Key Actions That Can Improve Health And Longevity After Midlife
From: MrPepper11 (MrPepper11_at_go.com)
Date: 03/08/05
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Date: 8 Mar 2005 06:02:12 -0800
March 8, 2005
The Baby Boomer Tuneup
Research Pinpoints Key Actions That Can Improve Health And Longevity
After Midlife
By ANDREA PETERSEN
Staff Reporter of THE WALL STREET JOURNAL
IT'S NOT TOO LATE. The tricks for a long, healthy life -- don't smoke,
eat right and exercise -- are well-known. But putting that into
practice often seems so daunting that people don't even try, and by
their 50s, many baby boomers figure that the damage has been done
anyway.
Researchers and doctors increasingly agree, however, that even modest
changes in middle age and later can have a dramatic impact on health
and longevity -- that people over 50 can benefit from what effectively
amounts to a tuneup. A recent study funded by the National Institutes
of Health, for example, showed that participants, who had a mean age of
51 and were at high risk of developing diabetes, were able to slash
their risk by half through modest weight loss and exercise.
The problem is that while people over age 65 are less disabled and more
spry than they used to be, there are signs that Americans in their 40s
and 50s are actually less healthy today, according to an analysis of
the annual National Health Interview Survey published last year in the
journal Health Affairs. And with life expectancy on the rise -- it is
now 78.2 years for a 50-year-old man and 82.1 years for a 50-year-old
woman -- boomers could be faced with decades of ill-health if they
don't make changes.
What follows is an effort to cut through the often-conflicting advice
and come up with a list of relatively simple, concrete actions that
people can undertake in middle age to help live a longer, healthier
life. The advice is based on the growing body of research in this area,
and on interviews with doctors, government officials and academics who
specialize in it. They are in addition to the basic screenings that
everyone over 50 should undergo -- regular cholesterol tests and
colon-cancer screening, for example. (For a list of some recommended
tests, see the resource at http://familydoctor.org/x4959.xml from the
American Academy of Family Physicians.)
Some of the advice here highlights risk factors that often arise in
middle age -- such as vitamin deficiencies, marital tension, even gum
disease -- and can have a surprising impact on health. Others are
efforts to simplify complex health guidelines -- on diet or exercise,
for example -- into tasks that can be done reflexively, from the two
vitamins that nearly every boomer should take to three key
weight-bearing exercises that can be done anywhere.
EAT YOUR SPINACH: Among all the research on fruits and vegetables, the
evidence appears to be greatest for the benefits of green, leafy
vegetables. Even far fewer servings than the government recommends can
make a difference.
Research suggests that such vegetables can prevent age-related
diseases, and even preserve cognitive function. A Harvard Medical
School study released last summer found that women who ate eight
servings or more a week of green, leafy vegetables such as spinach and
romaine lettuce had the cognitive function of someone 1.7 years younger
than women who ate three servings or fewer of the vegetables a week.
Scientists think that the reason fruits and vegetables are so
beneficial is that they are high in antioxidants, substances that
protect tissues from degrading. The government's recommendation for
people to eat five to 13 servings of fruits and vegetables a day can
seem pretty unattainable, but doctors say people will get benefits even
from much lower amounts. "Going from two to three servings is much more
important than going from seven to eight," says Walter Willett,
chairman of the department of nutrition at the Harvard School of Public
Health.
BOOST YOUR B12, AND YOUR D: A variety of vitamins, minerals and
nutrients are important for overall health, but we have particular
trouble metabolizing B12 and D as we age. And many nutrition experts
say boomers should take them in supplement form to avoid deficiencies.
A B12 deficiency can cause anemia and has also been linked to
neurological problems. In a study published in the journal Neurology in
2001, those with low levels of B12 and folate (another B vitamin) had
double the risk of developing Alzheimer's disease. Food sources for B12
include fish, eggs and milk and some fortified cereals. But Harvard's
Dr. Willett says the form of B12 in a multivitamin is better absorbed
than that from food. Be sure the brand you choose has 2.4 micrograms
per day.
A multivitamin is also helpful for ensuring adequate intake of vitamin
D; you need at least 1,000 international units per day. Aging skin has
a tougher time absorbing vitamin D, which we largely get through sun
exposure. While admonitions to wear hats and use sunscreen to prevent
skin cancer are wise, that can also further limit our vitamin D.
Vitamin D is essential for calcium absorption, bone health and muscle
strength, and deficiency has also been linked to colon cancer. Fish is
a source of vitamin D, but people can't get enough from food alone, Dr.
Willett says.
FLOSS YOUR TEETH: Everyone knows dental hygiene is important for
healthy teeth. But it is also important for your heart. A growing body
of research shows a link between periodontal disease and stroke and
heart disease.
In a study published last year in the journal Stroke, for example,
those with severe periodontal disease (gum disease) had a 4.3 times
greater risk of stroke than those with either mild or no periodontal
disease. Scientists believe that infection in the mouth increases level
of inflammation in the blood, which can help create blood clots that
lead to strokes and heart attacks. Periodontal disease is most common
in those older than 50.
The best prevention for periodontal disease is to brush and floss at
least once a day and see a dentist for cleanings every six months, says
Sally Cram, a periodontist in Washington, D.C., and a spokeswoman for
the American Dental Association. It can be treated with intense
cleanings and antibiotics.
ANALYZE YOUR SLEEP: Increasingly, doctors are concerned that sleep
apnea, a condition where people periodically stop breathing during
sleep, leads to more than just some annoying snoring. In the past few
years, research has linked it to high blood pressure, stroke and
diabetes. Sleep apnea becomes more common during the late 40s and early
50s.
With age, muscle tone in the mouth diminishes, the tongue falls back to
cover the windpipe more easily and the soft palate is looser. About one
in five adults has at least mild sleep apnea, according to a 2003
article published in the Journal of the American Medical Association.
Data published last year from the large Sleep Heart Health Study showed
that even participants with mild sleep apnea had an increased incidence
of glucose intolerance and insulin resistance, conditions that lead to
diabetes.
Sleep apnea is diagnosed by a physical examination of the mouth and an
overnight sleep study that measures how frequently a patient stops
breathing. Treatments include a special mask worn during sleep, surgery
to shorten the uvula and dental devices.
PUMP IRON: The benefits of strength training to maintain muscle as we
age are well-documented. But it is increasingly clear that strength
training has benefits for the heart as well, and one new effort has
boiled training down to simple exercises that you can do in the home or
office.
Strength training -- or resistance training -- involves controlled
exercise using weights or the force of gravity to strengthen muscles.
Muscle mass begins to decrease by about 5% per decade after the age of
40, so strength training is vital to prevent a host of problems,
including sarcopenia, a loss of muscle mass and strength that puts
people at risk for falls and thus lethal hip fractures.
But new research also shows that strength training has surprising
benefits for the heart, reducing levels of homocysteine, a blood marker
that can indicate risk for heart attacks and strokes. In one 2003 study
by researchers at the University of Virginia in Charlottesville, six
months of resistance training, three times per week, cut homocysteine
levels by more than 5%. Those who didn't train saw a 6% rise in
homocysteine levels.
This doesn't mean you need to start doing bench presses at the gym. The
International Longevity Center, a New York-based nonprofit, is
promoting three simple exercises that provide the benefits of
resistance training without requiring fancy equipment. (See
http://www.ilcusa.org/_lib/pdf/sarcoib1103.pdf for details.)
WALK THE DOG: Aerobic exercise not only reduces blood pressure and the
risk of cardiovascular disease, but it also helps preserve cognitive
function. A study published last year in JAMA showed that women aged 70
to 81 years old who were most active experienced less cognitive decline
that women who were less active. The Centers for Disease Control and
Prevention recommends at least 30 minutes of moderate activity most
days of the week. But leading doctors, including Wojtek Chodzko-Zajko,
head of the department of kinesiology and community health at the
University of Illinois at Urbana-Champaign, say those 30 minutes don't
have to be all at once: A quick walk with the dog, a couple of trips up
the stairs and a few laps around the mall over the course of the day
add up.
KISS YOUR SPOUSE, AND CALL YOUR COLLEGE ROOOMATE: Middle age is a time
when relationships can be rocky as people deal with empty nests,
elderly parents and their own looming retirement, according to
psychiatrists. So it can be particularly valuable to maintain strong
relationships and an active sex life, which research has shown to have
benefits for health and longevity.
"The decade between 50 and 60 is a period of major turbulence," says
Arthur L. Kovacs, a psychologist in Santa Monica, Calif. "Death becomes
a more constant companion and this leads to a kind of stocktaking."
A study published in 1997 that followed 918 Welsh men over a decade
showed those who had the highest frequency of orgasms had half the risk
of death during a 10-year period than those with the lowest frequency.
Friendships are important, too. A study published in Lancet that
followed 1,200 people in Stockholm, Sweden, for three years, showed
that those with a limited social network had a 60% increased risk of
developing dementia.
CHECK YOUR SKIN: The risk of skin cancer soars during midlife, but new
techniques are making it possible to diagnose skin cancer earlier and
treat patients with less pain and scarring.
The average age of onset of melanoma, the most deadly form, is 50. The
average age of onset for other skin cancers is 60, says Andrew J.
Kaufman, assistant clinical professor of medicine at the University of
California, Los Angeles.
One new technique, dubbed dermascopy, uses a magnifying instrument and
an oil placed on the skin that allows light to penetrate the skin's
surface. Since the doctor is better able to see if the spot has
characteristics of cancer, it may allow for earlier diagnosis. It can
also eliminate some unnecessary biopsies. The American Cancer Society
recommends that everyone 40 and older get a yearly body check from a
doctor.
BRUSH UP ON FRENCH VERBS. OR PLAY THE CELLO. OR GO DANCING. There is
now strong evidence to support the common-sense belief that stimulating
activities can help us stay mentally sharp as we age.
The ability to act on new information, to multitask and to retrieve
information from memory all gradually decline beginning in one's 20s.
But it becomes more noticeable after the age of 40, says Molly V.
Wagster, program director of the neuropsychology of aging branch at the
National Institute on Aging.
In a 2003 study published in the New England Journal of Medicine, those
who most frequently read, played board games, played musical
instruments or danced had a 63% reduction in the risk of dementia. In a
2002 study following 801 Catholic nuns and priests, an increase in the
level of cognitive activity was associated with a 33% reduction in the
risk of developing Alzheimer's disease.
GET SCREENED FOR DEPRESSION: There are specific risk factors for
depression at midlife, say mental-health experts, and the signs aren't
always easy to spot, particularly in men.
The good news is that the risk of depression overall goes down after
you hit 40. The dark cloud is that, for men, suicide rates rise after
40. Women also face a slight increased risk of suicide around
menopause, says Douglas G. Jacobs, associate clinical professor of
psychiatry at Harvard Medical School. "Any time you have hormonal
changes, it is going to affect mood," Dr. Jacobs says.
Symptoms of depression include difficulty sleeping, weight change and
feelings of worthlessness. But in some people, especially men,
depression may manifest itself with fatigue, irritability and a lack of
productivity at work. Those with symptoms should consult their doctors.
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