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Healthy for 100 Years

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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.

For more on aging gracefully, click here.

References:

[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.

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