Why We Live Longer Is More Important Than How Long We Live

I recently came across an article written by Michael Wolff that appeared in New York Magazine titled, "Mom, I Love You. I Also Wish You Were Dead. And I Expect You Do, Too." The gist of the article is that there is no good reason to live longer. The author paints a picture that living longer means a more painful, slow death.

It is a frightful article written by someone who is clearly in pain watching his mother suffer from a terminable illness. However, it is also just plain wrong. The fact that the author makes statements with reckless abandonment may be forgiven given his state of mind. But, I don't believe for one moment that what he has to say is true in most cases of extended longevity.  Why? Because the scientific facts speak otherwise.

A recent study from the Longevity Genes Project, launched by the Albert Einstein College of Medicine in New York City, supports my assertion. The results of the study, focused on near-centenarians, showed that the majority of  them were found to be "relaxed, friendly, conscientious and upbeat about life." Importantly, added the authors, "an easy laugh and an active social life were observed to be a group norm, while neuroticism was notably the exception. What's more, feelings were more commonly shared as they arose, rather than stifled and squelched." Not quite the doom and gloom reported by Mr. Wolff.

Mr. Wolff would have his readers believe that dementia strikes virtually everyone as we age. In fact, less than 50% of Americans over 85 develop dementia and about a quarter of all dementias are now directly linked to lifestyle, and thereby, may be preventable. What I think was missed by Michael is that why you live longer is as important as what that life looks like.

If you live longer only due to the miracles of modern science and technology, such a life may not be worth living. The goal is not to be alive at any cost, strapped to money machines that ka-ching with every passing moment. The reason to live longer is to enjoy more healthy years of life free of disability and pain.

A second recent study, that helps confirm healthy living can extend life even in the retirement years, demonstrates how to achieve such a life.  Led by Emily Nicklett, an assistant professor of social work at the University of Michigan School of Social Work, in Ann Arbor, the study, which was designed to explore the impact of exercise and nutrition together, found that women who were both the most physically active and the highest consumers of fruits and vegetables were eight times more likely to be alive after the study's five years of follow-up, compared to women who scored lowest on both counts.


There you have it. By living a healthy lifestyle, the women in the Michigan study avoided premature death and reported living quality lives. It's not surprising because exercise and good nutrition have been shown repeatedly to keep depression, dementia, falls, cancer, diabetes, heart disease, and stroke at bay for long periods of time.

The bottom line is we all eventually die and how we die is often unpredictable. But living a healthy lifestyle increases the probability of enjoying more good years. Michael Wolff ultimately misses the real point. If his mother had taken ill a number of years earlier, would the situation have been any less poignant and painful? Watching a parent suffer at any age is difficult for most children. Having a few more good years with the parent(s) before the process begins is a gift.

So if you want to live a longer, functional, and disease-free life, a word to the wise should be sufficient. Learn how to eat properly and get enough exercise to remain in good form and fitness. Michael Wolff may long for his mother's passing, but I long to keep my patients healthy and enjoying life for many more years because it beats the alternative.

Longevity and Weight: What's the connection?

For the past year, I have been meeting with, treating, and lecturing to over a thousand seniors. Although this is not a scientific conclusion, I notice that people in their late 80s and above are never markedly overweight and those who are markedly overweight often look older than they are. This is consistent with a study of Jews of Eastern European descent that are believed to have a longevity gene that confers the potential to live into their 90s and above. The study showed that despite sometimes living unhealthy lifestyles, none of those living into their 90s were overweight.

A study reported today further supports this conclusion.

First, let's review what is the Body Mass Index (BMI).  BMI is a measurement of weight classification calculated by factoring in your weight and height. It is an imperfect measurement because it doesn't differentiate between high body fat and muscle content. BMI has been used by the World Health Organization as the standard for recording obesity statistics since the early 1980s. (The formula is pasted at the end of the blog.) Here in the U.S., it is also the most commonly used measurement to determine underweight, normal weight, overweight, and obesity.

Generally a BMI below 18.5 is considered underweight, 18.5-25 is considered normal, above 25 to 30 is overweight, 30 to 35 moderately obese, 35 to 40 severely obese, and above 40 very severely or morbidly obese.  (It is used differently for children but I won't discuss that here. Write me for more information.)

In a new study,  Nicholas J. Timpson, PhD, of the University of Bristol, in England, and colleagues found that for every .8 (point eight)  increase in BMI, ischemic heart disease risk rose 52%.

 "These data add evidence to support a causal link between increased BMI and ischemic heart disease risk, though the mechanism may ultimately be through intermediate factors like hypertension, dyslipidemia, and type 2 diabetes," the group wrote in the May issue of PLoS Medicine."

Furthermore, they explained that "Observational studies, both prospective and retrospective, consistently link higher BMI to heart risks across different populations, but haven't convincingly demonstrated causality because of the possibility of confounding, reverse causation, and bias."


Everyone knows that being overweight is often associated with developing chronic diseases like heart disease, diabetes, stroke, cancer and dementia. However, this study is a big deal because it shows a direct correlation between weight and heart disease risks.

So it turns out that what I have been noting empirically, is in fact, scientifically grounded. The heavier you are over a BMI of 25 the more likely you are to die prematurely from ischemic heart disease, and I suspect, from other diseases as well.

At a health fair on Monday, I greeted passersbys with "How would you like to add more healthy years to your life?"  I thought this question will receive a resounding yes every time asked and it would allow me to engage the person in a meaningful conversation regarding the benefits of taking advantage of Medicare's smorgasbord of wellness and preventive services. I was wrong.

At least a quarter of the people said they were not interested. Perhaps it was my delivery or they were wary of what I was offering as too good to be true.  I really don't know the reason, but it amazed me anyway that anyone could answer that question negatively. I shouldn't be surprised.  Since the introduction of new wellness and preventive benefits in January 2011, less than 94% of eligible seniors nationwide have taken advantage of over $1,000 worth of these life-enhancing benefits. These services were implemented by Medicare to help seniors avoid chronic disease, prevent heart attacks, lose weight, and allow for early disease detection. Yet, few doctors are providing the service and few seniors are receiving them. What gives? Do they not know of the benefits or are they simply not interested?

I can't profess to know exactly what goes through seniors minds (even though in my past work experience I led an organization that cared for 5 million seniors), as I am a generation younger, but it still breaks my heart that they are not all willing to do whatever they can to live longer, healthier lives.

I can only imagine the fears they have of doing so-fears of developing dementia, fears of running out of money, fears of being institutionalized, or being left alone with the passage of friends and family. These can be legitimate fears as they can and do happen, but early planning can make a difference and I know plenty of seniors who continue to enjoy life into their 90s and beyond. I recently presented to three centenarians, the oldest 103. They all peppered me with questions.

Many seniors don't realize that the longer they live, the more good years they have enjoyed. A researcher at Albert Einstein College of Medicine also concluded that the longer you live, the less you spend on medical care. That may not make sense at first pass, but when you think about it, it begins to resonate. Living longer typically means you have less sick days and that means less visits to doctors, etc. Medical costs are a huge drain as we age and avoiding such expenses preserves our capital.

The bottom line is whether you do it for yourself, for some member of your family, or for any reason that motivates you, take care of your health (and weight) so that you can enjoy a long, healthy life.

BMI formula:

Can You Grow Your Brain?

Does exercise lead to a better brain? According to an article in today's New York Times Magazine, it can.  In a recent blog, I discussed a number of studies that show that exercise can elevate mood and can have the same medicinal effect as antidepressants in treating mild to moderate depression. So you don't need to be a Rhodes Scholar to appreciate the therapeutic benefits of exercise.  However, we apparently do need a scholar by the name of Justin Rhodes to tell us why. Dr. Rhodes, a psychology professor at the University of Illinois conducted an interesting set of experiments with mice that showed that among four sets of mice, those who engaged in the most exercise saw an increase of new neurons or brain cells, even more than those who received the most mental stimulation.

The credit for this effect is partially given to something called B.D.N.F. When I first saw this acronym, I immediately thought that it stood for Brains Do Need Fun. Alas, it actually stands for the more mundane Brain Derived Neurotrophic Factor, which in layman's terms means it makes brains grow. I still like mine better because fun does make everything better, but it's still good to hear that we can potentially grow our brains. Scientists, however, believe that the growth from exercise in mice is not solely from  B.D.N.F, because they think that the process must include other complex biochemical processes and genetic cascades.

I am a huge believer in the benefits of exercise not only for mental health, but for heart health as well. Every study I've ever read supports that conclusion. However, I have my usual set of problems with these mice studies. First, it was done in mice, which means it is not necessarily extrapolatable to humans. In fact, scientists are unable to study similar affects in humans, although studies do show an increase in B.D.N.F levels after exercise.

Second,and more importantly, if exercise increases brain size and density, wouldn't professional  athletes have bigger, healthier, and more durable brains than the rest of us? I've yet to read or hear of a study that showed that athletes are smarter, develop less Alzheimer's, and in general have healthier brains than the rest of the population. Have you? Perhaps there is a threshold regarding the effects of exercise? Perhaps, when you start from zero and steadily increase, you experience heart and brain benefits up to a point, and then further increases lead to deterioration? That theory would be consistent with a couple of studies I've read that showed that professional athletes all develop some form of heart damage from their high levels of exertion.

Now please don't us this blog as an excuse to avoid exercise. It's not. The average person is no more likely to reach that turning point when exercise becomes potentially harmful than they are to grow their muscles "too big" in a gym. Professional athletes generally waive caution in pursuit of excellence, and most people will never get close to that level of endurance (nor should they).

Physical activity is the hallmark of health and longevity. All studied centenarian communities are predicated on constant physical activity. If that's not possible for you due to the nature of your work or other circumstances, then schedule, if possible, robust exercise for ideally 30 minutes a day. If you miss a day, ignore it and do better the next day  Even ten minutes of brisk activity a day was shown in one study to decrease heart attack risk by 50%. (Not a perfect study, but as you may have learned by now they never are, are they?) Minimally, get out of your chair every 55 minutes ans either take a walk, go up and down stairs, or do some jumping jacks.

Nevertheless, how do you know if your exercise is adequate for good heart and brain health? My rule includes singing. For endurance related aerobic exercise, try to get to the point where singing becomes difficult. Not where your singing becomes difficult for others, which may always be the case, but for you. By the way, if these words compel, you to start exercising or increase your level of exercise, please consult with your personal physician before doing so.

Ultimately, I can't tell you if the brain is figuratively or literally like a muscle that grows stronger with exercise, but I'm pretty sure that like a muscle, if you don't use it, you will lose it. 

100 Year Olds Ask The Best Questions

Among the several topics I lecture on is The Role of Genetics in Longevity and How to Live to 100. (If you want to hear the lecture, please follow this link http://www.youtube.com/watch?v=dcmX4UFAyB4 for part 1). Yesterday, I gave the lecture in a continuum care community. The day before, I lectured on How Supplements and Vitamins Are A Waste of Money and May Be Harmful in another community. (If you want to hear that lecture, here's the link http://www.youtube.com/watch?v=TzU1UN1Wr0o for part 1.)

I bring these lectures up because often my audience consists of people over the age of 90 and in fact, the lecture two days ago had two people over the age of 100. Is that a coincidence? I don't think so. As part of my research into what it takes to live to 100, the conclusions across the board were extremely uniform. Stay engaged, strive for meaning and purpose in life, and keep learning as part of a healthy lifestyle process. It didn't surprise me that the individuals who asked the most questions after the lecture were the oldest people in the room. The 102 year old was asking specific questions about which supplements she should take. I quipped that she should keep doing what she's doing because it seems to be working. I nevertheless invited her to the practice so we could spend some time together and I could more carefully review the actual supplements she takes.

You may be asking yourself why would I want to engage someone who has already surpassed the centenarian mark for a wellness visit? The answer is because she has the potential to become a super centenarian (greater than 110) and for all I know she could outlive the oldest person on record, Jeanne Calment, who lived to 122, but died in 1997.

This 102 year old lady was completely with it, displaying a razor sharp mind, but some perceived fragility. However, even  more impressive was the second centenarian who I would have mistaken for 80, and who asked even better questions and had a slight spring in her movement.

It truly excites me when I meet people, regardless of which combination of good genetics, healthy lifestyle, and modern medicine helped them, manage to surpass the century mark. I have been in the senior care industry over23 years and the number of centenarians is clearly growing. Yet, at the same time, we read almost daily headlines trumpeting increasing obesity and diabetes rates, with the majority of American still succumbing prematurely to heart disease and cancer. This dichotomy raises what I think is the all important question, do we have a choice which camp we ultimately fall into?

By now, the answer should be obvious but it's worth repeating it. Absolutely, we have a choice! We can choose to pursue a longer, healthier life or we can rationalize that since that are some many things that can harm us, it doesn't matter what daily choices we make when it comes to food, diet, stress, etc.

My high school basketball coach once said to me that he was working on his second million before his first, because he thought the second million was easier. I likewise jokingly tell people not to work on living to their next decade; rather, they should strive for the decade after that.

No doubt that for some, living to 100 comes relatively easy because they have uniquely protective genes and they have always lived a charmed life. The numbers in fact show that these Escapers as they are called, only represent 15% of all centenarians.

43% of centenarians are called Delayers, which means their first major illness came after the age of 80.

But the most exciting group, representing 42% of all centenarians are the Survivors, people who had a major illness before 80 and still lived to 100.  I suspect that major illness was a wake-up call that stirred them to action. This number deserves repetition. People who had a major illness before the age of 80 still managed to live to 100. Wow! That is great and should give everyone hope that living to 100 may be possible for you.

Do you really need to learn that you have cancer, heart disease, or diabetes before you are motivated to action? I pray not. Isn't it time you made plans to join the growing community of people living into their 90s and 100s?

Don't get left behind. Today, right now, find out how you can live to 100 and chart a course to a longer life. The best reason to do so is because the longer you live, the healthier you've been. Ask your doctor what you can do or call us at MDPrevent and let us offer you the guidance and support you need. What are you waiting for?