NEW PARMA – may/june 2011

How to choose the right doctor?  Doctor Massimo Spattini is the second Italian doctor who has achieved the certification in A4M Anti-aging Medicine in the United States. He explains to us what we should know.

Massimo Spattini is the second doctor in Italy (together with Doctor Filippo Ongaro, NASA advisor and in charge of ESA – European Space Agency),  who has achieved in Las Vegas the specialization certification in A4M Anti-Aging  Medicine.

What does A4 M mean?

American Academy Anti Aging Medicine (A 4 M) which is an institution founded about 20 years ago by Ronald Klaz and Robert Goldman. They had realized how necessary a new concept of medicine was since traditional medicine did not satisfy the needs of people. Anti-aging Medicine might sound new, but it is actually a return to the traditional Hippocratic concept of the union of the body and mind, that is of man holistically conceived. Traditional medicine has gradually become specialized, losing the global vision which is however fundamental. In fact, medicine must treat the body as a whole, as there is a functional link not only between all the body organs but also between the body and the mind. These concepts have already been expressed in modern Psycho-neuro-immune-endocrinology, which tends to identify strict links between the psyche and the nervous system, the immunological and endocrinologic systems just as if there existed a network of correlated communications between them to ensure the maintenance of health. Therefore, Anti-aging Medicine rediscovers these ancient concepts which had already belonged to traditional Chinese and Ayurveda medicine. Hippocrates himself declared that, in order to remain healthy, a healthy diet and exercise were necessary. Therefore, a more positive view of life and care of oneself. Lifestyle lies at the foundation of Anti-aging Medicine, together with more modern concepts made possible by technological progress such as genomics, that is the study of DNA, that is of our genes and predisposition to diseases. Traditional medicine is based on the treatment of the symptoms whereas Anti-aging is predictive and preventive. That is, the ability to foresee a possible rise of risk and predisposition to a certain pathology gives us the possibility to put into practice all the methods to avoid the occurrence of this risk. Anti-aging Medicine unites cutting edge technology, such as nanotechnology, and technological super miniaturized instruments which allow us to reach the cellular level. It approves of the use of stem cells which in the future might lead to avoid transplant of whole organs thanks to tissue regeneration.

Genomics is arousing a lot of interest, but at the same time we wonder whether it is right or not to know that we are predisposed to a disease rather than to another one… Is it easier to treat than to prevent?

It is a simplistic view. In fact, excluding genetic alterations which inevitably lead to a full-blown disease, the rest refers to a predisposition which might not lead to the disease when a certain style of life is adopted. We can say that one third of our biological destiny is determined by genetics, but two thirds of it is determined by epigenetics. That is, our behaviour, the food we eat, the environment we live in. So if we know that we are predisposed to a disease we might find in us greater motivations and choose to adopt a certain style of life to successfully avoid the occurrence of that disease.

This is a revolution, almost a Copernican revolution, in the sense that we really have the way to understand if a person is predisposed to develop certain diseases and in the near future we will have the technological instruments able to spotlight even at cellular level certain modifications which might lead to a certain even tumor pathology. At present most diagnostic techniques can identify a damage when it has already reached advanced proportions and therefore require invasive interventions or exclude any at all. We will have diagnostic techniques which can prevent tumour occurrence allowing us to intervene with mechanisms of regenerative medicine. At present it has been proven that life style strategies, correct diet and the use of specific integrators can influence our genetic expression. A healthy diet is the fundamental source from which our body gets the substance in order to accomplish its structural and energy tasks. If we ever should build a house with sand instead of cement it is evident that the first earthquake will make it collapse.

All right, but what can we do if we find fruit and vegetables containing pesticides at the supermarket or bread made with contaminated grain? Or if we have time only to eat a sandwich at our lunch break?

It is very difficult, but we are aware, each one of us can do as much as they can. It is obvious that this is in relation to our knowledge as well as to our economical possibilities. There are many variables to take into account. Eating a sandwich for lunch is unfortunately wrong. We must examine the lifestyle of the people who live longest in the world: they are the inhabitants of Okinawa, a number of people over 100 years old 100 times higher than in the USA. Their lifestyle   is fundamentally relaxed, based on a healthy diet of fruit, vegetables, little meat, fish, spices like turmeric which has remarkable antioxidant and anti-tumour effects. They drink large amounts of green tea which is also rich in antioxidants, they do a lot of light exercise…these people do not only live up to 100 years, but, at that age, they perform like people of 70. On the contrary in the Western world  the mean age is 80 years old, but the fundamental question is: in which conditions do they reach a certain age? With  Alzheimer or on a wheel chair?

Yes, but besides the diet, Okinawa must also present other factors.

Certainly, it is a rural society and Okinawa, at present, is a sort of laboratory where many scientists are studying. There can be many factors involved, but in any case their diet has a low glycemic index, that  is, with a low amount of simple sugars and few saturated fats.

So is meat to be avoided?

We must make it clear that the studies carried on the negative effect of meat included encased meat (wurstel, sausages, etc) which actually have a high amount of saturated fats and therefore have negative effects. But if we considered lean meat like chicken or turkey we would obviously have different results. The same applies to fowl because they are animals that feed naturally and not with chemically added seeds or with food that animals do not naturally eat. Consider for example  salmons that are fed with flour mixtures while they would naturally eat shrimps rich in omega 3.

But who can afford to buy wild salmon fished in Alaska?

The advice is that being aware of the importance of a healthy diet (30 to 40 percent of tumours are connected to our diet and the same applies to cardiovascular diseases), we will be able to choose the least harmful diet if not the best. There are other alternatives to a cappuccino and croissant for breakfast, like for example a portion of fruit and yoghurt. As for sandwiches, some salad with an egg or tuna or legumes and a portion of fruit is a better and easy solution. At the restaurant one can choose fish and vegetables or legumes, a slice of bread, a portion of fruit, salad. It is only a matter of choice and one does not have to eat necessarily elaborated food or have first course, second course, dessert and end the meal with spirits and so on only because at the restaurant. In a study carried out on 22444 people, a point was given them for every healthy choice. Healthy choices were for example abstaining from smoking, doing some exercise, drinking very little spirits (from a glass up to 14 glasses of wine in a week, not drinking any alcohol at all is actually worse) taking a dose of vitamin C corresponds to eating five portions of fruit and vegetables. Between those who had scored 4 points and those who had scored 0 points there was a biological age difference of 14 years. They were therefore 14 years younger.

Besides prevention, a healthy diet and style of life, can you give a concrete example of Anti-aging Medicine?

Not long ago a 47 year old woman came to me presenting a very debilitating carpal tunnel syndrome diagnosis at both hands. It is a painful and invalidating wrist oedema causing tingling in the fingers. The therapy she had been advised was to submit herself to an operation. But did anybody investigate what caused it? The woman’s syndrome was linked to a pre-menopausal hormone imbalance which, causing a progesterone deficit, led to hyperoestrogenism, therefore a  oestrogen level rise and water retention. The woman in fact had put on 8 kilos although she had not changed her diet. The woman solved all her problems and avoided the operation after two or three months simply correcting her diet habits, taking integrators which helped her to lose weight and drain the water and submitting herself to a therapy of bio-identical hormones. This is Anti-Aging Medicine: understanding what causes the problem. Who should have done so in this case? An orthopaedist? An endocrinologist as the woman had a progesterone deficit and a surplus of oestrogens? Or a dietician as she had to lose 8 kilos? No. A doctor with a global vision of things and overall competence should have started a treatment also with the help of specialists. Clinical exams are not sufficient. Sometimes there are laboratory problems when, for example, the laboratory results do not give the clinical values of the disease the person presents all the symptoms of. If, for instance, the clinical exams of the TSH test give normal value results, but the subject presents all the clinical aspects linked to hypothyroidism: unjustified gain in weight, a greater sensitivity to the cold, oedema, constipation, drop in body temperature, dry hair, swollen neck, the subject is surely hypothyroid even if the values are normal. There is probably a problem with the receptors non working.

But how can the patient choose the right doctor?

When people have to choose a doctor they can avail themselves of indirect experiences. They can search on the net the kind of competence the doctor has, his educational background, his written works, his collaborations… today it is possible to get all the information you need  in order to make the right choice. The internet allows the patient to get any information on his medical problem and even to expose the doctor…it is impossible to improvise, especially with Anti-aging Medicine.


Are supplements which are sometimes criticized and sometimes abused really useful or not?

The correct use of certain supplements is fundamental for our health and to avoid some types of degenerative diseases ranging from tumours to cardio-vascular ones. However, people often tend to self-prescribe them as a result of the negative campaign against them. If doctors adopted a more positive attitude they would be taken correctly. Unfortunately, people are often bombarded by misleading information. The Mediterranean diet, for example, recommends the use of carbohydrates such as pasta and bread, but this is not the proper Mediterranean diet which is instead based on the consumption of fruit, vegetables, fish, olive oil, legumes and also pasta or better still wholemeal not refined cereal. But there are food lobbies which contribute in giving wrong messages. So we must not be against proteins or excessively against carbohydrates which must be eaten in the right doses depending on the type of person, their physical activity and relative age. The problem is that the information doctors receive comes from their pharmacological informers. And I have the feeling that doctors do not always tend to widen their knowledge, while our profession demands constant updating. But, as the demand for this type of anti-ageing drugs is greater than the offer, I believe doctors will come to accept them for fear of losing this type of patients.



 Anti-ageing Medicine is not very popular at the moment, owing to quite a lot of reasons. One of them is that it goes against many specific interests as, for example, those of the pharmaceutical industries which do not gain from prevention but from treatment. Besides, people more easily swallow a pill rather than adopt a new style of life. However, there are a number of indications connected to the marketing of other products (beauty or vitamins) which prove that there is interest in Anti-ageing. Particularly the so-called baby boomers – that is the people born in the period of the economic boom (from ‘45 to ‘65), at present detaining 70% of the economical power in the world – are very interested in remaining fit, active and vigorous as long as they can and are therefore willing to invest in this direction. At present, there is great demand, but in Italy there is not the corresponding offer, whereas in America more and more Anti ageing clinics are being opened. I have always been very interested in what is happening abroad and, starting from the ‘80s, I have often been to California where I have taken part in internships and seminars in the attempt to acquire cutting edge knowledge. It is important above all in the field of medicine to have a broad outlook, to be open to the outside world. I believe it is fundamental for one’s personal development, and, for me, America has always been the most natural reference point. I have always appreciated the American world because I believe that meritocracy prevails over there, while in Italy not what you know but who you know is so important for one’s career. It is not surprising that during the last Anti-ageing congress which took place in Las Vegas in December 2010, I was the only Italian present on 4000 operators coming from all over the world. This might have been due to the obstacle of a foreign language, to the fact that congresses are not linked to credits or that Pharmaceutical Companies did not sponsor the attendance. In the USA Anti-ageing medicine has been well known and practised for over 20 years and so it is clear that the Americans are well ahead in this field concerning research, organization, health care and the practical application of these concepts.