Author’s Note: We recently had the opportunity to interview Dr. Bradley Wilcox about the importance of reducing chronic inflammation and just as importantly, what steps we can take to accomplish this. Formerly a clinician at the Queens Hospital, he’s now a fulltime research scientist. Dr. Willcox trained at the University of Toronto, the Mayo Clinic, and Harvard Medical School. Dr. Willcox’s research teams have identified several important genetic and environmental risk factors for aging and aging-related chronic diseases. His research team in Okinawa identified the first longevity-associated gene, and his research team in Hawaii was the first to identify the association of the FOXO3 gene with human longevity. He is on the Editorial Board of several leading gerontological journals, including the Journals of Gerontology. He has been recognized with a Dorothy Dillon Eweson Award for Advances in Aging Research, the Henry Christian Award from the American Federation for Medical Research, a Director’s Citation from the Centers for Medicare and Medicaid Services, and other honors. Dr. Willcox is also the author of a New York Times best-selling book on healthy aging, The Okinawa Program. His work has appeared in cover articles of Time Magazine, National Geographic, and on Oprah, Good Morning America, NOVA Science, BBC, and other outlets.
Q: First of all, please describe your job?
A: As a geriatrician, the vast majority of my time is spent treating people who suffer from the afflictions of old age. These are almost always chronic in nature — heart disease, arthritis, cognitive decline, diabetes, and the list goes on.
Q: What is the connection between inflammation and aging?
A: Oxidative stress and inflammation are the key factors for development of chronic disease and other ravages of old age. Oxidative stress—let’s call it inflammation, is believed to be a principal mechanism of aging.
Q: How do you prevent inflammation and chronic disease?
A: The good news is that most of the ailments I treat can be markedly delayed and largely prevented by a healthy diet, exercise, and other lifestyle factors. The right food can be a powerful prophylaxis that can actually thwart illness. The Okinawan people — who are the longest lived people in the world — use the term nuchi gusui, which literally means “food is medicine.” But modern medicine is just beginning to understand the biochemistry behind the concept of food as medicine. After two decades of research, I believe that the Okinawan diet is a veritable Rx for longevity and healthy aging.
Q: Can the kinds of foods in the Okinawan diet be a guidepost for people who live in America?
A: Absolutely. Consuming the right foods, with the right micronutrients, mitigates risk for many age-associated diseases and, perhaps, modulates the very rate of aging. Thus, it’s no coincidence that the Okinawans consume home grown turmeric, sweet potatoes and other local foods, including several vegetables rich in marine phytoactive compounds such as astaxanthin. All these foods are available in Hawaii and on the mainland. More importantly they will help mitigate inflammation, which is not our friend.
Q: Can you talk a little about astaxanthin?
A: Yes. It’s known as a marine carotenoid, found in seaweeds and kelp. It’s part of the Okinawan diet and shows particular promise in our research. The compound has powerful, broad-ranging anti-oxidative and anti-inflammatory properties. Research indicates astaxanthin may benefit those suffering from inflammation-related conditions including arthritis and rheumatoid disorders, metabolic disease, as well as cardiovascular, neurological, and liver diseases. It’s available as a supplement both in a natural form (which you can buy at Costco) or as a nature-identical compound (which you can purchase at GNC).
Q: What’s the difference between the natural product and the “nature identical” product?
A: This is a natural compound (sold as Bioastin) is derived from algae, whereas the nature-identical version (ZanthoSyn) is synthesized. They are both good for you. ZanthoSyn, however, is has greater bioavailability, meaning it’s absorbed better by your system and hence packs more punch. One 12gr ZanthoSyn tablet is roughly equivalent to three 12 gr tablets of Bioastin. (Full disclosure, I’m on the scientific advisory board for Cardax, the company that produces ZanthoSyn).
Q: What’s the bottom line on your research regarding he FOXO3 gene and longevity?
A: In short, the FOXO3 gene, which everyone has, is strongly associated with human longevity. However people that have certain variants of this gene have a 2-3 times greater chance of living to 100. I’m also convinced that FOXO3 is connected to mitigating inflammation. The bottom line is that even if you don’t have the “best” FOXO3 variant in terms of longevity, by expressing or “turning on” the gene, you’ll be able to duplicate the “longevity” mechanism.
Q: So how do you “turn on” the FOXO3 gene?
A: You can do it by eating certain foods, which is one of the functions that the Okinawan Diet achieves. What we’ve learned is that certain micronutrients found in the same foods I mentioned earlier, Okinawan sweet potatoes, turmeric, marine-based carotenoid-rich foods (e.g., seaweeds and kelp) and other items have compounds such as astaxanthin that will express this gene.
Q: You said the Okinawan Diet is a diet is a veritable Rx for longevity. Can you draw a distinct connection between diet and healthy aging?
A: Healthy aging, which means absence of chronic illness, is the best way to grow old! Eating foods I’ve described can actually help prevent you from getting ill. By some estimates, 80% of coronary heart disease (CHD) and type-2 diabetes mellitus and 40% of cancers may be prevented by modifying dietary habits. We’ve found that Okinawans who eat a traditional diet gained an additional 6% survival time from age 65 (1.3 years) versus other Japanese and an additional 20% survival time (3.6 years) versus Americans. Perhaps most notable is that Okinawans gained almost a decade of additional disability-free life expectancy compared with Americans. Some of the compounds that help express the gene, such as, along with other marine carotenoids such as polysaccharide fucoidan, xanthophyll fucoxanthin have some amazing qualities such as inhibiting cancer growth, fostering reduction in bad cholesterol, and lowering triglycerides. The shorthand is that by stimulating the FOXO3 gene with the right foods and phytonutrients, odds are you will live longer and healthier.
Q: What other biological roles do these foods play in assisting healthy aging?
A: The compounds contained in the foods I mentioned trigger our biological systems into mimicking an ancient survival mechanism called caloric restriction. Caloric restriction has been unequivocally proven to make organisms live longer. It sounds strange but the less you eat (up to about 30% less than usual), the longer you live so long as you maintain a diet adequate in macro- and micronutrients. A diet that contains compounds that turn on caloric restriction’s biological mechanisms may also make you live longer and healthier.
Q: 
I thought caloric restriction means fasting—starving yourself. I don’t want to do that!
A: You don’t have to starve yourself to promote caloric restriction. Instead, you can mimic caloric restriction by eating certain foods that imitate caloric restriction’s biological effects, thus getting the benefits of caloric restriction without the deprivation. Our studies, and those of others, have shown strong support for this.
Q: Can you discuss any recent research you’re involved in that might be of interest?
A: I’m glad you asked. My colleague Richard Allsopp, a Ph.D. Professor over at the John A. Burns School of Medicine, has just recorded preliminary findings from a trial focused on how astaxanthin impacts FOXO3 in mice. Like me, Dr. Allsopp focuses on the cellular and molecular mechanisms of aging. What he’s found seems to confirm what we believe about the efficacy of astaxanthin. The upshot is that when mice ingest astaxanthin, FOXO3 is expressed in a statistically significant manner in the heart and to a lesser degree in the blood and skeletal muscles. This implies that you’re getting an anti-flammatory and stress resistant effect from astaxanthin in vital organs. By “stress resistant” I mean that you’re seeing a reduction in inflammation in the tissue which can be measured by reduced cytokine levels. If it reduces inflammation in a mouse, that’s a pretty good indication that it will work in humans too.
Q: Any parting advice?
A: Eat lots of vegetables, fish, engage in regular physical activity, avoid tobacco and drink moderately. Wouldn’t hurt to take astaxanthin either.
****************
Dr. Willcox is Principal Investigator of the National Institute on Aging-funded Kuakini Hawaii Lifespan Study and Kuakini Hawaii Healthspan Study, which are ancillary studies on aging from the Kuakini Honolulu Heart Program. He is also Professor and Director of Research at the Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, located on the Kuakini Health System campus. He is the Co-Principal Investigator of the Okinawa Centenarian Study and has been investigating mechanisms of aging for almost two decades with this study.