Howard S. Friedman, Ph.D.2013-05-18T22:32:09-04:00Howard S. Friedman, Ph.D.http://www.huffingtonpost.com/author/index.php?author=howard-s-friedman-phdCopyright 2008, HuffingtonPost.com, Inc.HuffingtonPost Blogger Feed for Howard S. Friedman, Ph.D.Good old fashioned elbow grease.Healthy for 100 Yearstag:www.huffingtonpost.com,2012:/theblog//3.12956002012-02-24T12:20:00-05:002012-04-25T05:12:01-04:00Howard S. Friedman, Ph.D.http://www.huffingtonpost.com/howard-s-friedman-phd/Note: This column is by Howard S. Friedman, Ph.D. & Ephraim P. Engleman, M.D.
One of us is a 100-year-old physician who has been in an ongoing research study since 1917, and the other is a baby-boomer health researcher who has been heavily involved in conducting that remarkable study. This is a unique case in which we have a lifetime study of unparalleled scope and a physician-participant who lived through it.
It was near the end of the first World War that 7-year-old Ephraim Engleman was identified as a bright child and music prodigy, met psychologist Lewis Terman and began an extensive set of interviews and assessments. Eph and 1,527 other boys and girls have been followed ever since by a group of scientists, including myself, studying longevity. This project is thus different from the usual centenarian study that locates and studies a group of non-perishables who have seen the full century. The problem with most such research is that we don't really want to see if centenarians eat yoghurt, are super-cheery, or take naps; rather, we need to know what they were doing 40, 60 and 80 years ago that led step-by-step to their current good health!
Entering its tenth decade and now called The Longevity Project, the study has collected millions of data points throughout the years. Although the research methods and statistical analyses for studying 1500 individuals across 90 years are mind-bogglingly complex, the good news for laypersons is that the emerging findings are remarkably well-captured by the examples of a life like Dr. Engleman's. There are a variety of paths to a healthy old age but a few core principles raise your chances of beating the odds. The startling thing is their relevance to policy.
Neither of us recommends the usual do-nothing retirement, and in fact Eph is still hard at work at 100. Worried about being a go-getter? The research clearly reveals that the responsible and successful achievers thrived in every way, especially if they were dedicated to things and people beyond themselves. Even at 100.
Of course healthy food, physical activity and prudent decisions matter, but not in the ways you might first think. Both of us love bananas, although Eph no longer buys green bananas. It is clear that eating and activity are parts of -- not the causes of -- a healthy life, and a balanced diet works fine for most people. Neither of us likes inactivity (get out of your chair after reading this!), but we are reasonable with the risks we take. It was a sparsely-travelled rural interstate where Eph got a speeding ticket for doing his age.
But how does one stay responsible, involved, and focused? Here is where the Longevity Project really points to something often overlooked. It is our social ties -- whether through good friendships, or meaningful work or community organizations -- that naturally facilitate the other elements of healthy thriving. For men, a generous, happy marriage helps a lot, and Eph has been married for over 70 years. Women benefit also, but often do quite well if they get rid of the troublesome men in their lives. If you are a master violinist like Eph, keep playing in your chamber group, even at 100. But any social organization involved with bringing out the best in human nature will do; Eph stays active and keeps young in the club dedicated to the arts that he joined in 1937.
No doubt many patients suffer due to bad luck, and we all have our vulnerabilities. There is no point in blaming the victim, but one of the striking findings is the surprising extent to which educated individuals can make their own good or bad luck. It is not an illusion that some people are catastrophes waiting to happen.
Could we have a world filled with many productive, healthy 100-year-olds? It is not so far-fetched. Good genetic endowment is of course important to health and long life, but not as much as most people imagine. Scientists estimate that 20 to 50 percent of the variation in longevity is due directly to the genes we are born with.[1][2] A lot is due to how we proceed step-by-step through the years, a process that depends on community. A key reason some places (like Okinawa, Japan) have so many centenarians is that they have so many 60- and 70-year-olds on healthy pathways. Although our policymakers give lip service to the idea that health depends on lifestyle, it is now much clearer what comprises that lifestyle or how to get there.
What are the lessons of this almost century-long study for good health in this disharmonious election year? They are the amazing health consequences -- yes, health consequences -- and associated economic benefits of promoting a world of responsible individuals thriving in loving relationships, with meaningful, dignified work and cohesive communities. This is a mantra that those of us working for the public health increasingly chant, but perhaps it takes a 100-year-old example in a 90-year study to serve as an inspirational reminder.
If you are interested, The Longevity Project was just published in paperback edition by Plume.
Howard S. Friedman, Ph.D. is a health psychologist and author of The Longevity Project (with L. Martin), and Ephraim P. Engleman M.D., Clinical Professor of Medicine, is a rheumatologist. Both are at the University of California (Riverside / San Francisco respectively).
For more by Howard S. Friedman, Ph.D., click here.
[1] K. Christensen, J.W. Vaupel. "Determinants of longevity: genetic, environmental and medical factors." Journal of Internal Medicine. 1996; 240: 333-41.
[2] Stefan Walter, et al. "A genome-wide association study of aging." Neurobiology of Aging. 32 (2011), 2109.e15-2109.e28.]]>President Obama at 50 -- Is the Job Taking Its Toll, or Is He Thriving on It?tag:www.huffingtonpost.com,2011:/theblog//3.9173762011-08-03T13:51:03-04:002011-10-03T05:12:01-04:00Howard S. Friedman, Ph.D.http://www.huffingtonpost.com/howard-s-friedman-phd/The Longevity Project, where we studied 1500 bright Americans who were first assessed as children in the 1920s. They were followed for their whole lives, and we studied how well they aged and how long they lived. To see how our findings might apply to President Obama (on his 50th birthday), I opened up the book and filled out the assessments -- the quizzes -- a person can use to see how he or she is doing on the long life trajectories; but of course I filled them out as the president might.
The first one is very easy. The Longevity Project found that one of the best predictors of long life is persistence and conscientiousness. Whatever else you think of Mr. Obama, there is no doubt that he strives and persists and plans and is about the least impulsive guy you can imagine! Top score. I then looked at marriage. Here, The Longevity Project found that a man who is suitable to a stable marriage and who gets and stays married to a supportive wife is very likely to live a long life. Check, Mr. Obama has that one nailed.
The Longevity Project found that if your parents divorce during your childhood, that can be a very significant threat to your later health and longevity; but if you have achieved success and feel a sense of accomplishment by young adulthood, then this added risk disappears, and in fact you have learned how to be resilient. Indeed, you may be better able to face the future. I would say that being president of the Harvard Law Review at age 29 counts as some degree of early success, wouldn't you?
Then there is the big issue of the great stresses and challenges of being president. Here, our work discovered one of its most important and amazing findings, namely that striving and pressing forward in a very difficult but meaningful job is not at all a threat to your health. Those who advanced steadily in their challenging careers, and had the power to make things happen, were helped, not harmed, by the stresses. In fact, many of those who worked the hardest lived the longest, especially if their work involved assisting others by working on something bigger than themselves. Naturally, it is hard to imagine advancing higher and being more involved in the lives of other people than being President of the United States.
The discoveries of The Longevity Project give us probabilities and cannot say with certainty how healthy a person will remain and how long any individual will live, but things are looking really good for President Obama, on the longevity front at least. A good scientific guess based on the findings of The Longevity Project is that the challenges of the presidency will help rather than hurt his health, and Mr. Obama likely has many more healthy decades ahead of him.
When we were updating the Facebook page on The Longevity Project, an interesting speculation arose. We have found that having lots of people in your social network--and here I mean the old face-to-face kind of social network -- is a very good predictor of health and long life. Nobody yet knows if having lots of friends in your online Internet social networks is going to be good for your health, but I noticed that the President is liked by over 22 million people on Facebook and has over 9 million followers on Twitter! Methuselah, watch out.
All of my analysis assumes that the President is not sneaking cigarettes in the Rose Garden. So keep a sharp eye out on his lung capacity when he blows out his birthday candles.
]]>Searching for the Secrets to Longevitytag:www.huffingtonpost.com,2011:/theblog//3.8942652011-07-13T16:21:22-04:002011-09-12T05:12:01-04:00Howard S. Friedman, Ph.D.http://www.huffingtonpost.com/howard-s-friedman-phd/How To Live Forever." As a health scientist, Leslie was there with filmmaker Mark Wexler to provide research-based insight into the real reasons why some people stay healthy and live long.
Wexler's intriguing film interviews a gaggle of healthy old people, including my favorite, Jack LaLanne. Jack lived in good health until age 96. I admire Jack because he was always willing to defy the conventional wisdom. Starting as a teenager, Jack set out to keep himself healthy, becoming a nutrition nut ("nut" is his term), a performer (with the first TV fitness show) and a body-builder. He founded one of the first work-out gyms, back in the 1930s! Later in life, Jack was famous for selling a juicer, so that everyone could drink lots of vegetable juice.
But what was really Jack's secret? He did many health-nut things, but which really mattered? From other studies, there is of course now good evidence that staying in shape with strong muscles is generally a healthy obsession -- despite the many doctors who at the time warned against risks of becoming muscle-bound, impotent, and worse. The juicer? Maybe, but there is really no good evidence that vegetable juice is the secret to longevity.
Plus, Jack was not like you and me. In his 40s, he swam the Golden Gate channel while towing a one-ton boat. At around age 60, he swam from Alcatraz Island to Fisherman's Wharf, handcuffed and shackled. I don't know about you, but even if I managed to spend every minute of my life lifting weights in Jack's gym and drinking his vegetable juice, I could never accomplish any of his amazing feats. In other words, Jack differed from the typical person in many ways. Even Jack did not know precisely what his key to good health was.
The good news is that there is a way to find out. The way that I would proceed is to follow a large number of promising, healthy children for their whole lives and see who stays healthy and lives longest. This is exactly what Leslie and I have been doing for the past 20 years.
Our findings (reported in The Longevity Project) reveal many, many other things that Jack did that bode well for good health. For example, after an early divorce, LaLanne married Elaine Doyle in 1959 and stayed happily married to her until his death earlier this year. That is over 50 years! In The Longevity Project (which started in 1921), we discovered that long, happy, supportive marriages are especially good for a man's health. (Not necessarily for women, but that's a different story.)
Our eight-decade research study also discovered that having a successful career, striving for a worthwhile cause and being in daily contact with lots of people are very good predictors of staying healthy and living long. Jack did all of these with a vengeance. And all are being confirmed in the few other life-long studies now ongoing.
On the "Today Show," Leslie pointed out that you cannot understand much about the causes of health and long life by studying only people who succeeded. They don't really know the answer. And they usually don't remember what they were doing 50 or 60 years prior. So why do we keep turning to old people and asking them about the secrets to health and longevity?
Well it makes for a provocative, entertaining film, but it is only a story. In long-term research like the Longevity Project, we can see more clearly how one set of healthy steps brings on other healthy strides, until one is on a healthy path. Health accumulates. This deeper, long-term approach is more difficult to master, but it is the road most taken by individuals destined to stay healthy -- and wind up in a film about how to live forever.
]]>What The Founding Fathers Can Teach Us About Longevitytag:www.huffingtonpost.com,2011:/theblog//3.8893292011-07-04T17:57:14-04:002011-09-03T05:12:02-04:00Howard S. Friedman, Ph.D.http://www.huffingtonpost.com/howard-s-friedman-phd/
The Founding Fathers, like the presidents of today, lived highly stressful lives that were full of hard work. They led lives of rebellion, war and the harshest political strife, as well as lives full of many personal tragedies. They faced the constant pressures of knowing that the well-being and survival of countless others were in their hands and depended upon their successes. Yet they thrived and lived long. How could this be?
In a small sample of individuals, it is impossible to know for sure, but the core of the founders' secret emerged in a 80-year study of the paths to robust health and long life. For the past 20 years, I and my colleagues have been following and analyzing the lives of more than 1,500 bright Americans who were first studied as children back in the 1920s. When they were about ten years old, these children were described and judged by their parents and teachers in astounding detail. They were then followed every five to ten years throughout their lives, regularly describing their personalities, their activities, and their accomplishments and failures. With extensive statistical analyses and numerous validation studies, The Longevity Project isolated the important individual influences on long life; and the findings turned out to fit the founding fathers in amazing correspondence.
The characteristic most basic to long life was persistence. We health researchers call it "conscientiousness" but it often comes down to planning, prudence and persistence, persistence, persistence. Whether you like it or not, a key element to becoming a national leader, both then and now, is a powerful willingness to stick to it. Such individuals do not shun responsibility, avoid adversity, or duck hard work. They do not chill out and they do not take it easy.
One study does not prove the assertion, even when it is an eight-decade study, but more and more research is now confirming the evidence that emerged in The Longevity Project. For example, some presidents in our history were slackers, but yes, there is even a published scientific study showing a positive correlation between conscientiousness and longevity for the 32 American presidents who could be so studied.
As you might guess, some of it is will power. In fact, Adams and Jefferson kept themselves alive until July 4th, as did the fifth president, James Monroe (who also served in the Continental Congress). If Madison (who died June 28th) had managed to hold on for six more days, the first four post-Washington presidents would have all died on the Fourth of July. But it is also much more than will power.
We have found that individuals who persevere and live a meaningful, productive life are the ones most likely to live a long and healthy life: the persistence and involvement naturally bring a whole host of healthy behaviors, psychological reactions, and social relationships. Founders are thrivers and survivors.
Whether it's your mutual fund appealing for greater individual retirement savings, or it's a misguided evaluation of Social Security benefits, the specious argument always goes something like this: Americans born in the year 1900 could expect to live about 49 years. Post-war baby boomers of the late 1940's will live on average to their late 60's, and babies born today have a life expectancy of about 79 years. Therefore, we now need to delay retirements in order to be fair to the next generation and be true to the original aims of the Social Security system. Wrong. There may be good reasons to reform social security, work longer, and save more, but increased longevity isn't one of them. And there may be good reasons to plan for your golden years, but an extra dozen years on the golf course is not very likely at all.
The reality is that the average 1946-born baby boomer retiring this year can expect to live about 18 years. Compare that to his or her grandparents who retired at age 65 in the 1960's and could expect to live 15 years, and you see the proper comparison. The correct evaluation involves life expectancy at age 65, not at birth! The truth, surprising to many, is that the average increase in life expectancy for a 65-year-old is only about three or so years. The increase is even smaller for retirements at ages beyond 65. And the social security retirement age is already being raised by two years (to 67).
The fallacy arises from the fact that life expectancy is measured from birth, but years in retirement is measured from about age 65. Reductions in infant and child mortality have been dramatic during the 20th century, but 65-year-olds today are not strikingly healthier or longer-living than 65-year-olds of the previous generation or two. If life were being extended for decades there would be lots of 115-year-old Americans running around, but there aren't any at all.
These errors about life expectancy in retirement are so seductive that I have seen them not only in politics but in economics, in sociology, and even in a speech by an Ivy League president. It is true there will be many more people in the very, very tiny minority who live to 100, a "striking" but irrelevant increase. It is wonderful that many fewer Americans have heart attacks in their 50's (due to blood pressure and cholesterol meds), but this is not producing a large extension of adult lifespan in old age. Importantly, the great benefit to society -- the dramatic drop in infant and child morbidity and mortality -- has been due mostly to low-cost vaccines and to public health improvements like better sanitation and nutrition.
There are many excellent reasons for able older Americans to keep working beyond age 65 -- health reasons, economic reasons, and national security reasons, and I document some of these in my recent book on The Longevity Project. My own scientific research on aging and longevity -- with an 8-decade monitoring of pathways to long life -- confirms that staying productive is a key element of long-term health and happiness. But the hard truth is that most 65-year-olds today will not be collecting those extra Social Security checks and enjoying an additional dozen or more of the golden years. On average, they'll live only a bit longer than their parents. Increased longevity is not a valid argument for changing social security payouts; it's phony.
The irony is that it probably doesn't have to be this way. There are documented ways to live a longer and healthier life. There's the rub. For half a century now, since the days when President John Kennedy invigorated the President's Council on Physical Fitness and led the way with 50-mile hikes, we have known that major lifestyle changes could reduce medical costs while increasing adult life expectancy significantly. We know what needs to be done but we're very confused about how to make it happen. Our educational interventions are generally ineffective. With an obese, sedentary, junk-food population -- and millions of smokers, alcoholics, drug abusers, reckless drivers, and neglected children -- we don't have to worry that the average American will live an extra dozen or more years in retirement. The costs to everyone's pocketbooks and the serious threats to our aging population are not coming from increasing longevity. With a clearer view of the facts, we can better debate the solutions.
Howard S. Friedman is Distinguished Professor at the University of California in Riverside. His latest book is The Longevity Project: Surprising Discoveries for Health and Long Life from the Landmark Eight-Decade Study. NY: Hudson Street Press.
]]>Does Being Happy Improve Our Health? You Might Be Surprisedtag:www.huffingtonpost.com,2011:/theblog//3.8411652011-04-02T11:35:00-04:002011-11-17T09:02:45-05:00Howard S. Friedman, Ph.D.http://www.huffingtonpost.com/howard-s-friedman-phd/
On the face of it, the idea that an Elizabeth Edwards or any other brave person riddled with cancerous tumors could laugh away the disease -- that they would get better if only they tried really hard to cheer up -- is a form of magical thinking that is terribly implausible. Of course, someone will always offer up an example -- an anecdote of a miraculous recovery -- and there are indeed rare cases of a seemingly miraculous healing. But for every miracle, millions of brave patients succumb. Was it because they did not laugh enough?
Could good cheer open clogged arteries, release insulin to a diabetic or repair a diseased kidney? Not based on any good scientific studies that I've ever read (and I've read thousands of studies). Well, how about helping us fight the common cold, which is self-limiting, and from which almost everyone soon recovers, whether they are watching "Seinfeld," "Glee," a vampire show or "PBS NewsHour"? OK, I'll grant that perhaps a TV diet of "Grey's Anatomy," "House," and "Private Practice" might improve your medical astuteness, but that's hardly a case of cheery self-healing.
The false idea that good cheer is the key to good health arises from the very common observation that contented people are often healthy people. This is undoubtedly true. It has been documented in many ways in many studies. Of course, it is also true that healthy people tend to be happier than people careening from one health problem to another. So, is happiness causing good health, or is good health causing happiness? Most of the time, neither is correct.
Because happiness is associated with good health, some scientists looked around for causal links in human biology; that is, they searched for the hormones and blood cells that might account for this correlation. There, in plain sight for happiness researchers, were striking discoveries made by neuroscientists in the 1970s and '80s, namely the findings that the immune system can be affected by hormones associated with emotions. In fact the hormones associated with stress are a key component of immune system responses. Voilà, a light bulb went on: Maybe good cheer revs up the immune system and knocks out those nasty cancer cells and cholesterol clots! Not so fast.
There's a problem. I hate to be the one to switch off the voilà light bulb, but the evidence is slim to nonexistent that people who cheer themselves up will boost their immunity, beat back their cancers and atherosclerosis, and thereby live long, healthy lives. It's true that pieces of this process have been documented in rats, and occasionally in primates like monkeys, but I always wonder how one measures the happiness of rats! And anyway, rats do not watch "Seinfeld," and even monkeys do not watch "Glee."
So why are happy people healthier if their happiness is not affecting their health? I and my research collaborators have been looking at this issue for the past twenty years, as part of a detailed scientific study we call The Longevity Project. Following over 1,500 Americans across many decades, we have found that the same behaviors, personalities, friendships and careers that make you happy are the ones that help you stay healthy.
Happiness did not emerge as the cause of good health and long life. Instead, happiness and health were both results of certain patterns of living. We found that there are many things that you can do to simultaneously promote your happiness and your health (perhaps joining a glee club?), but laughing at your TV screen is definitely not one of them. Just as the amount of news that happens in the world every day always exactly fits the newspaper, it is also true that the links between happiness and health are not what they first seem. If you are interested in seeing the details and mapping the contours of your own life's trajectory, we provide self-quizzes and plenty of real-life examples in our book on The Longevity Project.
The striking scientific findings in The Longevity Project upend the common advice from the lands of laugh therapy, self-esteem clinics and highly indulgent parents. In fact, worrying turned out to be a very good thing. Many of the boys, girls, men and women we studied for so many years were happy and healthy because of the meaningful lives they led -- that is, lives full of dedicated work, genuine friends and dependable lifestyles. And yes, the accompanying stressful challenges were part of the secret. Laughter and pleasure from the joys of accomplishment and involvement turned out to be an indicator of good health. But watching the funniest TV shows all evening while you sit and snack is definitely not the ticket to health. "Cheer up and live long" is a dead-end myth.
I used to wonder why people would turn to a scientist to ask a question about the supernatural -- does praying extend life? There is of course an intellectual problem involved, and scholarly interest in such matters traces back several hundred years to the philosopher David Hume, who wrote about the reasoning and evidence needed to establish the existence of miracles. But these days, I think people ask about prayer because the "science" of modern medicine is often too quick to reduce health to simple mechanical cause-and-effect relations, and so many patients feel a dissatisfaction and frustration with sterile medical care that sidesteps the human spirit.
Lots of studies show that religious people tend to live longer, but the studies usually have little idea why. (An obvious exception -- where the reason is clear -- involves those rare cases that examine non-smoking religious groups.) Because we cannot randomly assign individuals to an experiment in which some are religious and some are not, the best study would be one that follows people throughout their lives, measuring their religiosity and other characteristics. This is what we did; it is the first such study ever done. At various points in their lives, from childhood on, the participants reported on their religious instruction, their Bible reading, their worship, the extent to which they were religiously inclined, and much more.
Our findings confirmed that individuals who were religious, especially women, were more likely to live longer lives. But why? The very religious women tended to be quite friendly and sociable, but were also inclined to be worriers. We found that we could explain their long lives by taking into account their outgoing-yet-worrying personalities, and their good, helpful social ties and behaviors. In other words, for these individuals, religion was a core and stable part of who they were and how they behaved -- and it served them well in terms of long life. But there was more!
It was the least religious women who were, on average, least likely to live a very long life. These women were not religious in young adulthood and stayed that way throughout their lives. They were generally bright and productive but they were less likely to be very extroverted and trusting, less likely to get and stay married, and less likely to have children or to be extensively involved in helping others. Herein lay the core of our striking finding: overall it was not religiosity per se that was so important to long life, although it helped many women. Rather it was the characteristics that tended to go along with being religious that explained why these women lived longer. Those who gradually left their religious involvement were at high risk if they also let their community involvement falter and diminish. We found that the social engagement that is so much a part of religious community is one key explanation for the health of many religious people. Yes, those who prayed together, stayed together, and helped each other stay healthy. Naturally, many people found deep social ties and a meaningful community outside religion, and they thrived as well.
What about spirituality? We did uncover various hints of the health importance of a deeper meaning in life. Of course, many people live a consequential, purposeful life outside of any religious context; but many others find such meaning through religious wisdom. In The Longevity Project, we profile a man, Douglas Kelly, for whom meaning was everything. Kelly worked for the U.S. Army in 1946 evaluating some of the highest-ranking Nazis in preparation for their war-crimes trials in Nuremberg. But evidently, this life-changing experience with horror shattered Kelly's sense of agency and meaning, and he met a shocking early death. Those who developed catastrophizing, negative thought patterns were inclined to precipitous actions, injuries, accidents, suicides and related risks.
While we cannot provide empirical confirmation about whether being pious is important to gaining eternal life, The Longevity Project did uncover good evidence that at least some aspects of congregational participation can be relevant to the length of one's mortal life. It was the social involvement and service to others that went along with being religious that explained why these people, especially the religious women, lived longer. You may have heard the old saw that says, "The best of Men cannot suspend their Fate; The Good die early, and the Bad die late." This turned out to be myth! Instead, we sum it all up by saying, "It is the Good ones who can actually help shape their fate; The Bad die early, and the Good do great!"
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