How to Live 100 Healthy Years
SAN FRANCISCO (MarketWatch) — It takes “guts and smarts” to live to 100 and still feel well, says Dr. Walter Bortz, a scientific researcher, author, geriatrician and octogenarian marathon runner.
By now most of us know what we should be doing to protect our health. And for a variety of reasons or excuses — lack of time, money, motivation, long commutes and the like — many of us still aren’t getting enough physical activity.
Dr. Walter Bortz.
Bortz, a Stanford University professor of medicine and author of the book “Next Medicine,” wants to make it easier and more financially attractive for Americans to keep their bodies from falling into disrepair.
For decades, he’s researched and cautioned people about disuse syndrome — a collection of problems such as premature aging and compromised cardiovascular, musculoskeletal and immunological function that results from prolonged disuse and increases the risk of chronic diseases like diabetes.
The most important of Bortz’s 150 scientific papers, he says, came out in 1982. It differentiates physical disuse from aging, reassuring people that they can tune up their bodies to perform better and fight disease more effectively at any age.
“You can’t stop the sands through the hourglass, but you can snug up the aperture,” he says. “It’s not how old you are — it’s how you are old. And that's a choice."
Here are four of Bortz’s health tips, along with four of his proposals for revolutionizing the health-care system:
1. Move more
Physical activity is paramount to a healthy, long life — and you can reap the benefits at any age. The opposite is also true: inactivity can be deadly, Bortz says.
After age 50, you can’t afford to be sedentary. “Exercise for young people is optional,” he says. “Exercise for old people is an imperative.”
What exactly should you do? Any number of things: Walk, run, swim, row, bike or dance. Even sex counts, he says, “if you do it right.” That means getting your heart rate up three times a week for at least a half hour each time. Golf can be good for you, too, provided you ditch the cart and walk.
As you age, your legs become your most important organs, Bortz says. Doing balance exercises also helps you maintain the ability to continue walking into old age.
“It’s never too late to start,” he says of even modest physical activity, “but it’s always too soon to stop.”
2. Own your self-care
Don’t cede control to the “disease cartel,” as Bortz describes the medical industry. Be persistent in improving your health behaviors and build your competence over time. Remove any psychological barriers you may have set up.
For instance, if you hate the way your make-up runs when you exercise, don’t wear it, he says. If you can’t walk very far, make a jaunt around the block your first goal instead of a mile. And take advantage of any incentives your health plan offers to get and stay healthy.
Bortz cites the serenity prayer (“change what you can, accept what you must, but know the difference”) and the work of his friend Albert Bandura, the renowned psychologist, on self-efficacy.
The four steps to achieving self-efficacy, according to Bandura, are small steps of mastery, peer examples, social persuasion and diminishment of cues of failure.
These self-efficacy steps are crucial to helping people maintain their health and reach their potential, Bortz says. “Just like writing a prescription for penicillin, I go down my list of four.”
Of course, there are places where danger rules, making exercise low on the list of priorities. If you feel your neighborhood isn’t safe to walk around in, be creative in finding local authorities willing to address the obstacles. A few years ago, Bortz writes in his book, he and a group of medical students were surprised to find that some residents surveyed in East Palo Alto, Calif., weren’t seeking a visiting nurse or more convenient clinics. Topping their health-services wish list was better control of pit-bull dogs.
3. Stay engaged with life
The old maxim “make yourself useful” applies to healthy aging, Bortz says. Maintain social activity and intellectual pursuits. Fight loneliness.
4. Don’t waste time on anti-aging hoaxes
Longevity “experts” who sell vitamins aimed at helping you live longer are in the snake-oil business, Bortz says, and those who tout the potential to live 150 years or more are ignoring the second law of thermodynamics that makes such a human life expectancy impossible.
How to revamp the system
Here are Bortz’s four strategies for improving the nation’s health-care system.
1. The U.S. needs more nurse practitioners and diabetes educators, who Bortz says have done more to improve people’s health “than all the endocrinologists put together.” There’s a mismatch between the number of procedure-oriented, high-tech specialists available and the demand for health-care providers who spend most of their time talking with and educating patients.
“Doctors are way over- and mal-trained for their job,” he says. “You need health advocates.”
2. Medical education needs to shift away from the intensive-care unit and into the outpatient setting and home-care arenas where more health care is taking place, Bortz says. “Students lament they know every gene or electron but don’t know how to talk to a fat person or a smoker.”
3. AARP should invest in health promotion and embed it in everything they do. The powerful seniors’ lobby has successfully protected Medicare and Social Security but could do more to help people live healthier lives, he says. Connecting seniors with “fitness ambassadors,” he writes, is one idea.
4. Make capitalism work for health rather than against it, Bortz says. The U.S. needs more salaried doctors and integrated nonprofit health systems such as Kaiser Permanente, he argues. They can practice prevention effectively by detecting patients’ potential health problems early through their shared electronic medical-record system, which should result in better quality care and lower health-care costs.
Kristen Gerencher is a reporter for MarketWatch in San Francisco