As a boy, I wanted to live to 100, even before I knew what a centenarian was. I've always attributed this to my close relationship with my grandparents, my fascination with the human body, and even Willard Scott's regular birthday greetings to 100-year-olds on the "Today" show. But, of course, getting to 100 requires more than mere optimism. Remaining healthy means a lifetime of making the best choices based on the best information.
A little background: My interest in the environment and public health is what took me to the wilds of Ecuador, but my wanderlust didn't stop there. I went to medical school in North Carolina, spent some time in Boston doing genetic research on (what else?) centenarians, and then moved to New York City for a residency in internal medicine followed by a fellowship to study geriatrics. Obviously, my medical training has given me the information needed to make healthy choices. But all of us -- no matter what our background -- still have to find our own motivation. I recognized mine when I chose a headline for this column. After all, living to 100 is vastly different from merely surviving to 100.
Six words say it all: Think smart, think ahead, start today. Like almost every physician I know, I can't emphasize prevention enough. Sidestepping future health problems today rather than running headlong into them tomorrow is just common sense. The easiest way to do this? Don't compartmentalize health into a box that you peek into every now and then -- and definitely don't wait until some imaginary, long-away "start date" (such as January 1) to focus on integrating smart choices into daily habits. Here are a few informed choices I have made about my personal health, ideas you can adapt easily to your own fully lived lives.
Many of us are so busy counting calories that we often ignore the cornerstone of a good diet: Four or five cups of fruits and vegetables a day. If you focus on meeting that requirement, the calories will usually take care of themselves. In summer, it's easy. My garden will be winding down in the weeks to come, and I'll miss going outside, picking a ripe tomato, and biting into it a few minutes later on a sandwich. When I plan my garden next year, I know I'll grow baby spinach (because it's chock-full of nutrients) and blueberries (like many other colorful fruits, they are a great source of cancer-fighting antioxidants). Those who can't garden may want to stake out farmers' markets (ams.usda.gov/farmersmarkets/map.htm) or buy a share in a farm cooperative (localharvest.org). As it turns colder, most of us will rely on grocery stores. A fascinating and comprehensive new book, "Foods to Fight Cancer" (DK Publishing; 2007), reviews the compelling evidence for making the produce aisle a main destination.
The American Heart Association recommends 30 minutes of any type of physical activity every day of the week to improve heart health, and you can spread those minutes throughout the day. (But keep in mind that losing weight means exercising longer and harder.) My advice is to make exercise a part of your routine, to find something that interests you and that you like doing. When you enjoy taking a stroll around the neighborhood after dinner or before breakfast, for instance, you'll start calling it your "walk" instead of your "exercise." I make sure I exercise seven days a week, but I vary things: I do weight training, cardiovascular work, and yoga. On days when I can't make it to the gym, I make sure to at least walk to work and back home again (two miles round-trip).
When it comes to eating right and exercising, we can all use a little support. I visualize patients -- and now readers -- as cheerleaders of sorts, because if I don't practice what I teach, what good would my lesson be? Decide who this person is in your life, and discuss your health goals with him or her. Children are great for this. They love to tell their parents what to do. Another option: Check with your health insurance provider. Some offer health-coaching services through their websites.
Anything we bring into our homes or put onto our bodies can affect our health. I use natural or green products whenever I can -- detergents, cleansers, toothpaste, shampoo, etc. If a bathtub cleanser is labeled "nontoxic," for example, that means it's safe for kids and safer for me and the environment. I recently had to replace the wood decking on the terrace of my New York City apartment. I wanted to avoid pressure-treated wood, which is sprayed with chemicals meant to prevent insect infestation yet pose potential environmental and health risks. I opted for composite lumber, which is made from recycled plastic and sawdust. It looks beautiful and works well.
Okay, twist my arm. With the mounting evidence that alcohol may benefit cardiovascular health, and that red wine is rich in resveratrol, a disease-fighting antioxidant, I've started drinking one glass every night with dinner. (I have to skimp on the rhubarb pie to accommodate the roughly 100 calories in a 4-ounce glass.) The benefits of drinking more than that are outweighed by the potential negatives, so I stop there.
Researchers say good things about caffeine (it may help short-term memory and reduce the risk of Parkinson's disease and liver cancer) as well as bad (it may promote high blood pressure and decrease bone density). Me? I'm uncomfortable being so dependent on what is, essentially, a drug. I'd like to wake up just one morning for a change and not start plotting how soon I can get my fix. When I worked 36-hour hospital shifts as an intern, one can of soda would keep me alert, but soon enough it took two to do the trick, and then four. This month I'm going to wean myself off caffeine, starting with just one less ounce a day. Living better and longer means taking an active stance on health maintenance -- taking control instead of letting something else control you.
7. Vitamins, Minerals, and Supplements
Who doesn't want to swallow a pill for better health? Unfortunately, there is little solid evidence that taking a daily supplement does anything for you. Supplements should really be reserved for times when a true need can be documented. For example, if your doctor tells you that you have high levels of homocysteine (a heart-damaging amino acid) you could take a folate supplement, which helps reduce homocysteine levels in the bloodstream. In general, you should consider whether supplements -- many of them quite expensive -- are the best use of your health-care dollars. One recent Danish study found that people who took vitamins A, C, or E got no benefit. Indeed, those participants who took A and E suffered slightly worse outcomes. My advice: Spend the time and money on buying and eating better food, not on supplements.
8. Stress Management
Chronic stress can lead to chronically elevated cortisol levels. Cortisol, the hormone produced during times of stress, has been linked to heart disease and even cancer over the long term. But a good diet and a regular exercise routine, or any activity that makes you feel less stressed, can help lower cortisol levels. For me, walking is a time to process the events of the day.
9. Medical Mindfulness
Know your numbers. By the age of 30, everyone should know their total cholesterol, triglycerides, low-density lipoprotein (LDL), high-density lipoprotein (HDL), blood pressure, and body mass index (BMI). The first three numbers can be lowered by eating less animal fat and fewer carbohydrates and sugars. A low HDL level -- the so-called "good" cholesterol -- can be increased with exercise. I always advise patients to know their blood-pressure stats. Hypertension can be a silent killer that causes kidney disease, cardiovascular disease, and even vascular dementia before it's diagnosed. And knowing your BMI helps you determine where your body falls on the bell curve and set practical exercise goals if necessary. For a simple BMI calculator, check out cdc.gov/nccdphp/dnpa/bmi/index.htm.
While we're waiting for personalized health records to become available on the web, I've posted the templates that I use for my medical records here. If you print these and fill them out, including details about your family history and your own medical history, they will help you have a more productive annual physical. Seeing my own doctor regularly -- in addition to following all the advice I've laid out here -- will help me catch potentially life-threatening problems early.
People with a positive outlook live longer and suffer fewer chronic illnesses than those who don't. That's more than enough reason to keep me smiling all the way to the century mark.
Text by Dr. Brent Ridge