'How to Live to 100'

Copy of this 11-year old article found here:
http://www.bumc.bu.edu/Dept/Content.aspx?DepartmentID=361&PageID=5900

Newsweek
How to Live to 100
Decrepitude isn't inevitable. New research shows we all have the tools to live longer lives and die faster deaths.
June 30, 1997

By Geoffrey Cowley


At 104, Angeline Strandal doesn't place much stock in doctors. "If they start poking around you," she says, "they'll only make you sick." The Massachusetts centenarian does go in for a physical once in a while, but she hasn't been seriously ill since the time she came down with appendicitis--in 1925. "People ask me what I eat," she says. "I'm a vegetarian, more or less. I never smoked. I don't drink either. That's one of my good qualities. And I keep my bedroom window open 365 days a year." Strandal has outlived 11 siblings and a husband, who died back in 1931, but she still cooks every day except Sunday for her 67-year-old daughter and her 69-year-old son. She also catches a daily mass on TV, roots faithfully for the Boston Red Sox and loves nothing more than a good heavyweight fight. "Every day I ask God to give me one more day," she muses. "And believe it or not, he does."

We baby boomers may soon find ourselves emulating Angeline Strandal, or someone like her, as devoutly as we once did Jim Morrison. We've watched our parents or grandparents die in their 70s--often sick, lonely and helpless--and we're beginning to sense that life should be longer and richer than that. "When the boomers started turning 50, it was like the start of the Oklahoma land rush," says Dan Perry, director of the Washington-based Alliance for Aging Research. Surveys by Perry's organization suggest that today's 50-year-olds are suddenly serious about living to 100, and keen to get there in reasonably good health.

"They don't want to spend any time at all in a nursing home," he says. "The fear of losing independence and the ability to fend for oneself is overwhelming."

Well, it turns out we may have a say in the matter. A growing body of research suggests that chronic illness is not an inevitable consequence of aging, as we've long believed, but more often the result of lifestyle choices that we're perfectly free to reject. "People used to say, 'Who would want to be 100?' " says Dr. Thomas Perls, an instructor at Harvard Medical School and director of the New England Centenarian Study. "Now they're realizing it's an opportunity." So are booksellers and magazine publishers. "Live long, die fast," the dust jackets urge us. "Dare to be 100." Many of us will fall short of that number simply through bad genes or bad luck. And high-tech medicine isn't likely to change the outlook dramatically; drugs and surgery can do only so much to sustain a body once it starts to fail. But there is no question we can lengthen our lives while shortening our deaths. The tools already exist, and they're within virtually everyone's reach.

Life expectancy in the United States has nearly doubled since Angeline Strandal was a kid--from 47 years to 76 years. And though centenarians are still rare, they now constitute the fastest-growing segment of the U.S. population. Their ranks have increased 16-fold over the past six decades--from 3,700 in 1940 to roughly 61,000 today. And the explosion is just getting started. The Census Bureau projects that one in nine baby boomers (9 million of the 80 million people born between 1946 and 1964) will survive into their late 90s, and that one in 26 (or 3 million) will reach 100. "A century ago, the odds of living that long were about one in 500," says Lynn Adler, founder of the National Centenarian Awareness Project and the author of "Centenarians: The Bonus Years." "That's how far we've come." If decrepitude were an inevitable part of aging, these burgeoning numbers would spell trouble. But the evidence suggests that Americans are living better, as well as longer. The disability rate among people older than 65 has fallen steadily since the early 1980s, according to Duke University demographer Kenneth Manton, and a shrinking percentage of seniors are plagued by hypertension, arteriosclerosis and dementia. Moreover, researchers have found that the oldest of the old often enjoy better health than people in their 70s. The 79 centenarians in Perls's New England study have all lived independently through their early 90s, taking an average of just one medication. And when the time comes for these hearty souls to die, they don't linger. In a 1995 study, James Lubitz of the Health Care Financing Administration calculated that medical expenditures for the last two years of life--statistically the most expensive--average $22,600 for people who die at 70, but just $8,300 for those who make it past 100.

These insights have spawned a revolution in the science of aging. "Until recently, there was so much preoccupation with disease that little work was done on the characteristics that permit people to do well," says Dr. John Rowe, the New York geriatrician who heads the MacArthur Foundation's Research Network on Successful Aging. Over the past decade, Rowe's group and others have published hundreds of studies elucidating the factors that help people glide through their later years with clear minds and strong bodies. The research confirms the old saw that it pays to choose your parents well. But the way we age depends less on who we are than on how we live--what we eat, how much we exercise and how we employ our minds.

The Magic of Exercise

Suppose there was a potion that could keep you strong and trim as you aged, while protecting your heart and bones; improving your mood, sleep and memory; warding off breast and colon cancer, and reducing your overall risk of dying prematurely.

Respectable studies have shown that exercise can have all those benefits--even for people who take it up late in life. Experts now agree that most of the physical decline that older people suffer stems not from age but from simple disuse. When we sit all day, year after year, our bones, muscles and organ systems atrophy. But exercise can preserve and even revive them.

When Dr. Ralph Paffenbarger started tracking the health of 19,000 Harvard and University of Pennsylvania alumni back in the early 1960s, many experts thought vigorous exercise was downright dangerous for people over 50. But by monitoring the volunteers' activity levels and health status over the years, the Stanford epidemiologist turned that wisdom on its head. In a landmark 1986 study, Paffenbarger showed that the participants' death rates fell in direct proportion to the number of calories they burned each week. Those burning 2,000 a week (roughly the number it takes to walk 20 miles) suffered only half the annual mortality of the couch potatoes, thanks mainly to a lower rate of heart disease.

The alumni study wasn't set up to gauge the benefits of any particular exercise regimen, but subsequent studies have shown that different activities bring different rewards. Everyone now agrees that aerobic exercise preserves the heart, lungs and brain. And researchers at Tufts University have recently shown that weight lifting can do as much for the frail elderly as it does for high-school jocks. When Dr. Maria Fiatarone got 10 chronically ill nursing-home residents to lift weights three times a week for two months, the participants' average walking speed nearly tripled, and their balance improved by half. Two had the audacity to throw away their canes.

Miriam Nelson, another Tufts researcher, has since shown how a series of simple strength-training exercises could help keep women from resorting to canes in the first place. She recruited 40 volunteers--all past menopause, none taking estrogen--and split them into two groups. Half continued life as usual, while the other half went to Tufts twice a week to pump iron. Over the course of a year, the women in the control group suffered a predictable loss of bone density, but the weight lifters enjoyed slight increases. They didn't lose weight (that wasn't the goal), but they lost fat, and many ended up measurably stronger than their daughters, who were 30 to 40 years younger. Dorothy Barron, who was 64 when she joined Nelson's experiment, says the experience not only remodeled her body but gave her more energy and confidence than she had had since her youth. Five years later, she still lifts weights--and she has added power walking, horseback riding and white-water rafting to her hobbies. When people ask why she pushes herself so hard, she replies, "I'm too old not to."

Eating to Nourish Long Life

We all know that living on fat, salt and empty calories can have a range of nasty consequences, from obesity and impotence to hypertension and heart disease. Yet we seem to forget that there are other ways to eat, and that people who adopt them stay younger longer. George and Gaynel Couron will never forget that lesson. The Sacramento, Calif., couple gave up eating meat back in the early 1920s, when they became Seventh-day Adventists. They eventually strayed from the church and its dietary edicts, but they returned to both in 1943, when George suffered a heart attack. Today he's 100 years old, and Gaynel is 98. They've been married for 81 years and have 14 kids ranging in age from 58 to 80. They have slowed down a bit (they're not planning any more children), but George still takes great delight in growing and eating his own tomatoes, melons, beets, squash and black-eyed peas. As he puts it, "We're still perking along." No one can say exactly what role food has played in the Courons' good fortune, but the age-reversing effects of a plant-based diet are not in question. In controlled studies, San Francisco cardiologist Dean Ornish has shown that a diet based on low-fat, nutrient-rich foods not only prevents heart disease--the Western world's leading cause of early death--but can help reverse it. And other studies suggest that dietary changes could virtually eliminate the high blood pressure that places 50 million older Americans at high risk of stroke, heart attack and kidney failure.

"Hypertension is not an inevitable part of aging," says Dr. Boyd Eaton, an Atlanta-based radiologist who has written extensively on nutrition and chronic illness. "It's a disease of civilization." You wouldn't know that from watching people age in this country. Hypertension afflicts a third of all Americans in their 50s, half of those in their 60s and more than two thirds of those over 70. But preindustrial people don't follow that pattern. Whether they happen to live in China or Africa, Alaska or the Amazon, people in primitive settings experience no change in blood pressure as they age, and the reason is fairly simple: they don't eat processed foods. Dr. Paul Whelton of Tulane University's School of Public Health has spent the past decade tracking 15,000 indigenous Yi people in southwestern China. As long as they eat a traditional diet--rice, a little meat and a lot of fresh fruits and vegetables--these rural farmers virtually never develop hypertension. But when they migrate to nearby towns, their blood pressure starts to rise with age. "Their genes don't change when they move," Whelton says. "Their diet does."

What makes processed food so harmful? Salt is one key suspect. When you subsist mainly on fresh plant foods--as our ancestors did for roughly 7 million years--you get 10 times more potassium than sodium. That 10-to-one ratio is, by Eaton's reasoning, the one our bodies are designed for. But salt is now showered on foods at every stage of processing and preparation (a 4-ounce tomato contains 9 mg of sodium, 4 ounces of bottled tomato sauce nearly 700 mg), while potassium leaches out. As a result, most of us now consume more salt than potassium. "Modern humans are the only mammals that do that," says Eaton, "and we're the only ones that develop hypertension." Correcting that imbalance takes some effort, but it doesn't require moving to the bush. In fact a recent clinical study suggests that dietary changes can reduce blood pressure as markedly as drug treatment, and can produce results in as little as two months. In the study (known as DASH, or Dietary Approaches to Stop Hypertension), researchers at several institutions placed volunteers on one of three diets. Those on a low-fat menu that included 10 daily servings of fresh fruits and vegetables, plus two servings of calcium-rich dairy products, reduced their systolic and diastolic readings by 5.5 mm and 3.0 mm, respectively. And those suffering from hypertension got reductions of twice that magnitude. "We suspected this was possible," says nutritionist Eva Obarzanek of the National Heart, Lung and Blood Institute, the federal agency that sponsored the study. "Now we know the size of the effect."

Researchers have since shown that a simple potassium supplement can bring similar if less dramatic benefits. That's worth knowing, but keep in mind that potassium is just one of countless age fighters found in real food. The antioxidant vitamins in a tomato or a green leaf can help boost immunity and slow the corrosion of aging cell membranes, and the B vitamins may help protect your heart. By eating plants, you also bathe yourself in cancer-fighting phytochemicals, bone-saving calcium and the fiber needed to maintain the colon and modulate blood sugar. Best of all, you can down them by the bushel without getting fat.

Staying Connected and Engaged

Exercise and good food may help keep you going, but successful aging is also a psychological feat. Loneliness, for example, can speed your demise no matter how conscientiously you care for your body. "We go through life surrounded by protective convoys of others," says Robert Kahn, a University of Michigan psychologist who has studied the health effects of companionship. "People who manage to maintain a network of social support do best." One study of elderly heart-attack patients found that those with two or more close associates enjoyed twice the one-year survival rate of those who were completely alone.

Companionship aside, healthy oldsters seem to share a knack for managing stress, a poison that contributes measurably to heart disease, cancer and accidents. Researchers have also linked successful aging to mental stimulation. An idle brain will deteriorate just as surely as an unused leg, notes Dr. Gene Cohen, head of the gerontology center at George Washington University. And just as exercise can prevent muscle atrophy, mental challenges seem to preserve both the mind and the immune system. But what most impresses researchers who study the oldest old is their simple drive and resilience. "People who reach 100 are not quitters," says Adler of the National Centenarian Awareness Project. "They share a remarkable ability to renegotiate life at every turn, to accept the inevitable losses and move on." Merle McEathron knows all about accepting losses. She's 102 today, but she was just 7 when she found her mother dead on the floor at her childhood home in Vincennes, Ind., felled by a heart attack. As the oldest girl in the family, Merle had to raise her baby sister and take over cooking and cleaning for her father and two older brothers ("I stood on a box to reach the range," she recalls). She married at 15, but her man left her at 25, so she started a general store and worked there long enough to put both of her sons through college. The boys were grown by the time World War II came along, but she found other ways to stay busy. She worked as a house mother at the Cadet Club, a military social center, where young airmen took her flying in small warplanes after hours. And when the war ended, she got in her Buick and headed for Arizona.

She was 51 years old by the time she hit Phoenix, but the move brought many adventures, including three more husbands. After dumping one (a dance-hall sax player with a roving eye) and outliving the others, she moved herself into the Eastern Star retirement center to avoid getting lonely. A doctor assured her she would never walk again when she broke her leg four years ago, but she got herself a walker, made her way down to the exercise room and worked the injured limb until she could get around on a cane. Then she threw away the cane. She now walks a mile and a quarter each day, and every September she travels to Indiana for a reunion at the Cadet Club. When she gets there, she climbs over the wing of a restored World War II training plane, crawls into the cockpit behind the pilot and rides that baby into the sky.

With Anne Underwood and Mary Hager
Newsweek 6/30/97 Lifestyle/How to Live to 100

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I emphasized the entire last section because I read this article a long time ago, but I still think about that woman regularly. Screw what the doctor tells you! Such quacks.