Carbohydrate myths

food myths

When it comes to weight control, carbohydrates get a bad rap. In the past, fats were the bad boy, driven mostly by misinformation. However, the truth is in finding the right dietary balance; not indiscriminately excluding a key macronutrient.

The real problem with carbs is that we often don’t know what a portion should look like. So we eat way too much of it. If you’re not pairing carbs with fats or proteins, you probably won’t feel full.

Bread and pasta are not the enemy. Again, it’s the portions and the type of grains you pick that kill your weight-loss goals.


Pick a whole-grain option whenever possible, which has more fiber to keep you feeling fuller for longer. Whole-wheat bread, brown rice, ancient grains like quinoa and bulgur are good options. At the store, choose bread with five grams of fiber per slice.

Get the right kind of carbs by cutting out processed goods, sugary drinks, sweets, and packaged / convenience foods from your diet; they’re all packed with empty carb calories. Starchy veggies (potatoes, sweet potatoes, squash, corn, and lentils) and fresh fruit have more fiber.

Unless you have specific dietary requirements or allergies, carbs are a good source of fuel your body. Don’t throw them out; instead, focus on healthy carbs and a balanced diet.

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Repetitive Motion Injury

What is a repetitive motion injury (repetitive stress injury)?

Repetitive motion injuries, also called repetitive stress injuries, are temporary or permanent injuries to muscles, nerves, ligaments, and tendons caused by performing the same motion over and over again. A common repetitive motion injury is carpal tunnel syndrome. This disorder occurs when the median nerve, which travels from the forearm to the hand through a “tunnel” in the wrist, is compressed by swollen, inflamed ligaments and tendons. It is often seen with people who use computer keyboards or work on assembly lines.

The injury can be quite painful and can also cause numbness, clumsiness, and a loss of motion, flexibility, and strength in the area. It can worsen over time without treatment, and can result in a complete loss of function.

  • Facts about carpal tunnel syndrome

According to the National Institute of Neurological Disorders and Stroke, the dominant hand is most commonly affected and renders the most severe pain. Women develop carpal tunnel syndrome three times more frequently than men. Carpal tunnel is likely more common in people with a congenitally smaller tunnel space. Trauma or injury to the wrist, thyroid disease, rheumatoid arthritis, diabetes, and pregnancy can also contribute to the disorder. It usually occurs only in adults.

carpal_tunnel-300x285 carpal-tunnel-syndrome

Rehabilitation for repetitive motion injuries

A rehabilitation program for repetitive motion injuries is designed to meet the needs of the individual patient, depending on the type and severity of the injury. Active involvement of the patient and family is vital to the success of the program.

The goal of rehabilitation after a repetitive motion injury is to help the patient return to the highest level of function and independence possible, while improving the overall quality of lifephysically, emotionally, and socially.

In order to help reach these goals, repetitive motion injury rehabilitation programs may include the following:

  • Exercise programs to stretch and strengthen the area
  • Conditioning exercises to help prevent further injury
  • Occupational therapy
  • Heat or cold applications
  • Use of braces or splints to immobilize the area
  • Pain management techniques
  • Patient and family education, especially regarding proper ergonomics for the workplace (ergonomics is the science of obtaining a correct match between the human body, work-related tasks, and work tools)

The rehabilitation team for repetitive motion injury

Rehabilitation programs for repetitive motion injuries are usually conducted on an outpatient basis. Many skilled professionals are part of the repetitive motion injury rehabilitation team, including any or all of the following:

  • Orthopedist/orthopedic surgeon
  • Neurologist/neurosurgeon
  • Primary care doctor
  • Sports medicine doctor
  • Occupational medicine doctor
  • Physical therapists
  • Physiatrist
  • Occupational therapist
  • Vocational counselor
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Arthritis and other rheumatic diseases are characterized by pain, swelling, and limited movement in joints and connective tissues in the body. According to the CDC (Center for Disease Control and Prevention), nearly 50 million people in the U.S. have some form of arthritis or chronic joint symptoms.


Arthritis, which literally means inflammation of a joint (where two or more bones meet), actually refers to more than 100 different diseases. Rheumatic diseases include any diseases that cause pain, stiffness, and swelling in joints or other supportive body structures, such as muscles, tendons, ligaments, and bones.

Arthritis and other rheumatic diseases are often mistakenly associated with old age because osteoarthritis (the most common form of arthritis) occurs more often among elderly persons. However, arthritis and other rheumatic diseases affect people of all ages and are more common in women than men.

Arthritis is usually chronic, which means that it rarely changes, or it progresses slowly. Specific causes for most forms of arthritis are not yet known.

What are the parts of a joint?

Joints are the areas where two bones meet. Most joints are mobile, allowing the bones to move. Joints consist of:

  • Cartilage. A type of tissue that covers the surface of a bone at a joint. Cartilage helps reduce the friction of movement within a joint.
  • Synovial membrane. A tissue called the synovial membrane lines the joint. The synovial membrane secretes synovial fluid (a clear, sticky fluid) around the joint to lubricate it.
  • Ligaments. Strong ligaments (tough, elastic bands of connective tissue) surround the joint to give support and limit the joint’s movement.
  • Tendons. Tendons (another type of tough connective tissue) on each side of a joint attach to muscles that control movement of the joint.
  • Bursas. Fluid-filled sacs, called bursas, between bones, ligaments, or other adjacent structures help cushion the friction in a joint.

Health Knee Joint

What are the most common types of arthritis?

The three most prevalent forms of arthritis include:

  • Osteoarthritis. The most common type of arthritis. It is a chronic disease involving the joints, particularly the weight-bearing joints such as the knee, hip, and spine. Osteoarthritis is characterized primarily by the destruction of cartilage and narrowing of the joint space. It can also include bone overgrowth, spur formation, and impaired function.It occurs in most people as they age, but also may occur in young people as a result of injury or overuse.
  • Fibromyalgia. A chronic, widespread pain in muscles and soft tissues surrounding the joints throughout the body.
  • Rheumatoid arthritis. An inflammatory disease that involves the lining of the joint (synovium). The inflammation may affect all of the joints.
  • Other forms of arthritis, or related disorders, include the following:
    • Gout. A result of a defect in body chemistry (such as uric acid in the joint fluid), this painful condition most often attacks small joints, especially the big toe. It can usually be controlled with medication and changes in diet.
    • Systemic lupus erythematosus (lupus). A very serious, chronic, autoimmune disorder characterized by periodic episodes of inflammation of and damage to the joints, tendons, other connective tissues, and organs, including the heart, lungs, blood vessels, brain, kidneys, and skin.
    • Scleroderma. A very serious disease of the body’s connective tissue that causes thickening and hardening of the skin.
    • Ankylosing spondylitis. A disease that affects the spine, causing the bones of the spine to grow together.
    • Juvenile idiopathic arthritis (JIA) or juvenile rheumatoid arthritis (JRA). A form of arthritis in children ages 16 or younger that causes inflammation and stiffness of joints for more than six weeks. Unlike adult rheumatoid arthritis, which is chronic and lasts a lifetime, children often outgrow JRA. However, the disease can affect bone development in the growing child.

What are the symptoms of arthritis?

The following are the most common symptoms of arthritis. However, each individual may experience symptoms differently. Symptoms may include:

  • Pain and stiffness in the joints
  • Swelling in one or more joints
  • Continuing or recurring pain or tenderness in a joint
  • Difficulty using or moving a joint in a normal manner
  • Warmth and redness in a joint

The symptoms of arthritis may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

hand with arthritis

Hand with Arthritis

How is arthritis diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for arthritis may include:

  • X-rays or other imaging procedures (to show the extent of damage to the joint)
  • Blood tests and other laboratory tests, including:
    • Antinuclear antibody (ANA) test (to check levels of antibodies in the blood)
    • Arthrocentesis or joint aspiration (to remove a sample of the synovial fluid to determine if crystals, bacteria, or viruses are present)
    • Complete blood count (to determine if white blood cell, red blood cell, and platelet levels are normal)
    • Creatinine (to monitor for underlying kidney disease)
    • Sedimentation rate (to detect inflammation)
    • Hematocrit (to measure the number of red blood cells)
    • Rheumatoid factor test (to determine if rheumatoid factor is present in the blood)
    • Urinalysis (to determine levels of protein, red blood cells, white blood cells, and casts)
    • White blood cell count (to determine level of white blood cells in the blood)
    • Uric acid (to diagnosis gout)
    • HLA tissue typing (to look for genetic markers in ankylosing spondylitis)
  • Skin biopsy (to diagnose a type of arthritis that involves the skin, such as lupus or psoriatic arthritis)
  • Muscle biopsy (to diagnose arthritis or rheumatic diseases, such as polymyositis or vasculitis)

Rehabilitation for arthritis

An arthritis rehabilitation program is designed to meet the needs of the individual patient, depending on the type and severity of the arthritis. Active involvement of the patient and family is vital to the success of the program.

The goal of arthritis rehabilitation is to help the patient return to the highest level of function and independence possible while improving the overall quality of life–physically, emotionally, and socially. The focus of rehabilitation is on relieving pain and increasing motion in the affected joint(s).

In order to help reach these goals, arthritis rehabilitation programs may include the following:

  • Exercises and to control joint pain and swelling
  • Exercises to improve mobility (movement) and physical fitness
  • Heat and cold therapy
  • Massage
  • Transcutaneous electrical nerve stimulation to help relieve pain
  • Acupuncture
  • Stress management and emotional support
  • Joint immobilization and methods to protect the joints from further damage, degeneration, and deformities
  • Nutritional counseling to improve weight control
  • Use of assistive devices
  • Patient and family education

rehabilitation for arthritis

Rehabilitation after joint replacement

The goal of hip and knee replacement surgery is to improve the function of the joint. Full recovery after joint replacement usually takes about three to six months, depending on the type of surgery, overall health of the patient, and the success of rehabilitation.

Rehabilitation programs after joint replacement may include the following:

  • Exercises to improve mobility (movement) and physical fitness
  • Gait (walking) retraining
  • Pain management
  • Nutritional counseling to improve weight control
  • Use of assistive devices
  • Patient and family education

The arthritis rehabilitation team

Arthritis rehabilitation programs can be conducted on an inpatient or outpatient basis. Many skilled professionals are part of the arthritis rehabilitation team, including any or all of the following:

  • Physical Therapist
  • Orthopedist/orthopedic surgeon
  • Rheumatologist
  • Physiatrist
  • Primary care doctor (for example, family medicine or internal medicine)
  • Rehabilitation nurse
  • Dietitian
  • Occupational therapist
  • Social worker
  • Psychologist/psychiatrist
  • Recreational therapist
  • Vocational therapist

If you have been diagnosed with Arthritis, give us a call for a complete assessment and a rehabilitation plan through physical therapy. +1 (480) 335 2747

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6 common myths about physical therapy (physiotherapy)

Physical Therapy or Physiotherapy is a specialised and useful mode of treatment, which helps recovery from neuromuscular injuries and joint conditions, among other health problems and complaints.


Some people think of physical therapists as either drill sergeants or glorified exercise coaches. However, physical therapists are highly trained professionals who have studied the design, structure and function of bones, muscles, ligaments and joints in depth. This helps them accurately diagnose and treat conditions which restrict mobility and normal function, helping you heal better, faster and preventing recurrence of such injuries.

1) So, does physical therapy just mean exercise? No. Physical therapists assess the functional status of the whole patient. They then work out the treatment, which often includes exercises of various types to promote flexibility and strength. They help to recover useful function and sensation. They suggest necessary or helpful lifestyle modifications.

You don’t need to be injured to visit a Physical Therapist (fact)

2) Is physical therapy painful? Well, pain reduces movement rather than easing it. In fact, the body does best when movements are challenging but not painful. We select exercises which increase flexibility and weight-bearing gradually, according to the improvement in your injured part.

3) Doesn’t physical therapy take too long to produce results? Well, it’s not a one-size-fits-all solution. It tackles a range of conditions, from paralysis or weakness due to trauma, birth injury or stroke to chronic arthritis or post-surgery rehab. It takes various forms, which last for different lengths of time. However, in most common conditions, such as neck or back pain, or joint stiffness, improvement is felt and seen in a few sessions. If you are willing and committed to following up, you will experience the benefits sooner rather than later!

4) Would your body have healed itself with time, even without physical therapy?physio

The body heals itself quite marvelously, so some degree of recovery always occurs. However, when a painful or weakening condition has progressed to involve other joints and muscles, you need help. In such cases, physical therapists can play a critical role in restoring function and movement.

5) “But it’s just massage!”. Well, not exactly, though. Massage by an experienced physical therapist does wonders in soothing and mobilising painful and tight muscles or joints. However, they also use a spectrum of physical methods like heat or cold, ultrasound, infra-red, as well as joint mobilisation, range-of-movement exercises, aquatic therapy, specialised sports injury rehab or post-surgical rehab programs to get you feeling useful and healthy again!

6) And it is not just for the old, or for sportspeople either! Physical therapy can help anyone who finds movement painful or difficult, or would like to be fit. There is no reason why you need to bear chronic pain. Why not call us now and get in touch with our physical therapists, for a full assessment and a personalised treatment and care program? It could change your life!

What is Allied Health?

betty and vickAllied health professions are those which deliver services related to the prevention, diagnosis and treatment of disease, apart from the medical profession. Thus this vast group of professionals includes physical therapists, podiatrists, orthotists and occupational therapists and many others.

This group is remarkable in that they contribute directly to the recovery of function, preserve independence and mobility. This is especially important in lowering the risk of complications due to prolonged illness or injury.

These are highly trained professionals holding a tertiary (university) degrees in their field of study. Despite the usefulness of their contribution to the patient’s recovery and well-being, these services are usually not covered by Medicare.

Allied health professionals may be grouped into technicians or technologists. Technologists or therapists are more intensively trained to understand the framework of normal structure and function of the joints. Thus they can diagnose and prescribe treatment for conditions affecting mobility and function. Technicians or assistants receive training aimed at carrying out procedures which are prescribed by the therapists or technologists. Their education is less demanding but focused on the acquisition of necessary practical skills.

Thus the allied health professionals play a vital role in helping patients to return to full usefulness and independence. May their tribe increase!

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When exercise results are slow

Maybe it’s a new year’s resolution or you want to get into shape for some exciting event (e.g. weddings, summer vacation, sports competitions, etc.). You’ve started training hard at the gym; or so you thought…

Despite your best efforts, workout results seem negligible or non-existent. How can that be? After all the time, money and energy devoted to the cause, is that all there is?

So, is it time to pull the plug on physical fitness and go back to your past bad habits? Absolutely not! Regular physical movement is vital for maintaining a healthy lifestyle. However, realize that training smart is just as important as training hard. Maybe it’s time to step back and investigate the lack of results.

Resultado de imagem para lazy people working out

Here are five common reasons your workouts may be falling short now. Some should be obvious, while others may surprise you:

Your workouts do not match your fitness goals

Have you written down your fitness goals? Is it muscular strength, fat loss, greater agility or flexibility? Cardio endurance or explosiveness (power/speed)? How about timelines? Are you giving yourself six-weeks, twelve-weeks, or a full year to accomplish your milestones?

There is no way you will achieve your goals without appropriate exercises and a clear schedule for making it happen. It’s not rocket science to set up, either on your own or with professional guidance (see below), but please do it today.

You dont work out often enough

You will never get to where you want to go without literally taking the necessary steps. If you seek moderate health gains, perhaps a daily (and brisk) thirty-minute walk is enough. However, for significant weight loss and/or muscle gain results, expect to budget forty to fifty minutes in the gym, three or more times weekly. Ensure that your workouts are frequent, intense and without distraction.

You are overtraining yourself to exhaustion

Believe it or not, exercising too hard and too often can, in some instances, be more detrimental than doing nothing at all. While moderate cardiovascular exercise (e.g. walking, light jogging, biking, swimming, etc.) can be performed every day, other programs risk leaving you tired and vulnerable to injury. Muscles need adequate rest and recovery time for repair and growth, so overworking specific body parts is not recommended. Avoid “spot training” in favour of full-body or split training sessions.

Also ensure that you get enough rest nightly.

Doing it all without the benefit of outside help

Professional and upper-level athletes recognize the benefit of certified coaches and trainers, so why not follow their example? Fitness club members have access to qualified specialists who can evaluate your current training habits and make sound recommendations. Whether you need a few tweaks or a complete overhaul, this might be your best move. Also, don’t underestimate the motivational and accountability benefits of a training buddy to keep you on track.

Home gym enthusiasts (especially beginners) should also avail themselves of professional advice, even if it costs a bit of money. Physiotherapists in particular are invaluable sources for people recovering from serious injury.

Need to start eating properly

You are what you eat and we would be remiss to ignore the importance of proper eating habits during your training cycle. Nutritionists and dieticians offer great meal ideas and food consumption guidelines for the general population, but they can also tailor weekly meal schedules for your needs.

Logically, avoid foods that are high in sodium, refined sugars and starches and unhealthy fats. Load up on fruits, vegetables, whole grains (if not gluten-intolerant) and lean meats. Drop typical snack food fare like potato chips, soft drinks and cookies.

Remember, your physiotherapist is well equipped to advise you in all these matters. Speak to us today and get the results you deserve.

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Neuroplasticity and Repetitive Practice: 2 secrets for Stroke Rehab Success

There are two essential ingredients that your rehabilitation regimen needs for success: neuroplasticity and repetitive practice.

These two things can make a MASSIVE difference in your recovery, so we’d like to share a quick lesson about it with you.


Neuroplasticity is how your brain rewires itself and heals after stroke. When there is damage in the brain, neuroplasticity allows your brain to rewire new connections around the damage.

For example, if stroke damaged the motor cortex of your brain (which controls movement) then you may have impaired leg movement. In order to regain leg movement, you can engage neuroplasticity to rewire your brain.

Which begs the question, how can you engage neuroplasticity?


The answer is repetitive practice.

Repetitive practice involves practicing something over and over and over, which leads to stroke rehab success!

As they saying goes, “You are what you repeatedly do”.

Because the more you repeat something, the more ingrained it becomes in your brain.

And that’s why repetitive practice is sooo important for stroke recovery.

The more you repeat something over and over, the more you strengthen the new neural connections in your brain.

And the stronger those connections become, the stronger you become.

Repetitive practice is how you will get your life back after stroke and recover the fastest way possible.

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How to find the Motivation to Exercise

You have heard the expression “where there’s a will there’s a way.” This applies to exercise as it does to everything else. It is not easy to get out of bed early in the morning or head for the gym after a hard day’s work. If you are not in the best physical condition or are recovering from an illness or injury, it’s that much harder to put in the effort. So, how do you acquire the motivation to exercise?

Resultado de imagem para exercise in pairs

The following tips will help you drum up the motivation to start and maintain an exercise program:

  1. Think about the benefits of exercise – improved health, reduced stress, weight loss, better sleep, to name a few .
  2. Set realistic goals. If you have never exercised before, you want to start slowly, so your goal might be to exercise 3 days a week for 15 minutes, then increase the frequency and length as you become stronger.
  3. Find a buddy. Having someone who exercises regularly can encourage you, especially on days when your motivation is low.
  4. Do something you enjoy. Exercise does not have to be boring or strenuous. Dancing, walking, swimming, cycling are all enjoyable, effective forms of exercise. If you do it with a partner, it can be even more fun.
  5. Choose pleasant surroundings. A scenic park or countryside can provide sensual delights in addition to the benefits of exercise.
  6. Choose the right time. Some people work out best in the morning, others in the afternoon. Some like hot weather, others are invigorated by the cold. Know yourself and what suits you best.
  7. Choose the right clothing and footwear. You will not be motivated to exercise if you are not comfortable in what you are wearing. Dress to suit the weather and be careful to wear the right shoes.
  8. Listen to music. This can help you pass the time and make your workout more enjoyable.
  9. Vary your workout. As you become stronger, you may get tired of the same routine. You can incorporate other forms of exercise such as weights, swimming or Yoga.
  10. Keep a positive attitude. This will help you stay motivated.

Before beginning any form of exercise, consult a professional. If you need help getting started, you can see a physiotherapist who will set up a program that is just right for your age and physical condition.

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How to start a Walking Program

Whether you are an athlete in the prime of life, an elderly person or someone recuperating from an illness, walking is one form of exercise that nearly everyone can, and should, participate in. All you need is a comfortable pair of shoes and the will. In many physiotherapy programs, walking forms the basis of treatment. Walking as a form of exercise that costs you nothing and has many benefits which we will explore in this article.



How to start a walking program:

Before you begin walking or any type of exercise, you should first consult a health care professional. The rate at which you begin walking will depend on your physical condition. If you have been ill or have followed a sedentary lifestyle for a long time, do not try to do a three-mile sprint during your lunch break. Take it slowly at first, wear comfortable clothing, sturdy shoes and don’t forget to breathe.

  • If you cannot breathe easily while you walk, it means you are going too fast.

Who may benefit from walking:

Walking benefits everyone. If you are in the peak of health, walking can help maintain your condition, but if you are recovering from illness or injury, walking is a safe and effective means of regaining stamina and conditioning weak muscles.

Walking is highly recommended for:

  • Cardiac rehabilitation: walking is a major part of therapy for persons recovering from a cardiac condition.
  • Stroke rehabilitation: helps correct gait abnormality and increase strength.
  • Sports injury: repairs damaged tissue, strengthens muscle and promotes healing.
  • Arthritis: relieves pain and improves joint flexibility.
  • Diabetics: helps the body metabolise sugar, thereby decreasing glucose levels in the blood.
  • Obesity: increases metabolism, reduces fat, tones and strengthens muscles.
  • Osteoporosis: the weight-bearing mechanism of walking helps increase bone mass.

Walking is a whole body exercise which benefits not just your leg muscles, but your upper body, heart and lung muscles as well. It tones and conditions the body, helping you lose weight, feel better and look better. Walking increases endorphins (the feel-good hormones), and if you walk outdoors you receive the added benefit of Vitamin D which strengthens bones. If you are thinking of beginning a walking program and don’t know where or how to start, give us a call. We will give you all the help you need.

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Can Science make us immortal?

Screen Shot 2017-11-19 at 11.00.25 AM

If you’re alive in 20 years, you may be able to live forever.

In 1786, average life expectancy was just 24 years. A hundred years later (1886) it doubled to 48. Right now a newborn can expect to live an average of 76 years. With recent discoveries in biology, many scientists predict that life expectancy will continue to triple-digits. In fact, if they are correct, humans shouldn’t have to die at all in the future. Screen Shot 2017-11-19 at 11.02.10 AM

“Over half the baby boomers here in America are going to see their hundredth birthday and beyond in excellent health. We’re looking at life spans for the baby boomers and the generation after the baby boomers of 120 to 150 years of age.” — Dr. Ronald Klatz of the American Academy of Anti-Aging.

Today’s quest for the fountain of youth is taking scientists inside the genetic structure of cells and paying less attention to the role of stress and diet on life spans. Would-be immortals flock to anti-aging clinics and shell out as much as $20,000 a year for treatments that include hormone therapy, DNA analysis, even anti-aging cosmetic surgery. These experimental therapies offer no guarantees of immortality — just the promise of prolonging life.

“Anti-aging medicine is not about stretching out the last years of life. It’s about stretching out the middle years of life… and actually compressing those last years few years of life so that diseases of aging happen very, very late in the life cycle, just before death, or don’t happen at all.” — Dr. Klatz.

Why do we age and die?

The cause of what we call “aging” is now being understood. This new understanding may soon move anti-aging cosmetics and surgery to the ranks of snake oil and Siberian yogurt as life-extension fads — but not yet. There are a few obstacles that need to be addressed.

Just when you thought that holographic TV and outer space travel were on the future horizon of modern technology, immortality has silently been revealing itself to scientists like Doctor John Langmore [right] of the University of Michigan’s Department of Biology.

Dr. Langmore and his group looked inside human cells, at the very essence of human life: the DNA molecule. Specifically, Dr. Langmore looked at the tips of the DNA molecule — a previously overlooked part of the double-helix molecule — that contain a kind of chain of repeating pairs of enzymes.





Called telomeres, these molecular chains have often been   compared to the blank leaders on film and recording tape. Indeed, telomeres seem to perform a similar function. During the replication process the spiral DNA molecule must split in half and reassemble a copy of itself. Protecting the vital DNA molecule from being copied out of synch, telomeres provide a kind of buffer zone where mis-alignments (which are inevitable) will not result in any of the important DNA code being lost.

Perhaps the best analogy I have heard is to compare the telomeres to the white margin surrounding an important type written document. In this analogy, the printed text is the vital DNA code while the white space is the “blank” telomeres. Imagine that this paper is repeatedly slapped on a copy machine, a copy is made, and then that copy is used to make another copy. Each time the paper is subject to errors of alignment and these errors accumulate. After enough copying, it is probable that the white space will diminish and some of the actual text will not be copied. That’s what happens inside our cells and it is the reason we get old and die.

As any cell gets older, it is under attack by oxides and free-radicals in the body and environment. We survive as living beings because our cells have the ability to duplicate and replace themselves before being killed by these natural causes. Each time our cells divide, the DNA molecule makes a new copy of itself.

DNA is a complex molecule that resembles a spiral ladder. When it divides, it splits along the “rungs” then each half of this “ladder” rebuilds the missing half — viola! — two DNA molecules. Now the cell can divide. The old cell dies and the new cell continues on.

Screen Shot 2017-11-19 at 11.04.34 AM

But the procedure is very complex and not perfect. Usually a small portion of the DNA molecule is lost, misaligned and not copied. Since errors are more frequent on the ends of the DNA molecule, this area, the telomere, does not contain any important DNA information and the effect is insignificant.

Telomeres — programmed to die!

Scientists observe that the length of telomere chains becomes shorter as we grow older. Eventually the telomeres become so short that cell replication produces lethal errors or missing pieces in the DNA sequence, ending the cell’s ability to replace itself. This point, when the cell has lost vital DNA code and cannot reproduce, is called the Hayflick limit. It’s the measure of how many times a cell can copy itself before it dies.

Some cells in our body have a very high hayflick limit. Cells that line the inside of your mouth and intestines, for example, are constantly being worn away and replaced. Indeed these cells appear to have the ability to regrow telomeres even in aged bodies. Scientists were curious why some cells shut down telomere growth with age, and some do not.

Dr. Langmore used physical, biochemical, and genetic techniques to study the structure and function of telomeres. His group developed a cell-free system to reconstitute functional model telomeres using synthetic DNA, and studied the mechanism by which telomeres normally stabilize chromosomes and how shortening of the telomeres could cause instability.

The protein factors responsible for stabilizing the ends of chromosomes are being identified, cloned, and studied. Electron microscopy is used to directly visualize the structure of the model telomeres. Dr. Langmore’s group used new enzymatic assays to determine the structure of telomere DNA in normal and abnormal cells grown in vivo and in vitro, in order to address specific hypotheses about the role of telomeres in aging and cancer. It’s exciting research, for sure, and there have been some promising discoveries.

Scientists have discovered an important enzyme that can turn the telomere production on the DNA molecule “on” and “off.” It’s called telomerase. Not surprisingly, it seems that as we get older, the amount of telomerase in our cells decreases.

The Cancer Problem

You might be wondering why biologists don’t simply find a way to keep our body’s telomeres long. This would prevent replication errors and humans could live indefinitely. The big problem is cancer.

Usually, if a cell makes an error in copying itself, the error will prevent the cell from duplicating itself in the future. So the mistake is limited. But with cancer, cells with errors somehow “turn on” the production of telomerase and make the mutant cell immortal. Now, aberrant cells can reproduce unchecked and outlive normal cells. This is the process that creates tumors.

Since we all have mutant, pre-cancerous cells in our bodies, nature has decided to shut off the telomerase as we age, thus preventing these mutant cells from growing telomeres. It’s a kind of programmed death — a trade off to reduce our lifespan in order to save us from being riddled with tumors. Nevertheless, some pre-cancerous cells manage to re-activate their telomeres and this has caused the research to focus more on blocking telomere production rather than trying to extend it.

[Right: A 3-d rendering of the telomerase enzyme.] The molecular structure shows an interesting “groove” (show in green) where the enzyme attaches to the end of the DNA molecule.

Ant-cancer researchers believe that by introducing a molecule to block this groove, the telomerase would become unable to attach itself to the DNA and thereby limit the length of telomere production. While this work holds hope for stopping tumor cells from reproducing forever, it does little to extend healthy cells from being rejuvinated. However, if the molecular “blocker” could specifically target only cancerous cells, without blocking telomerase activity in healthy cells, it could be a step towards human life extension if and when a pharmaceutical can be developed that activates telomerase in the human body. [4]

Interview with Dr. LangmoreViewzone asked Dr. Langmore to give us his thoughts on the role of telomerase, and the possibilities of using it to repair and lengthen telomeres in human cells. His comments follow:

Telomeres are special, essential DNA sequences at both ends of each chromosome. Each time chromosomes replicate a small amount of the DNA at both ends is lost, by an uncertain mechanism. Because human telomeres shorten at a much faster rate than many lower organisms, we speculate that this telomere shortening probably has a beneficial effect for humans, namely mortality. The telomere hypothesis of aging postulates that as the telomeres naturally shorten during the lifetime of an individual, a signal or set of signals is given to the cells to cause the cells to cease growing (senesce). At birth, human telomeres are about 10,000 base pairs long, but by 100 years of age this has been reduced to about 5,000 base pairs.

Telomerase is actually an enzyme (a catalytic protein) that is able to arrest or reverse this shortening process. Normally, telomerase is only used to increase the length of telomeres during the formation of sperm and perhaps eggs, thus ensuring that our offspring inherit long “young” telomeres to propagate the species.

ViewZone: How is mortality in non-germ line cells a beneficial effect?Dr. Langmore: The telomere hypothesis of cancer is that the function of telomere shortening is to cause cells that have lost normal control over growth to senesce (i.e. stop growing) before being able to replicate enough times to become a tumor, thus decreasing the frequency of cancer.

Immortal cells like cancer have an unfair advantage over normal human cells which are designed to senesce. But nature seems to have planned this human telomere shortening perhaps to prolong life by hindering the otherwise unchecked growth of non-immortal or benign tumors. Malignant, or immortal tumors can simply outlive the rest of the organism.

Malignant cancer cells are being studied because they appear to have altered the shortening of telomeres by turning “on” the telomerase. Thus it appears that some cancers and aging are both connected with the biology of telomeres.

It is possible that increasing telomerase activity in normal cells might stop the biological clock of aging, yet the side effect of this intervention might be an increase in the rate of cancer. Further understanding and refinement in the telomere hypothesis might lead to a way to slow the aging process and prevent or arrest cancer.

However telomeres function, they are an integral part in the very complex process of cell growth, involving many other factors as well. Telomerase might be the Achilles Heal of aging and cancer, but as our understanding of factors that interact with telomerase, factors that are responsible for telomere shortening in the first place, and non-telomerase mechanisms for increasing the length of telomeres, we might find that one of these factors is more easily manipulated to slow aging or prevent cancer. Also there are additional factors that affect aging and cancer, which might prove in the end to be more important than telomeres and telomerase.

ViewZone: Are telomeres unique to individual DNA? If so, does this preclude any universal treatment for aging?

Dr. Langmore: Different individuals have telomeres with exactly the same DNA sequence but of different lengths. It is too early to say whether there is any relationship between telomere length in an individual and his or her life expectancy, or whether a treatment that would artificially lengthen telomeres would arrest (or reverse) the aging process. One problem is that even in one individual the telomeres of different chromosomes have very different lengths. Therefore an individual might have on average long telomeres; but, he might have one chromosome with a very short telomere that could affect cell growth.

ViewZone: In the work of Shay and Wright (see below), increased telomere length was positively associated with telomerase. How significant is this?

Dr. Langmore: Shay, Wright and all their many collaborators stimulated telomerase activity in normal cells. This was expected to 1) Increase the length of telomeres and 2) Prolong the lifetime of the cells in tissue culture. The treatment did both, in perfect agreement with the telomere hypothesis of aging.

ViewZone: How much was cell lifetime prolonged due to this treatment that reactivated telomerase?

Dr. Langmore: The increased proliferation of the cells was perhaps equivalent to hundreds of years of human life.

Dr. Langmore received his Ph.D. degree from the University of Chicago in 1975. He has held postdoctoral fellowships at the Laboratory of Molecular Biology in Cambridge and at the University of Basel.


[Above:] One of the more surprising developments in telomere structure was the discovery by collaborative efforts from Jack Griffith’s and Titia de Lange’s groups that mammalian telomeres looped back on themselves to form large lariat-like structures, called t-loops (Griffith et al., 1999).

This structure may help to conceal the end of the molecule from DNA damage surveillance mechanisms and guard against recognition of the chromosome terminus as a double-strand break.

More links to cancer

In the March 15 issue of the European Molecular Biology Organization (EMBO) Journal, Dr. Jerry Shay and Dr. Woodring Wright, both professors of cell biology and neuroscience at UT Southwestern Medical Center at Dallas, report manipulating the length of telomeres to alter the life span of human cells. Shay and Wright are the first to report this important finding. They received an Allied-Signal Award for Research on Aging to explore this line of research last year.

“By lengthening the telomere, we were able to extend the life of the cell hybrids,” Wright explained. “This study is strong evidence that telomere length is the clock that counts cell divisions.”

“The expression of the enzyme telomerase maintains stable telomere length. Telomerase is not detected in normal cells and telomeres shorten and then the cells stop dividing and enter a phase called cellular senescence.”

Shay and Wright have shown in earlier studies that telomeres maintain their length in almost all human cancer cell lines. This correlated with inappropriate expression of telomerase and as a consequence allowed the cell to become “immortal.” Cell immortality is a critical and perhaps rate-limiting step for almost all cancers to progress. Previous work by the UT Southwestern investigators showed that in a special group of advanced pediatric cancers the lack of telomerase activity correlated with critically shortened telomeres and cancer remission.

Naturally, the exploration of this enzyme is now the focus of much investigation, but for now the research is aimed at understanding how to turn telomeres “off” to limit the spread of “immortal” cancer cells.

Abnormally high levels of telomerase have been found in cancerous breast cells and have been evident in many kinds of tumors.[1]

Consequently, an idea gaining momentum is that the ability to measure and perhaps alter telomere length and/or telomerase activity may give physicians new diagnostic and treatment tools for managing the care of patients with cancer.

Shay and Wright tried to alter already-immortal cells by attempting to inhibit telomerase activity and cause telomeres to shorten. “Unexpectedly, we found the opposite result. Rather than inhibiting telomerase, our treatment caused the immortal cells to develop longer telomeres,” Shay explained. “Although we were surprised with the result, we now know there is a causal relationship between telomere length and the proliferate capacity of cells.

“Essentially, we combined the tumor cells containing experimentally elongated telomeres with normal cells and extended the life span of those cell hybrids compared to similar hybrids using cells without experimentally elongated telomeres.”

Shay and Wright said the mechanism that causes telomeres to lengthen is still unclear. However, Shay said, “Our observations increase confidence in the hypothesis that immortal cells and reactivated telomerase are essential components of human tumors. Ultimately, we may be able to regulate tumor cells by inhibiting telomerase activity.”

The potential implications for research on human aging also are significant. “It is still speculative, but understanding the role of telomere shortening in cell aging may give us the information we need to increase the life span of an organism,” Wright said. (News Releases from UT Southwestern)



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Some data from the WHO for the elderly


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