In recent years increasing numbers of Americans are using alternative approaches to conventional medicine. This includes 39% of people age 50 and older. Aging does not begin at age 65 but occurs across our life span. Physiological, social and psychological changes that occur during midlife can have major effects on health and thereby, the quality and duration of the rest of life. Such changes are particularly significant for women, where declining estrogen levels result in changes in the physiologic profile. Although estrogen therapy is widely recommended to midlife women with long term protection against heart disease, osteoporosis and Alzheimer's disease in mind, estrogen therapy is also associated with increased cancer risk and has side effects and most women choose not to take it. The initial focus of our proposed Center for CAM Research in Aging at Columbia University is on botanical and dietary approaches to clinical concerns of post menopausal women with the goal of rigorous evaluation of the efficacy, mechanisms of action, and possible risks of these approaches. The proposed Center contains three highly interactive clinical research projects and one basic science project, supported by administrative, biostatistical, and clinical research cores. Project One examines the influence of a macrobiotic diet, as compared to the addition of a single food to a typical diet, on various biochemical and cardiovascular parameters that may be influenced by estrogens. Project Two assesses whether these natural, dietary sources of estrogen prevent postmenopausal bone loss, one of the most important current public health challenges. State-of-the-art approaches to measurement of markers of bone formation and bone resorption will be combined with highly sensitive quantitation of bone mass. Project Three is designed to determine whether treatment with herb black cohosh is effective in reducing the frequency and intensity of menopausal host flashes. Project Four examines the bioactivity, mechanisms of action, and potential risks of a widely-used Chinese Herbal formula in cell culture and in vivo. All of the Program Projects are led by Principal Investigators with an active interest in complementary and alternative medicine and extensive experience with both clinical populations and basic research. While the proposed Center for CAM in Aging will initially evaluate dietary and herbal treatments in postmenopausal women, the score of work will be expanded through the Developmental Research Program to include other CAM modalities. In addition, a strong Career Development Program is proposed that will provide a critical link between researchers with an interest in CAM at Columbia and the larger CAM community. The proposed Center will take advantage of the unique institutional resources available at Columbia, will develop an interdisciplinary research program that targets significant health problems of aging, and will conduct the timely education and training of future CAM researchers.
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