The recipe for a long and healthy life
Do you want to live to 100?
For most of us, a long and well-lived life sounds rather tempting. So what can we do to get as much out of life as we can, for as long as we can?
It turns out we know some important things about what influences longevity; there's even a fun game online that will estimate how old you'll live to be. All you have to do is answer 40 quick questions related to your health and family history and a calculator (at the end of this post) will do the rest.
I'm not of course making light of issues of life and death; I call this calculator a game only to emphasize that we can't really know our destiny.
On the other hand, this calculator, designed by Boston University Medical School geriatrician Thomas Perls, can teach us quite a lot about what science knows-and doesn't know-about what influences longevity. It also offers some excellent health and nutrition advice. Dr. Perls is head of the New England Centenarian Study and is following some 1500 people, including centenarians and their families, and has looked at what made these people reach healthy old age.
One of the exciting findings of this ongoing study is that if you can escape common chronic diseases, such as heart disease, stroke, cancer, diabetes and Alzheimer's in your 60s 70s and even 80s, you're on the path to seeing 100. Centenarians generally have a really good quality of life into their 90s, and it seems that aging is delayed by decades for them. As Dr. Perls says: "The older you get, the healthier you've been".
The recipe for longevity
Let's start with what's unfortunately beyond our control: Longevity runs in families. More than 50 percent of centenarians have first degree relatives who lived to a very old age.
If you want to live to be 100 you'll also want to be born a woman. The centenarian club is 85 percent females. Sorry, guys!
Setting those statistical realities aside, most of us have more control over how long we live than we think. The other components of what makes for a healthy and long life have to do with a healthy lifestyle.
Here's my recipe:
• Eat well
Living to 100 is much more likely if you have a healthy weight-very few centenarians are obese and in fact, most of the men are lean. But nutrition goals go beyond achieving a healthy weight: The diet that's most linked to lower risk of chronic disease and a longer life is one that emphasizes moderation, and relies on mostly plant-based foods and less on animal products. It definitely doesn't include much processed food and it doesn't resemble the typical Western or American diet. But you needn't necessarily become vegetarian. The longest living Americans (as a group) are probably The Seventh Day Adventists, whose health habits-dictated by their religion-include vegetarianism. The classic Mediterranean diet-also associated in studies with good health and a longer lifespan-is also plant-rich and relies on vegetables, fruits, beans and grains, fish and a little meat and poultry. It is, in my opinion, extremely delicious, very practical and relatively easy to cook.
On the other hand, the island of Okinawa, Japan, is home to some of the leanest and longest-lived people on earth . Their diet isn't vegetarian but light in calories and heavy with plants. They eat mainly foods with low caloric density.
• Don't Smoke! There's no doubt about it-smoking is the cause of many serious diseases and shortens life. There are very few people with a substantial smoking history that achieved long and healthy lives and they're the exception which proves the rule.
• Exercise
Physical activity is key for health maintenance and for prolonging life. Physical activity doesn't require a gym membership, running a marathon or the latest exercise trend. Walking and leading an active lifestyle are much more typical of the studied centenarians. If you want to keep your mind fully engaged you'll need to exercise your brain, too. Mental stimulation improves brain function and protects against cognitive decline, as does physical exercise.
• Reduce stress
Long-lived people seem to be better at handling stress.
There is no universal recipe for stress reduction, though. I personally find that being out in nature is the best stress-relief-it beats even yoga. But I'll admit I forget all about the importance of stress reduction when I'm busy and stressed.
Social connectedness also appears often in recipes for healthy and long lives. Are meaningful relationships also a tool in stress reduction? Probably, although some might argue with that as they recall, for example, stressful family gatherings.
Dr. Perls also advises good sleep, aspirin (although aspirin for healthy people that aren't at special risk for heart attacks is falling out of favor lately) and tooth flossing for a longer life-but the topics above are generally considered the biggies.
What about supplements and anti-aging hormones?
Simply stated, there's no substantial proof that vitamin supplements (excluding vitamin D and calcium, which do seem to have a role in protecting postmenopausal bones) prolong life or prevent disease. The only thing vitamins prevent is vitamin deficiency, which is rare.
Neither multivitamins, nor individual vitamins and minerals, fared well in good quality clinical trials.
The National Institutes of Health gathered an expert panel to review the literature on multivitamins and supplements for chronic disease prevention in 2006. The consensus report noted:
"Most of the studies we examined do not provide strong evidence for beneficial health-related effects of supplements taken singly, in pairs, or in combinations of three or more…However, several other studies also provide disturbing evidence of risk, such as increased lung cancer risk with β-carotene use among smokers."
Antioxidants, such as vitamins A, C, and E, beta carotene, folate and the mineral selenium, are heavily promoted as disease-prevention and anti-aging tools. But the antioxidant supplements failed miserably in clinical trials; they haven't been shown to protect against heart disease cancer or stroke, and in fact their use has been associated with increased mortality .
The booming anti-aging industry adds to the traditional lifestyle advice and supplement recommendations an array of hormones and drugs; testosterone, human growth hormone, and melatonin are some of the commonly used regimens.
But most doctors see these therapies as extremely questionable: There is no good proof that they work, and they can be quite dangerous. Dr Perls is an outspoken critic of the anti-aging industry and calls it quackery .
Game time:
Try the calculator , get your feedback, and please come back to compare notes. Then let's put in a date for a good hike 55 years from now (that's when I'll be 100).
To our health!
Dr. Ayala
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