Anti-Aging or Successful Aging?

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WRINKLES, GRAYING, slowing reflexes. No wonder many people find the concept of "anti-aging" attractive. Even some physicians subscribe to it, lending credence to the idea that growth hormone boosters and other unproven pharmacologic agents might be able to turn back the march of time.

Kenneth L. Minaker, MD, chief of the Geriatric Medicine Unit at Massachusetts General Hospital in Boston, doesn't buy into that approach. "The term 'anti-aging' bothers me," he says. Granted, he concedes, "there are some unattractive aspects to aging." But he feels that doctors involved in the so-called anti-aging movement "are barking up the wrong tree." Anti-aging is "like anti-living," he comments, because aging is a natural part of what happens in life.

Not that Dr. Minaker believes people shouldn't try to stay healthy into old age. "Aging doesn't have to mean illness, and people shouldn't automatically associate the two," he says. "I'm all for people making personal lifestyle and behavioral decisions that preserve their ability to function over time."

Fortunately, Dr. Minaker notes, a lot of people have been learning how to take care of themselves so that aging is not synonymous with illness. "There are more and more older people in the United States," he observes, "but not more disabled people. Disability rates have been dropping consistently since 1980. That is, people spend more of their old age healthy. There has also been a striking improvement in life expectancy. In 1900, one in 1,500 women lived till 100. Today, one in 40 women can expect to live that long."

What, exactly, are the lifestyle decisions people can make to build into the aging process what Dr. Minaker calls "resilience and vitality"--qualities that will let them remain "young" well into old age and to die as old as possible? Upon going over the scientific literature on old, healthy people who lead full lives, Dr. Minaker has come up with 10 of them.

10 Lifestyle Habits for Successful Aging
Sleep 7 to 8 hours per night. We don't know all the reasons a good night's sleep promotes health and longevity, Dr. Minaker says. But there have been suggestions that people who sleep outside this range of circadian biorhythm are more prone to infection, intimating that proper sleep affects bodily systems such as the immune system.
Control weight. This one's well understood. Excess weight paves the way for heart disease, diabetes, cancer, osteoarthritis--in short, for conditions compromising the well-being of tens of millions of Americans. A loss of as little as 10 extra pounds is often enough to effect such changes as a drop in blood pressure and cholesterol and thereby substantially cut the risk of chronic, debilitating diseases.
Exercise. Vigorous physical activity, just like maintaining a healthier weight, is important for warding off many of the illnesses that plague Americans. Consider that exercise appears to make the body more sensitive to the efforts of the hormone insulin to get sugar out of the blood and into all the organs and other tissues, where it's used for energy. And if sugar leaves the blood more efficiently, that means there's less chance for diabetes to develop. Exercise also keeps the heart and bones strong and staves off muscle wasting, which renders many older people much more frail than the aging process alone would make them.
Limit alcohol intake. While one drink a day for women and two for men is associated with lower heart disease risk, people who drink more than that are at increased risk for cancer of the esophagus, cirrhosis of the liver, and death from accidents and suicides. (Roughly 50 percent of accidental deaths and suicides in the United States are alcohol-related.)
Don't smoke. Smoking is the most preventable cause of death in our society, with tobacco responsible for nearly one in five deaths. Not only are smokers up to 20 times more likely to die of lung cancer than non-smokers, they also are more likely to get cancer of the mouth, kidney, and other organs as well as more likely to end up with heart disease, chronic bronchitis, and emphysema.
Eat breakfast. As with getting a good night's sleep, it's not entirely clear why people who report that they eat breakfast live longer than others. But there may be a psychological effect. If you start out with a nutritious morning repast, such as whole-grain cereal with milk and fruit mixed in or an egg with a slice of whole-wheat toast and a fruit salad or fruit juice, you may be less inclined to "mess that up" with junk-food snacking throughout the day.
Snack seldomly. While not all researchers agree on this point, Dr. Minaker believes we "were meant to be intermittent feeders" rather than all-day grazers.
Why might it be better to eat discrete meals rather than snack throughout the day? "The leading hypothesis is related to insulin," Dr. Minaker notes. Every time you eat, insulin is released to remove the sugar from your blood. And constant surges of "insulin in your bloodstream are related to the development of heart disease," whereas "intermittent spikes of insulin appear better suited to health," he explains.

8. Become more educated. This might seem like a stretch, but "it has some pretty solid grounding," says Dr. Minaker. "If you look at education levels in men and women," he notes, "the more years of schooling you have had, the lower your mortality." In fact, he comments, black men have a life expectancy that's 7 to 10 years shorter than that of white men. But if you match black men to white men based on education level, "the survival difference disappears."

Why? "The hints are that the more educated you are, the more connections there are between nerve cells--the more wiring--to help the brain put forth an idea or plan of action," says Dr. Minaker. Thus, "the better prepared you are to make decisions that allow you to survive."

9. Stay socially connected. There's "a rich body of information in the social science research arena" about this, Dr. Minaker observes, and it's "very profound." Consider, he says, research on people who are highly integrated into their social networks. For instance, in some farming communities in the eastern part of Finland, "if you don't wave back to the postman, he tells someone, and they contact you," Dr. Minaker points out. They literally "build" communities that way, in which people are watching out for other people. And if you compare those communities to others in Finland where the social connections aren't as strong, "the mortality rates are much lower."

It's not just the fact that someone will come to your house if, say, you've fallen or had a heart attack. People who are not socially connected are more likely to "give up," Dr. Minaker says. "And when you give up, you accelerate dying. If you've got a reason to live," on the other hand--because you live with somebody who cares about you or have neighbors who do--"your chances of living a year after a heart attack or hip fracture are much better."

10. Maintain optimism and happiness. Optimists tend to do better than pessimists, Dr. Minaker says. "People who are severely depressed don't live as long"--they're more apt to ignore illnesses and lose or gain weight without taking stock of their health and doing something to correct it.

Much of optimism (or pessimism) is about temperament, which can't be changed. But the more socially connected you choose to be, the more educated, and the better you eat and sleep, the easier it is to maintain an optimistic outlook no matter what your disposition.

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