fairly universal today was made possible by the Gregorian calendar proclaimed on October 4, 1582 for Roman Catholics by Pope Gregory XIII.

The Gregorian calendar reformed and eventually replaced the Julian calendar. The main change in the Gregorian calendar was its different spacing for leap years. This change led to the average calendar year having a length of 365.2425 mean solar days. The Gregorian calendar continued to use the names of the 12 Julian months, however.

It brought the year closer to the 365.2422-day solar year brought about by the Earth's revolution around the Sun. The Gregorian calendar dropped 10 days from the Julian calendar to bring the vernal equinox from March 11 back to March 21. To accomplish this, the Papal Bull creating the Gregorian calendar declared the day after October 4, 1582 to be October 15.

The Gregorian calendar has become the most widely used civil calendar in the world. It is the calendar used in “ISO 8601:2004”, the international standard for representation of dates and times. ISO 8601 represents date and time and starts with the year, followed by the month, the day, the hour, the minutes, seconds and milliseconds.

Happy Beddian to you

Now, we come to a birthday oddity most of us never knew existed: the “Beddian birthday.” Yes, it isn’t fake news and yes, you can look it up in Wikipedia.

Your Beddian birthday occurs during the year that your age matches the last two digits of the year you were born. So, if you were born in 2022, you’re Beddian birthday would be 22 years-old. If you were born 2007, it would be seven years old. But if you were born in 2000, your Beddian birthday would be your 100th.

This longevity math doesn’t look good for most Millennials (1981 to 1996) and some of the guys that belong to Generation Z (1997 to 2012). If you’re a Filipino Millennial born in 1996, your Beddian birthday will be your 96th. And if you were born in 1981, you’d have to live to become 81 years-old to become Beddian.

As the average life span of the Pinoy male is currently only 67 years old, reaching 96 would be a huge win. Pinays can expect to hit 75 years-old on average, but getting to 96 is also a reach. It’s a lot tougher for Gen Zers born in 1999 and 2000, as you can see from the math. Living to be a hundred would be almost miraculous.

New anti-aging technologies being developed in the West promise to extend our lives past 150. Some longevity scientists even claim aging can now be reversed.

Called by some as the “Golden birthday,” the Beddian birthday is a once in a lifetime phenomenon for a minority of a population. The Beddian birthday is another reason to make merry but it hasn’t gone viral since it made its appearance in 2007. 

The Beddian birthday originated with the late Bobby Beddia, a New York firefighter. A story published by The New Yorker in 2007 recounted Beddia telling a visitor to his fire station about how lucky he was to have survived until his birth year.

Asked to explain by his puzzled visitor, Beddia said he was born in September 1953. To him, this meant his current age (53) was the same the final two digits of the year in which he was born. Sadly, Beddia was killed fighting a fire the very same day he gave that interview. The story about him carried the title, “The Firefighter’s Theorem.”

No birthdays for some

Surprisingly, celebrating a birthday isn't a universal event even today. A number of ethnic groups and some religions still don't count the years of the lives of their people.

Among these birthday abstainers are most Muslims because birthdays aren't part of the Islamic tradition. There are also the Hindus, who generally regard a person's death as more auspicious than his birth.

Jehovah's Witnesses, an American sect that rejects Jesus’ physical resurrection and denies the Christian Trinity, repudiates birthdays because they claim the only birthdays mentioned in their Bible are among men that didn’t worship Jehovah. The Witnesses are not Christians.

 

 

Do you really want to live forever and ever?

 (Published in ENRICH magazine, 2022)

THE GOD WE CALL SCIENCE continues to prise open previously locked doors that hold the secrets to our living far longer and healthier lives, and to eventually reversing the aging process -- miraculous as this might sound.

Over the past two decades, a plethora of research studies into the cellular and molecular bases of aging has revealed a variety of techniques, both simple and esoteric, that will allow us to add healthy years to our lives.

As a consequence, the quest to attain a longer "healthspan," otherwise called "healthy aging," has replaced the current goal of increasing one's lifespan but submitting to the many geriatric diseases that make longevity a pain to endure. Alzheimer's, arthritis, diabetes and loss of eyesight are among a range of degenerative and communicable diseases that curse the elderly amongst us.

Now, however, reaching the "oldest-old" age of 90 is no longer wishful thinking with new longevity extending technologies such as "epigenetic rejuvenation," and "hyperbaric oxygen therapy." But if living to be 180 years-old or much older isn't your cup of organic green tea, you might soon be able to choose to reverse your age and become a real-life Benjamin Button, but absent the sad ending.

"Soon" might come as early as 20 years from now. This vision of radical life extension and an on-demand "Fountain of Youth" should become options available to us.

It must be mentioned the longest lived person on record is the French supercentenarian, Jeanne Calment, who was on this Earth for 122 years and 164 days. She was born in 1875 and died in 1997. A devout Roman Catholic, Calment loved chocolates, oranges and bananas and exercised regularly. She also smoked at least one cigarette a day and almost daily drank a glass of port wine.

One longevity devotee predicted longevity technology was advancing so rapidly that "most people will have access, and quite affordable access, to life extension technology." This forecast made in 2021 by multimillionaire Dmitry Kaminskiy, who spends lavishly on longevity research, is quite too optimistic but does reveal the exciting state of current anti-aging technologies.

Filipinos should benefit from the life extension technologies being developed in the United States and other affluent countries such as Australia, Spain and Israel -- if and when these become affordable. Decades hence, these technologies might conceivably boost the life expectancy at birth in our country, which in 2021 stood at 71.4 years on average for men and women. Pinays live far longer than their men. They will survive, on average, to reach 75 years old compared to the Filipino male's 67 years old. This data does not, however, include the deleterious effect on longevity inflicted by COVID-19.

Think about it. Old but not infirm. Older but not "old" in the traditional sense of that word. Or as Hollywood icon Clint Eastwood (now 92 years old) aptly put it: "Aging can be fun if you lay back and enjoy it.”

Grandparents and the promise of immortality that is their grandchildren.

Less is good

The easiest way to live longer is to eat less. Yes, it's that simple. Eat less. Living longer by eating less is one of the claims made by people that champion methods such as intermittent fasting and the ketonic or keto diet.

Longevity researchers said eating less, also called calorie or caloric restriction (CR), might add at least five more healthy years to your life if doggedly pursued. CR has even been proclaimed by some commentators as the closest we can get to a real Fountain of Youth.

One can extend his lifespan by combining CR with exercise, access to competent medical care, a good diet (think Mediterranean diet), and avoiding vices such as smoking. Drugs and therapies currently under development might eventually add 10 to 15 more years to the average life while also boosting healthspan.

"There is plenty of evidence that calorie restriction can reduce your risks for many common diseases including cancer, diabetes and heart disease," said Dr. Edward Weiss PhD, a scientist from Saint Louis University in Missouri, back in 2008. "And you may live to be substantially older." His research has since been backed-up by other studies that came to the same conclusion.

New research over the past few years studying CR among humans indicates calorie-restricted diets can indeed slow down the aging process and increase longevity.

A study involving only 34 people and published in the peer-reviewed scientific journal, Cell Metabolism, in 2018 found that limiting calorie intake by 15% over two years can slow aging and protect against diseases such as Alzheimer’s, cancer and diabetes.

These people shed 5% or more of their body weight with much of this loss being fat. Also, they saw lower insulin levels and lower nighttime core body temperature. These outcomes are two key biomarkers of aging. 

Research involving mice show that cutting calories by 20% to 40% significantly extended the lives of these animals, which are regarded as good analogs to humans in clinical trials. A study released in 2006 found that mice eating 8% less and exercising a bit more over their lifespan reduced and even reversed aging-related cell and organ damage. Evidence that CR boosts lifespan in rodents is unquestionable, according to some longevity scientists.

"Our research provides evidence that calorie restriction does work in humans like it has been shown to work in animals," said Dr. Weiss. "The next step is to determine if this, in fact, slows age-related tissue deterioration. The only way to be certain, though, is to do a long-term study."

Scientists still don't know exactly why CR slows down the aging process. There is this theory CR lowers our metabolic rate and causes the body to generate fewer "free radicals," which are unstable atoms that cause aging and can damage cells. Free radicals are also implicated in a host of other diseases while damaging our arteries and, surprisingly, shrinking our brains.

CR decreases levels of "triiodothyronine" (T3), a thyroid hormone, and by so doing slows metabolism and tissue aging. It's not sufficiently clear if reducing T3 levels through CR does slow down the aging process, however. Scientists said a slowed metabolism is linked to longer lives in hundreds of animal species since it allows the more efficient use of energy.

How much calories should we restrict? In 2013, Dr. Anthony Leachon, who was then a consultant with the Department of Health, recommended a daily calorie intake for Filipino women of 1,500 calories and 2,000 calories for men. He said Filipinos should try to consume not more than 500 calories per meal.

This means consuming one cup of rice (200 calories), 100 calories of protein each of meat or fish, a serving of fruit equal to 50 calories and 50 calories of vegetables.

“If eating pork or beef, take only small portions,” noted Dr. Leachon, who has since risen to prominence as an expert on COVID-19.

While there are no DOH guidelines about CR, an American study published in 2018 defined CR as eliminating anywhere from 15% to 18% of total recommended daily calories. In this regard, we must be aware that Americans have a higher recommended daily calorie intake compared to Filipinos.

American women likely need from 1,600 and 2,400 calories daily while men require 2,000 to 3,000, according to the 2015-2020 Dietary Guidelines for Americans.

Using these guidelines and applying it to Filipinos means Pinays should do away with 225 calories per meal while men should consume 360 fewer calories. Forgoing that cup of rice (200 calories) is the easiest way to start on CR.

The amount of calories you lose will depend on your age, overall health, height, weight, lifestyle and activity level, among other factors. It will, therefore, be wise to consult with a doctor before going on a calorie-restricted diet, especially if you're a senior citizen.

The downside to CR is it takes just too long and might harm your health if you're not careful. Many health experts agree a person might add 4.5 years to his life by eating 15% less starting at the age of 25, said Dr. Eric Ravussin, a professor of human physiology and director of the Nutritional Obesity Research Center at Pennington Biomedical Research Center in Louisiana. That's a really tough challenge most people can’t tackle..

Caloric restriction

Evolutionary biologist Dr. Jay Phelan PhD from the University of California, Los Angeles estimated that "40 years of caloric restriction would give a three to seven percent increase in longevity, so an optimistic estimate would be an additional four years or so."

Dr. Phelan in 2005 also said mice will live longer if their diet is restricted by 10%. Restricting their diet by 20% will make mice live even longer. "But restrict their intake by 60% and they starve to death," he warned.

There is also the danger that regularly eating fewer calories than your body needs might show down your metabolism and lead to muscle loss. Severely restricting calories can lead to fatigue. Also, maintaining calorie restrictions too long might lead to nutrient deficiencies.

The promise of youth

Sometime this year, if things go as planned, SOCOM, or the U.S. Special Operations Forces Command, will conduct clinical trials of an oral anti-aging drug. These historic trials will involve a pill with the potential to “delay aging” and “prevent onset of injury.”

SOCOM described the pill as a “first-in-class nicotinamide adenine dinucleotide, oxidized state (NAD+) enhancer.” NAD+ is a coenzyme central to metabolism and is a key molecule in preserving health and metabolic function. The anti-aging pill SOCOM will test contains health-enhancing food additives that boost NAD+ levels.

NAD+ helps slow down aging by lengthening our telomeres, which are the protective caps at the end of our DNA. In doing so, it reverses age-related damage at the cellular level. NAD+ also removes toxic free radicals from our bodies.

But SOCOM, whose job is to kill people, isn't interested in making their Special Forces operators live to a ripe old age despite their lethal profession. What interests SOCOM “is enhancing the mission readiness of our forces by improving performance characteristics that typically decline with age.”

SOCOM expects the trials will ultimately lead to the development of a drug that might see "improved human performance -- like increased endurance and faster recovery from injury.” In other words, SOCOM wants a drug that will enable its warriors to endure pain longer while healing faster from battlefield wounds. Think super soldier.

Telomere

Epigenetic rejuvenation

For the rest of the world, the value of the SOCOM-sponsored clinical trials is the anti-aging part of this project. The importance of the SOCOM trials is not lost on longevity scientists such as Dr. David Sinclair, a professor of genetics at Harvard Medical School and author of the bestseller, "Lifespan: Why We Age -- and Why We Don't Have To," published in 2019. This groundbreaking book details his research findings (some of them controversial) on the biological processes that cause aging.

Dr. Sinclair, a leading authority on longevity, makes the argument that “Aging is a disease, and that disease is treatable.” He sees aging as the single greatest risk factor for heart disease, cancer, diabetes, dementia, and many other diseases of age.

His incredible goal is to extend lifespan to 150 years by the end of the century. But his most astonishing claim is that natural death will eventually become a rarity. Sinclair sees a future world where we’ll be able to get vaccines and boosters that reverse aging and cheat death.

Dr. Sinclair asserts the “epigenome is reason why we age” because cells lose their identity. This is why “we grow hair in our ears,” he said. Asked if we can slow down aging or reset the aging process, his answer was emphatic: “I believe this is possible.”

The Australian biologist also says that “to reverse aging -- eat less often” since eating less turns on longevity pathways. He admits to practicing intermittent fasting, which might also be called a form of calorie restriction.

He's strongly interested in NMN or nicotinamide mononucleotide. Some studies have shown NMN has astounding beneficial effects that counter normal aging. NMN boosts NAD+ levels and is a crucial cofactor involved in over 400 metabolic reactions in cells.

Dr. Sinclair said he takes one gram of NMN daily plus resveratrol, metformin and aspirin, apparently with no adverse effects. He noted that NMN, which he calls a defense against aging, stabilizes the epigenome and turns on a longevity pathway. He's also a vocal champion of epigenetic rejuvenation, a most controversial aspect of longevity science.

Dr. David Sinclair. He is 53 years-old.

A scientific paper on epigenetic rejuvenation published in 2012 defines this therapy as "reprogramming the age of a cell in isolation while maintaining its differentiated state, thus effectively rejuvenating the specialized functions peculiar to that cell type."

Since then, scientists have discovered it’s feasible to partially reverse aging.  The biotechnologies in question hinge on altering our "epigenome," or the molecular machinery that determines which of our genes are switched on or off. As we grow old, our epigenome becomes dysregulated or unbalanced. This epigenetic dysregulation has been identified as one of the causes of aging.

The answer to moderating epigenetic dysregulation is epigenetic reprogramming. This technology makes it possible to reprogram, or change, a dysregulated, old epigenome into a younger state.

Making cells younger means upregulating four specific "Yamanaka factors" in a cyclical way, but not continuously. Yamanaka factors are proteins that can reprogram differentiated cells (or non-stem cells) by changing the epigenome. In his laboratory, Sinclair discovered we can reset our biological age by using the Yamanaka factors.

This partial cellular reprogramming involves applying Yamanaka factors (Oct4, Sox2, Klf4 and cMyc ) to cells long enough to reverse cellular aging and repair tissues. This has to take place without cells returning to pluripotency, or the capability of a cell to differentiate into one of many cell types.

Clinical trials have shown upregulating the Yamanaka factors for a short time made animal cells younger while reducing or undoing many other aging symptoms. The groundbreaking discovery that mature cells can be converted into stem cells was made by Japanese geneticist Shinya Yamanaka, and led to his being conferred the Nobel Prize for Physiology or Medicine in 2012.

The startling progress being made in developing therapies such as cellular reprogramming that promise to not only extend our lives but to also reverse human aging might also bring with it the danger of developing cancer. Epigenetic rejuvenation has been successful in mice, but only in mice thus far. No trials have been conducted with humans.

In March 2022, scientists at the Salk Institute for Biological Studies in California and American biotech firm Genentech, Inc released a paper claiming they safely and effectively reversed the aging process in middle-aged and elderly mice by partially resetting their cells to more youthful states.

"We are elated that we can use this approach across the life span to slow down aging in normal animals. The technique is both safe and effective in mice," said Dr. Juan Carlos Izpisua Belmonte, co-corresponding author who is a professor in Salk's Gene Expression Laboratory, and one of the pioneers in aging research.

The study saw Belmonte, a Spaniard, and his colleagues test variations of the cellular rejuvenation approach in healthy mice as they aged. A goal of the study was to establish the safety of the approach over a longer time span.

His laboratory in 2016 reported for the first time they’d used the Yamanaka factors to counter the signs of aging and increase life span in mice with a premature aging disease.

Promoting the well-being of elderly Filipinos