The Triage Theory by Bruce Ames

June 19, 2017

The Triage Theory by Bruce Ames 


 References:  AJCN 2009 AmesPNAS


 This topic is very important. It is how "wellness" and aging intersect.  Bruce Ames, a Professor of Biology and Molecular Biochemistry at Berkeley has been the chief proponent of it and has been articulating its implications since 2006. 


In essence, the theory maintains that populations of mammals, or creatures, on earth allocate micronutrients on a first-come-first-served basis. This serves the animal in the short term but creates long-term consequences and problems. The body "prioritizes" short-term survival over long-term health. There are about 40 critical minerals, fats, vitamins and "micronutrients" that we depend upon for optimal health. Each of them can be "optimal" or play a role in being deficient. It is not until that nutrient is critically deficient that we get a short-term "deficiency" disease. 


But because different organ systems may require different levels of the nutrient, short-term disease may not reflect the risk of long-term damage that ends up causing premature aging. One of his examples is Vitamin K. When we take coumadin to make out blood thin, we knock out a bunch of other functions that Vitamin K does. In the short term, our blood being thinner and less clot-prone might be medically life-saving because we have had a blood clot in our lungs, but in the long term, we end up with arteries that have calcified and "hardened". You will see it on X-ray. Folks who have been on Coumadin for years have all their arteries visible in calcified outline. 


Another example is Iodine. In severe deficiency, you get mental retardation. Iodine insufficiency is considered the number one cause of mental retardation in the worth by the WHO. It's terribly important to protect the brain, and heaven knows, our thyroids need iodine. What gives? Breast cancer and fibrocystic breast disease are both strongly linked to lower iodine intake. Optimal iodine intake is probably more on the order of 1-1.2 mg a day, whereas most Americans only get .250-.300 mg a day. 


Alkalinity and acid give another example. Very high animal protein diets with excess protein result is "acid" biological ash, needing neutralization. The human body, evolving from plant-eating backgrounds, is used to being vegetarian and only recently adopted a habit of eating meat (5 million years) so that we could get a bigger brain. Eat too much animal protein, and you have to sacrifice bone mass to neutralize the acid. American's get an extremely high level of animal protein between meat, fish, bird and dairy and resulting in a uniformly acidic environment. 


One in eight American women breaks a hip, the disease of aging that then does 30% of them in. This raises the spector of the safety of the "Adkins Diet" to which I would suggest that one focus on the fat and not the meat. The conundrum for wellness comes in the concept of "long-term health". It is easy to precipitate short-term illness, and discover the minimal requirement to prevent a particular organ system from failing. In just weeks, you can show that a level of Vitamin D below 32 ngm in the blood results in decreased cathelicidin and lowered immune function as shown by the inability to kill tuberculosis. It takes over 10 years to show that a level of Vitamin D of 50 versus 30 results in 70% less cancer. 


The web on nutrient interactions is marvelously complex and nuanced. That's the fun of it all. We have so much more to learn. Thank you Dr. Ames for opening this line of inquiry. I want to live long enough to fully appreciate it. 


 WWW.What will work for me. I've referred to the triage theory several times in the past. Our column on zinc was the last one. This theoretical construct should guide our thinking on all 40 micronutrients. What is too much? Too Little? Just right? I take Vitamin D, K2, fish oil, zinc, magnesium all because of this concept. You likely should too. 


 Pop Quiz

1. The RDA of vitamins and minerals are well known? T or F                    Answer:   Unfair, trick question. They are well known only for short-term disease states, not long-term wellness.

2. Premature aging is precipitated by missing micronutrients? T or F             Answer:   True: And that's the Triage Theory stated backward.

3.       Not mentioned in this column, but if you have read anything in this newsletter, you would have seen repeated references to its even more important role in.............brain health.

4.      Taking coumadin to prevent short term blood clots results in.........?         Answer: Long-term arterial calcification.

5.      Eating a pure cheese and meat diet (the all-American fast-food diet) results in what long-term stressor effect on the body?                       Answer:  Too much acid that has to be neutralized by borrowing calcium from? ........ Bones.



1. The RDA of vitamins and minerals are well known? T or F                                                                       Unfair, trick question. They are well known only for short term disease states, not long term wellness.
 
2. Premature aging is precipitated by missing micronutrients? T or F                                                              True:  And that's the Triage Theory stated backwards.
 
3. Vitamin B12 deficiency is key for the prevention of pernicious anemia. What else is it also critically important for?                                                                                              Not mentioned in this column, but if you have read anything in this news letter, you would have seen repeated references to its even more important role in.............brain health.
 
4. Taking coumadin to prevent short term blood clots results in.........?                                                                       Long term arterial calcification.
 
5. Eating a pure cheese and meat diet (the all American fast food diet) results in what long term stressor effect on the body? Too much acid that has to be neutralized by borrowing calcium from? ........         Bones.
 

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