The Longevity Code: Your Personal Prescription for a Longer, Sweeter Life by Zorba Pasterm, M.D., Susan Meltsner, Susan Meltsner (With)

• Read an Excerpt

Read an Excerpt

From Chapter 1, How We Age Today

Can We All Live to One Hundred?

One-hundred-year-old Alex Hardy grows fresh herbs and glorious perennials in the window boxes of the cottage he shares with his "child bride," Eleanor, a mere youngster at eighty-three. I often see the two of them out for a stroll on warm summer evenings, and I miss them when they head south to Arizona each November. By March I find myself wondering if Alex made it through another winter. But then I drive past his home, spot new seedlings beginning to sprout in his window boxes, and smile. My friend is alive -- and still well enough to continue doing what he loves most.

Alex is one of a dozen or so centenarians I've had the good fortune to know. Another is Betty Ellis. At 102 she is by far the oldest of my patients, and a true original. A farmer's daughter who became a farmer's wife, Betty raised five children before she and her husband, Ed, sold their farm and opened a restaurant, which she ran right along with him until 1951. That's when Ed, who was twenty years her senior, died. Betty kept the restaurant going and did most of the cooking for another thirty-plus years. At seventy-five, she sold the place to her nephew but hardly retired. She cooked for and took care of "old folks" (many of them a decade or more younger than she) for the next seventeen years.

With her hundredth birthday approaching, Betty briefly considered moving into an assisted-living facility, but not because her ability to handle the tasks of daily living was slipping away. No, Betty was simply tired of cooking. She wanted her meals prepared for her for a change. "Only their food was terrible," Betty grumbled. "Andthe time went too slowly." So she took a room in the home of a local minister and was soon supervising food preparation for his church's soup kitchen. As of this writing, she's still at it and showing few signs of slowing down.

While Alex and Betty are casual acquaintances, I've known Emma Axelrod my entire life. Hers is the name that conjures the most fondness when I think of people who have lived a long, long time.

Emma was eight when her family came to this country from Russia. They landed on Ellis Island, then traveled by train to Chicago, where they lived with relatives until they found a place of their own. It was a fairly typical immigrant story, one that played itself out again and again as each new wave of Emma's family arrived in the region.

Despite being a bright girl who did well in school, Emma dropped out at thirteen to help support a household nearly bursting at the seams with hopeful relatives. She went to work in a spice factory putting peppercorns in little boxes for fancy shops to sell to wealthy women. Although she sometimes peered into those shops, feeling a mixture of awe and envy, she would not have traded her life for anybody else''s. "A little hard work never hurt anyone" are words that Emma lives by. As far as she was concerned, the key to happiness was to "keep busy."

A real beauty, young Emma modeled for magazine advertisements until 1917, when she married Harry Axelrod -- and continued to keep busy. Emma "helped out" with her husband's carpet business and devoted herself to raising her son and daughter, "100 percent American." All three predeceased her, and each death was a tremendous blow. But Emma coped by involving herself in other people's lives. She filled her days by "doing this and that" for her synagogue, visiting shut-ins, chatting with neighbors, organizing card parties at the senior center, and calling in to radio talk shows.

At eighty she was as sharp and spry as any sixty-year-old, and at ninety-five she was still living on her own in a meticulously maintained apartment. But at ninety-eight she broke her hip, was hospitalized, then was transferred to a rehabilitation facility, where the staff determined that she was no longer able to function safely in an apartment.

Reluctantly she moved to a nursing home, a very nice place where residents are treated with grace and dignity, but still a regimented institution with fixed schedules, preset menus, and minimal freedom of choice. The very idea made Emma profoundly unhappy. But after a brief adjustment period, she has found that she likes the place.

In the nursing home she has a roommate to talk to. The nurses are pleasant, and the afternoons spent conversing with fellow residents or reminiscing with visitors are a joy. Indeed, being back in a social milieu has been a real longevity booster for Emma, who celebrated her hundredth birthday in 1997. Surrounded by friends and family and looking as if she would be around for at least another decade, she joined the exclusive club consisting of the world's longest-living men and women.

What's the secret to Alex's, Betty's, and Emma's longevity? Why have they lived for more than a century while more than 99 percent of their peers died at sixty or seventy or eighty-four? Did they have a genetic advantage, a better upbringing, healthier lifestyles, an exceptional outlook? Was it just a matter of chance? Or all of the above?

Longer and Better -- The Story of Our Lives Today

For centuries we humans have been fascinated with the idea of immortality and driven by the desire to stay young indefinitely. Countless quests have been fueled by the hope of finding the mythical fountain of youth whose waters were purported to make the old young again.

Over the years we've also tried to locate a "cure" for aging in various foods, drinks, minerals, lotions, potions, injections, and incantations. Thus far no magical elixir has been discovered, although biologists, sociologists, and other scientists have accumulated an impressive -- and still expanding -- body of knowledge. We now know a lot about how people age, what kills us prematurely, and how to prevent or avoid those killers, which substances and behaviors undermine health and which promote it. While this may not be enough know-how to put a lifetime of one hundred within everyone's grasp, I believe it gives most of us a chance to reach our nineties.

We're already living longer than any generation that came before us. Since the start of the twentieth century, average life expectancy in this country has climbed from forty-nine to seventy-six. The number of people surviving to one hundred or older (one out of every ten thousand Americans) has increased fivefold during that same period and is expected to triple again by the year 2020. Naturally, the ranks of men and women in their eighties and nineties have swollen, too, and those octogenarians and nonagenarians tend to be healthier and to do more for longer than they've ever done before. Active life expectancy -- the number of years people remain in a vital, independent state?is on the rise.

Today, athletes run marathons well into their seventies. Grandmothers graduate from college. Downsized employees in their forties, fifties, and sixties start their own businesses. Senator and former astronaut John Glenn returned to space as a septuagenarian. The late comedian George Burns continued to perform long past his ninetieth birthday.

And in Arles, France, Jeanne Calumet was still living in her own apartment at 110. She rode a bicycle and handled all daily living activities independently until her 115th year and might have gone on longer if she had not injured herself in a fall. When she died in August 1997 at the age of 122, she had lived longer than any person on record.

Some of these folks are exceptional individuals, having been trendsetters and fearless adventurers since childhood or recipients of remarkable genetic heritages. But most are everyday folks, more like us than not. They simply do not treat getting older as if it were a one-way express-train ticket to illness, infirmity, and inactivity. They go right on skiing, swimming, running companies, running for Congress, fathering children, painting masterpieces, tending to abandoned babies in hospital nurseries, and more. Their achievements are evidence that there is no statute of limitations on travel or learning or continuing any life-enhancing activity?no designated birthday when we must stop listening to rock and roll, start "acting like senior citizens," give up superhot chili peppers, or take up needlepoint. Of course, you're free to do any of those things if that's what you desire. But you don't have to.

The John Glenns, George Burnses, and Jeanne Calumets of the world give us hope. They become our role models. And so do regular people such as Alex Hardy, Betty Ellis, and Emma Axelrod. "If they can still do what they love at their ages, why can't we?" we wonder. Many of us can. What's more, you can add to your lifestyle -- a form of physical exercise such as resistance training or a mental challenge such as learning a foreign language. If you think your muscles or mind won't be up to the task when you're sixty, seventy, or eighty-five, think again.

In Maryland or Minnesota, Sweden or Japan or elsewhere, researchers have been keeping their eyes trained on average citizens who represent a cross section of races, religions, occupations, and socioeconomic statuses. They are participants in decades-long studies to identify and measure how humans age. They have allowed themselves to be poked, prodded, observed, evaluated, and questioned on a wide range of topics, some of them extremely personal.

These studies -- conducted separately and sometimes for different reasons -- all seem to support the same general conclusion: Although biological aging may be one of nature's givens and, at present, an unavoidable phenomenon, disease, disability, and decline are not.

In a cluster of research projects initiated by the MacArthur Foundation, a multidisciplinary team of scholars confirmed that the world is full of people whose risk for disease and disease-related disabilities is low, whose physical and mental functioning are high, and who remain actively engaged in life. Medicare, which has tracked the characteristics of folks over sixty-five for nearly two decades, reports that the percentage of older people who are significantly disabled has dropped by nearly 1 percent per year since 1983. That means that seniors today are 15 percent less likely to be disabled than seniors during Ronald Reagan's presidency. They're healthier, more energetic, and doing more for themselves than their parents or grandparents did.

The Baltimore Longitudinal Study of Aging (BLSA), a forty-year federally funded project involving nearly twenty-five hundred participants, has observed that many losses of function once thought to be age-related, including decreased joint mobility and memory lapses, can be slowed or stopped. Strength, stamina, and muscle mass do decrease with time -- you need only swing a tennis racket or hike with your son's college classmates to be convinced of that. But if you've stayed even moderately active, more than enough physical prowess remains to meet the demands of daily living. And even couch potatoes can regain some of what they lost. After ten weeks of weight lifting, a group of one hundred nursing home patients whose mean age was eighty-seven significantly increased the muscle strength in their legs. Clearly, any limits nature might set for us are not as fixed as we once believed.

Behind Every Centenarian: Technology, Medicine, and Personal Choice

If longer, healthier lives are the rule these days, medical science and public health measures can take a good deal of the credit. With the advent of industrialization came the wealth, science, and technology to separate drinking water from sewage, resolve housing shortages, and see that people got adequate nutrition. These changes alone marked the beginning of the end for certain diseases: tuberculosis was virtually obliterated when nutritional and overcrowding problems were eliminated; diseases such as cholera, dysentery, and typhoid fever, all spread by contaminated water, as well as airborne diseases including whooping cough, measles, diphtheria, and scarlet fever have all but disappeared in the developed world.

The introduction of vaccinations and antibiotics further reduced the damage done by infectious diseases, dramatically decreasing the number of deaths from polio, influenza, meningitis, and hepatitis. An international effort spearheaded by the World Health Organization literally eradicated smallpox worldwide.

While early gains went to infants and children, whose mortality rates had been many times higher than they are today, more recent developments have improved our odds of surviving conditions that strike the middle-aged. New equipment, medications, and procedures, including angioplasty and coronary bypass surgery, contributed to a drop in premature deaths from heart disease of almost 50 percent since the Beatles first appeared on the Ed Sullivan Show in 1966. Stroke deaths have decreased by nearly 60 percent as well. And we're more successful at managing chronic conditions, from diabetes and high blood pressure to atherosclerosis and asthma.

We've even made strides toward remedying the problem of injured or worn-out joints. The ability to replace knees and hips (more than a hundred thousand of them last year alone) has returned pleasure and mobility to many people's lives. I have patients who are now dancing, fishing, walking in the woods, or eating out for the first time in years.

New measures for extending or enhancing lives seem to arrive daily. Synthetic estrogens are being developed so that women can ward off osteoporosis and heart disease after menopause without increasing their risk for breast or uterine cancers. Faster computers and other advances are enhancing the effectiveness of mammograms, CAT scans, and MRIs. These are vital for the early detection of diseases that would be fatal if diagnosed at later stages. And the medical establishment is finally seeing the value of vitamin E, vitamin C, and folic acid supplements, touted for years by natural healers.

By doing their part to curb premature death and disabling conditions, all of the advances I've mentioned lengthen life span and improve life quality. But they're not the whole show. Technology doesn't operate in a vacuum. Indeed, it is rendered valueless if we don't elect to use it.

Take the screening test for cervical cancer, which you know as a Pap smear: a simple, inexpensive diagnostic test that successfully detects very early signs of a disease that once struck down young women by the tens of thousands, killing them in their twenties and thirties. Early detection makes it possible to treat the condition at a stage where it can be readily cured. However, the test, which saves thousands of lives every year, would do no good whatsoever if women didn't go to their doctors to get Pap smears. Because so many do go and the test does work, cervical cancer deaths have decreased by 90 percent since 1950. They could be wiped out almost completely if more women were tested every one to three years.

Likewise, the people who heeded the surgeon general's warnings about cigarettes when they were first made public more than thirty years ago are in much better shape today than those who didn't. Back then, nearly half of all adult Americans smoked. A decade later, only one-third did. And currently, among the college-educated, the number of smokers has dropped to less than 15 percent. This single change made as much impact on health as modern sanitation did.

Check Your Lifestyle

There is no alchemist's key to longevity, no foolproof formula or one-size-fits-all strategy for living longer and loving it. But that doesn't mean life is a crapshoot, with its length and quality determined by nothing more than a toss of the dice. There are proven ways to extend life expectancy (although not to eternity) and highly effective measures we can take to stay healthy, active, alert, and happy (if not forever young).

Although genetics, early childhood experiences, random acts of violence, and other circumstances beyond our control all contribute to health and longevity, the length and quality of our lives are in large measure shaped by the actions we take and the choices we make as adults. We can be sun worshipers and increase our odds of developing skin cancer. Or we can practice safe sex and reduce our risk of contracting AIDS and other sexually transmitted diseases. We can smoke or not, take advantage of mammograms and other early detection measures or not, buckle up or not, allow drivers to enrage us or not. Our daily choices influence how long we live and how well.

In a landmark long-term study conducted for the Human Population Lab in the San Francisco Bay area, Dr. Lester Breslow and Dr. Lisa F. Berkman looked at mortality among men and women between thirty and sixty-nine, homing in on seven high-risk practices: (1) smoking, (2) excessive alcohol consumption, (3) physical inactivity, (4) obesity or unusually low body weight, (5) sleeping fewer than seven or more than eight hours per night, (6) skipping breakfast, and (7) snacking. To varying degrees, all seven had an adverse impact on longevity. Subjects who engaged in these risky practices had death rates from 25 to 115 percent higher than those who did not.