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This chapter is from the book

Three Things You Can Do Now to Live Longer

Let’s start by discussing three things you can do now to live well and live longer.

Reduce stress! Recent research has found that the effects of stress may be much more ominous than previously thought. Stress may very well be the single factor between living a healthy and long life or a miserable and stunted one. Stress is not just something that wears us down and makes our muscles tighten up; it actually changes our internal biological systems.

Take just one system—the immune system. Studies have found that chronic stress, such as the kind endured by taking care of someone with Alzheimer’s disease, increases the level of cytokines called Interleukin-6. Normally, the IL-6 cytokines are good for you. Think of cytokines as proteins that act like little traffic cops, directing immune-responsive cells to places where you’ve been infected or injured. The IL-6 traffic cops help promote inflammation, a beneficial reaction as you deal with infection and trauma.

The problem is that when you’re not injured or infected, you don’t want these extra guys coursing through your body. They start whistling for these pro-inflammatory cells that have nowhere to go and pretty soon, you have a low-grade buzz of inflammation. Chronic inflammation is bad for you. It promotes muscle weakness. Studies found patients with elevated levels of IL-6 were more likely to be disabled later on because their muscles atrophied easier. Stressed patients with higher levels of IL-6 in their bodies had a harder time absorbing the full effects of a flu vaccine, making them more at risk for infection. Their bodies also took longer to heal from wounds. Chronic inflammation is linked to osteoporosis, cancer, diabetes, and arthritis. That’s why your dentist is always looking out for gingivitis—you don’t want a low-grade buzz of inflammation because it can cause a whole host of problems.

Stress, whether temporary or chronic, suppresses the body’s defenses against infection and malignant growth. It makes you at risk for diseases down the road. You can eat oat bran for breakfast and run five miles a day, but if you’re stressed out, you’re not getting the full benefits of eating right and exercising.

Scientists aren’t sure why stress elevates these IL-6 cytokines, thereby creating this chronic state of inflammation. But they do know that as you age, your ability to regulate these cytokines is diminished. It’s much easier for them to go wayward when you’re stressed.

Your job is not only to go get a massage every time you feel your shoulders tighten, but to also think about getting rid of or blocking the chronic stress before it happens. We’re talking big changes. Perhaps you need to learn to be a more optimistic person, therefore allowing you to cope better with challenges.

Or maybe you need to get out of an unhappy relationship. Or maybe you need to prepare for long-term care for your parents. These are the things that will matter for your health as much as exercising and eating right.

It’s incredible to think that stress, which isn’t something you can touch or see, can wreak such havoc on your body. We dive into more detail later about other ways stress can affect your body, including causing declines in natural killer cells and creating what researchers call an "allostatic load" that makes you more susceptible to diseases.

But for now, make it a commitment to reduce stress in your life. Think of it not just as creating a happier you, but also as a way of adding years to your life.

The older you are, the healthier you’ll be? Most people fear growing older because they’re worried about developing diseases that will ravage their bodies and minds. The statistics can be frightening—after age 40, your chance of developing chronic illnesses increases dramatically. Health screenings become more important than ever. Chances are, by the time you’ve reached 50 or so, you’ll probably know several close friends who’ve been diagnosed with cancer, suffered a heart attack, or developed diabetes. Or maybe it will be you.

There is a bright side to this. Each year that passes disease-free increases your chances of living longer in the future. It’s what statisticians call conditional life expectancy—the number of years more you’ll live based on your current age. Remember that life expectancy now for a man in America is 75 years. That’s at birth—just out of the starting gate. Consider that if you’re a man and you’ve reached age 50 in good shape, your life expectancy is actually going to increase more than three years to 78.5. If you’re lucky or smart and hit 65 in good condition, you’ll likely reach nearly 82! The news is just as good for women; if you reach 65, you’re likely going to outlive your man by three years.

Rather than dread reaching, say, age 65, you should be proud of it. That means you’ve just given yourself a huge chance to make it to 80 without any major problems. Ditto for reaching 85. Or 90. Or beyond. It’s the people who hit 50 and suffer a heart attack that have to worry. If you’re 75 and having a ball, you’ve got it made.

Some scientists link this phenomenon to James Fries’ "compression of morbidity" hypothesis, which basically theorizes that as you reach the upper limits of your lifespan, diseases tend to be compressed to the last years of life. In other words, if you haven’t developed diabetes by 65, chances are that you are not going to develop it until you’re very, very, very old. Or maybe not at all. People studying centenarians who carry the APOE4 gene for Alzheimer’s find that the risk of developing the disease falls dramatically after age 85. That’s right; the older the patients are, the less likely they’ll get dementia! If the patient hasn’t developed it before 85, chances are pretty slim he’ll develop it later, even if he carries the gene.

Your goal is not to get depressed with each birthday, but to celebrate the passing of another year. A birthday just means you’ve given yourself one more extension to live a longer and healthier life. Celebrate it!

If you want to age well, it is best to live in the U.S. or another wealthy nation. You’ve already done something wonderful for your longevity if you live in this country.

Sometimes, we take for granted that life expectancies are going up because we have access to a lot of medicine, clean water, flushing toilets, and well-stocked supermarkets. In other parts of the world, such as Africa, life expectancy is still a short 37 to 45 years because of violence, conflict, food shortages, poor sanitation, lack of access to clean water, and diseases such as AIDS. In Russia, life expectancy reversed course between 1989 and 1994 for men, falling seven years, owing to homicide, drugs, poor diet, and alcoholism.

Even with all we have access to, we’re not number one in terms of life expectancy. Other countries, such as Japan, France, Norway, and Italy have longer living people, and it is there we’ve tried to find the secrets to aging well. Is it their diets? Their exercise regimes? Their culture? We’re still trying to figure it out.

Living in America gives us some fundamental tools to help us reach old age gracefully. The U.S. has great medical care. Americans have plenty of material possessions, which though they don’t directly make us live longer, do offer us a more comfortable living. We have access to the finest education in the world, an important aspect to aging well.

Most importantly, we have control over our lives, which makes a huge difference in how well we age. In the exhaustive, 10-year landmark study funded by the MacArthur Foundation, "Midlife in the U.S.," researchers found that control "was associated with better health and well-being for adults of all ages." Americans have the freedom to age the way they want to—in some other countries without free societies, the concept of "aging well" is not really an option.

Remember that over 70 percent of the aging process is under your control. Having control can make a world of difference in your life and how well you age. Imagine if you didn’t have any control over your aging—and think about how lucky you are that we do.

Taking control of aging means tackling each section of your life and making sure it’s in the best possible condition: your body, your money, your mind, and, for lack of a better word, your soul. These separate areas of your life work in concert as you age. Your job is to make sure they are primed. If you do this, you give yourself the best chance to live a happy, healthy, and long life.

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