Living Better and Longer: Lessons From an 8-Decade Study
The Longevity Project followed 1,500 people over their entire life spans and learned a few things about living healthfully in the process
There's plenty of health information out there. Maybe too much. It comes in the form of newspaper or magazine articles, daily newsletters, Facebook posts, and tweets. Some is helpful, some is worrisome, some is fluff, and some may not be worth the paper (or pixels) it's printed on. New research studies offer illuminating, but often tiny, pieces of the puzzle that is the human body, so it can be hard to know what to make of them all. Consumers may be left feeling overwhelmed and not knowing which advice is worth its salt.
The huge volume of health information can cause other problems. As we read about the genetics behind disease and the physiological mechanisms behind behaviors like addiction and compulsion, it's easy to feel like our health is outside of our control. There's always a new gene being discovered that ups our risk for a certain disease.
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Even more, recent research into the impact of the environment (toxins, viruses) on certain medical conditions provides good evidence that there are external factors outside our control that also influence our health status.
It may be tempting to throw up your hands and say, "There's nothing I can do, it's all up to genes, chance, and the environment."
The fact is that research shows us every day that there are things we do to help ourselves live longer and healthier lives.
The amount of unexpected and intriguing new evidence prompted us to ask the question, "What is health, after all, and how to we get there?" Howard S. Friedman, Ph.D., a health psychologist who is Distinguished Professor of Psychology at the University of California, Riverside and co-author of The Longevity Project: Surprising Discoveries for Health and Long Life from the Landmark Eight-Decade Study, helped us sort this out.
Using the data from a famous long-term study, Friedman and his colleague and co-author Leslie R. Martin, Ph.D., looked at the behavior patterns of 1,500 people over virtually their entire life spans. By looking at the relationships between behaviors and how long the subjects lived, they were able to determine what people did that made a difference in longevity and what did not. "The beauty of The Longevity Project is that we don't have to speculate about explanations," says Friedman. "We can go back into the lifelong data and see."
Here, we'll discuss why it pays to pay attention not only to your body, but to your life as a whole, often in ways you might not think of, or may be contrary to what you grew up hearing. Envisioning health as a cluster of interconnected behaviors and habits, rather than a check-list of things to get done, is really what we should strive for.
Health Is a Path, Not a List of Behaviors
When health problems befall us, it's normal to feel like there's some massive lottery system at play, and we either have a winning or losing ticket. While there may be some element of truth to this, Friedman says that there's actually less chance than meets the eye. He tells us that "one of the most interesting findings of my Longevity Project was that a lot of things that seem like chance are really not random. Certain patterns and pathways lead step by step to good things, while others lead step-by-step to unhealthy things and poor health." Another way of thinking about this concept is that every disease has a cause or, more likely, a set of causes, whether they are identifiable to us in our relatively limited of understanding of disease or not.
For example, cancer develops because the mechanisms that normally keep our cell division in check break down. But this is just a description of what happens, not the basic underlying cause. The real, and less clear-cut, question is, "Why do these mechanisms break down?" The answer is likely not random, but a combination of many factors, including genetic predisposition, exposure to viruses or toxins at some point during life, and lifestyle choices like diet, smoking, alcohol consumption, and even certain social factors, is really what gives way to the growth of a tumor. So discovering how these factors interact is the real question.
By mapping out the habit patterns that healthy people tend to follow, Friedman and his team were able to determine which variables were common across the long-lived vs. the shorter-lived. In some cases, the findings flew in the face of conventional wisdom.
The CDC recently published a study showing that there are four healthy behaviors -- not smoking, limiting alcohol, exercising, and eating right -- that will make a significant difference in your likelihood of dying from any cause, particularly heart disease and cancer. (1) Another recent study showed that changing the most common lifestyle risk factors for Alzheimer's disease could cut down on millions of cases per year. (2)
But what about all the people who do everything right, and still encounter untimely disease or even death? Friedman says that even perfect checklists can amount to nothing. "I think simple checklists or lifestyle lists are worse than useless," he says. "We all know lots of things that are well-documented to be health-promoting and part of a healthy lifestyle -- stop smoking and substance abuse, stay active, eat right (mostly a plant-based diet), sleep well, don't gain weight, have friends. So why aren't most people healthy?! Instead, I advise, 'Throw away your lists' because our studies suggest that it is much more important to get on an overall healthy pathway." Changing one's constellation of health habits takes time; it may not be easy, but it is possible.
As mentioned earlier, health is best thought of as a cluster or cumulative effect. It's tempting to believe that changing a single aspect of your life will immediately lead to a significant health benefit. There's no doubt that changing a single behavior can help: for example, studies have found that quitting smoking has an immediate positive effect on blood vessels, and if you already have lung cancer, quitting smoking soon after diagnosis doubles your survival rate.
On the other hand, if you are leading an unhealthy life on multiple levels, changing just one behavior may not have a make or break effect on your health and longevity overall. Says Friedman, "most eye-opening is our finding that the risk factors and protective shields do not occur in isolation, but bunch together in patterns -- the healthy or unhealthy life trails that we call pathways."
Healthy behaviors occur in groups. This is one reason that modern studies are so difficult to interpret. Here's an example: Sure, eating more cruciferous vegetables (translation: members of the mustard family, like broccoli, Brussels sprouts, cabbage, and cauliflower) is correlated with longer life, but people who are eating these foods are likely partaking in a variety of beneficial behaviors, like exercising, not smoking, and preparing and enjoying all kinds of fresh foods. So when certain foods are looked at in isolation, they show an effect, but what is hidden in those results is really the bigger picture -- the cluster of behaviors and choices that brought the person to choose cruciferous vegetables in the first place.
That's because, Friedman tells us, "studies show that more conscientious and goal-oriented citizens, well-educated and hard-working, and with stable relationships well-integrated into their communities, are likely to thrive and be happy, and stay healthy and have a long life." Therefore, health is a long-term, multifaceted undertaking, which includes considerable psychological variables (more on this later), in addition to the physiological ones. You can't change overnight, but you can change over time. "Development of and changes into such patterns involve slow, step-by-step alterations that unfold across many years. But so does health. For example, connecting with and helping others is fundamental and so is more important than obsessing over a rigorous exercise program (even though moderate physical activity is important). But it not something you can do in three weeks." Learning how to -- slowly -- shift your habits over time to create a healthier overall picture, you will start to see that the whole is indeed more than the sum of its parts.
The Lifestyle-Gene-Environment Interaction
According to The Longevity Project, while genes account for about a third of our health, the impact of genes on disease risk may have as much to do with personality traits than whether you are genetically predisposed to develop a particular disease. Whether you are socially engaged, resistant to impulsivity, and conscientious -- factors that are determined both by nature and nurture -- gives you a leg up when it comes to health.
For example, offers Friedman, "persistence (and related traits of planning and prudence and self-control) turns out to be one of the best predictors of health and long life. Why are some people this way and why do some people become more this way?" The answer has partly to do with our brain chemistry, which is determined early on by both nature and nurture.
Differences in brain chemicals (such as serotonin) can, over time, "lead some people to become more conscientious and socially stable.... Some individuals, even though impulsive early on, become more mature. Others, even though predisposed to being conscientious, become more self-centered, lackadaisical, impulsive, and uncontrolled. In the Longevity Project we clearly saw changes in traits as individuals grew up and aged, some for the worse and some for the better." By being aware of your environment and how you interact with it, you can foster the personality traits that are most beneficial to your health and mental health.
(1) Ford ES, Zhao G, Tsai J, Li C. 2011. Low-risk lifestyle behaviors and all-cause mortality: Findings from the National Health and Nutrition Examination Survey III Mortality Study. American Journal of Public Health. http://www.ncbi.nlm.nih.gov/pubmed/21852630.
(2) Barnes DE and Yaffe K. 2011. The projected effect of risk factor reduction on Alzheimer's disease prevalence. The Lancet Neurology 10(9): 819-28.
For years, we thought that genes were immovable structures that determined everything from hair color to heart risk. We still understand that genes can play an important role in risk for certain diseases and conditions from cancer and high blood pressure to Alzheimer's and depression. But this is only part of the picture.
We've also learned in recent years that through the choices we make every day, we can influence the ways in which genes are expressed, essentially helping to "turn on" or "shut off" certain genes that contribute to our risk. This area, the study of epigenetics, has become a major point of interest in the scientific community, and one that will no doubt become more relevant as we begin to understand it more.
The Work-Longevity Relationship: Relaxation Is Overrated
We hear all the time that stress not only makes life unpleasant, but it will downright destroy us if we let it get out of hand. It's true that chronic stress, marked by elevated levels of the stress hormone cortisol, is linked to a battery of problems, from sleep disturbances and sexual problems to higher risk of heart disease and weakened immunity.
However, Friedman suggests that our current understanding of stress is fundamentally misguided: "There is a terrible misunderstanding about stress and motivation. Chronic physiological disturbance is not at all the same thing as hard work, social challenge, or demanding careers. People are being given rotten advice to slow down, take it easy, stop worrying, chill out, and retire to Florida." In contrast, the Longevity Project found that the hardest workers were the longest lived. "The responsible and successful achievers thrived in every way, especially if they were dedicated to things and people beyond themselves."
Friedman's point illustrates the difference between stress (anxiety) and busyness. The fact that leading a busy, motivated life is linked to longevity is likely explained by the "cluster" theory: people who have a healthier attitude about work and mental stimulation are also more likely to engage in other healthy behaviors, like being more social, eating well, and dissipating the actual stress that they do encounter. Beginning to shift your relationship with your work in small ways, and finding other outlets to keep intellectually stimulated, may do more to help your health in the long run than meets the eye.
The Impact of Others: A Socially Rich Life May Be the Best Medicine
Being socially active is a big element of living a long life. It's not only about having dinner at a friend's house once a week -- again, it's farther reaching and more nuanced that that.
Recent studies have shown that just having better relationships with coworkers at the office benefit one's health and longevity, and having stronger social support systems overall rivals quitting smoking in the impact it has on your health.
So, how do you become socially "rich"? Being involved socially occurs on many different levels. Involve yourself in your community, family, business, and personally relevant nonprofit causes any way you can. You might develop relationships with people with similar interests (try a cooking class, dance lessons, or local theater), get involved in one's community (volunteering at a local park or animal shelter), or form neighborhood groups to draw people together (if there's no parents' group in your area, why not start one?). Being engaged with your work, both intellectually and socially (with your co-workers), can improve your health, and highlights how one area of the "health cluster" blends into another.
"Our studies show that more conscientious and goal-oriented citizens, well-educated and hard-working, and with stable relationships well-integrated into their communities, are likely to thrive and be happy, and stay healthy and have a long life." The mechanism for this link is somewhat unclear still, but it has likely to do with how you weather the problems life throws at you. When you have a support system to help you through tough times and bounce ideas off of for resolving them, the unpleasant situations cause less emotional and physiological stress, which amounts to less of a toll on your well-being. With the number of studies showing how important being connected to others is for our health, it seems reasonable to start reaching out more to those around us -- it certainly can't do harm.
Happily Ever After? Why You Don't Have to Get Married to Live Long
Another bit of advice that many may take for granted is that getting married helps us live longer. But according to Friedman's data, we need to revisit this idea. "Magazines are full of advice to 'Get married and you will live longer,' but it is not true. Marriage was health-promoting primarily for men who were well-suited to marriage and had a good marriage. For the rest, there were all kinds of complications."
In fact, other studies have also found that some people who never marry scored higher on certain measures of emotional well being than married people. Friedman's study corroborates this idea, finding that marriage may not be the best bet for everyone: "Women who got divorced or stayed single often thrived. Even women who were widowed often did exceptionally well. It seemed as if women who got rid of their troublesome husbands stayed healthy.... Men who got and stayed divorced were at really high risk for premature mortality." Realizing which situation is right for your personality, happiness, and basic needs is critical. Most people probably don't get married to get healthy, but if you choose to remain unmarried or end an unhappy union, you should not feel that it is a disservice to your health and well being.
Does Divorce Benefit or Harm the Kids' Health?
It's long been believed that divorce puts children at a disadvantage, and there is no doubt that divorce can be hard on kids. Friedman's study found that children of divorce did not live as long as kids whose parents were still married.
But the study also deepens the discussion in some interesting ways. One is that when children of divorce grew up and had engaging jobs and relationships, their health risk was no greater than other people. And Friedman tells us, "The good news here is that we also discovered pathways to a resilient recovery, such as achieving a sense of personal accomplishment during the following two decades. Strength of character and maturity were important, consistent with other research." So, as we saw earlier, it is possible to change the odds, by engaging in a physically and emotionally well-rounded life. In this case, kids who developed a strong sense of self and achieved personal success were the ones who were able to shift the pattern and reduce their risk.
Activity Is the Best First Step
There is one area where Friedman and Martin's findings are in line with the current wisdom. If you were to change only one thing about your lifestyle, or are wondering what a good first step may be to spark the move towards a healthier cluster of behaviors, getting your body in motion is perhaps the number one thing you can do.
You've probably heard it many times before, (including here) but exercise, or really any form of activity, is a veritable fountain of youth. It's not just something your doctor tells you to fill the air -- it's actually one thing that has significant benefit both for healthy people and those who are currently battling health issues.
Most importantly, the research continues to explain just why it benefits health, both mental and physical. In addition to increasing life span, it slows the natural decline in the production of new neurons, helps improve mood in depressed and anxious patients, reduces Alzheimer's risk, lowers blood pressure, helps treat diabetes, and relieves the symptoms of IBS, just to name a few of its benefits. And physical activity seems to have a cumulative effect, so that even little "incidental" activities, like mopping the floor or walking over to speak to a coworker face-to-face rather than emailing her, can improve heart health. (3) In Friedman's own study, he found that people who were active -- in virtually any way -- were more likely to live longer, even if they began to be active in middle age. And you don't have to run marathons, he says: any hobby or pastime that gets you moving will benefit you. On the flip side, people who lead sedentary lifestyles -- for example,sitting for many hours and watching a lot of TV (4) -- are more likely to have earlier deaths than those who are more active.
Becoming active is a smart place to begin partially because it also tends to encourage healthy eating habits (or at least gets you away from the fridge), changes your body chemistry and metabolism, boosts your mood, and allows you to meet other people also endeavoring on the road to health. In other words, it works like the first domino in the setup, since it serves as a kick off for a number of the critical variables included in the health cluster.
Swinging the Pendulum Back to Health
Staying healthy is more than a "To Do" list. It's a way of living that involves a collection of interrelated healthy habits, behaviors, and ways of interacting with the world and people around you. Even more, being healthy is more than deflecting repeated health problems and living to 100 with so-so health. As Friedman says in his book, the goal of his longevity research "is not to lay out the factors that are likely to leave you the last one standing. Most of us, after all, would not wish to live extra years if they were years of constant decline and pain. But the fact is, those who live longer are also generally healthier throughout their lives." Indeed, embodying a healthy lifestyle doesn't only help you weather disease, but it helps you prevent it in the first place. You're lowering your risk for developing health conditions, by reducing as best you can all the factors that influence them. "Most people who live to old age do so not because they have beaten cancer, heart disease, diabetes, or lung disease; rather, the long-lived have mostly avoided serious ailments altogether," says Friedman.
Giving your body the tools it needs to fight disease involves an all-inclusive approach. Part of it is eating right to obtain all the nutrients you need to make healthy new cells and repair damaged DNA. It involves exercising to promote the growth of new neurons, the reduction of inflammation, and the battery of other health benefits it's been shown to have.
It's about reaching out in the community, to your friends, and through your work, to encourage psychological well-being, happiness, and a greater drive to live a healthy life in the first place. At our core, we're social, active, intellectually curious creatures, and fostering these very basic aspects of ourselves is what gives us the greatest shot at maintaining our health for the long term.
Image: REUTERS/Peter Andrews.
(3) McGuire KA, Ross R. 2011. Incidental physical activity is positively associated with cardiorespiratory fitness. Medicine Science and Sports and Exercise. DOI:10.1249/MSS.0b013e31821e4ff2
(4) Veerman JL, Healy GN, Cobiac LJ, Vos T, Winkler EA, Owen N, Dunstan DW. 2011. Television viewing time and reduced life expectancy: a life table analysis. British Journal of Sports Medicine. Epub ahead of print. DOI:10.1136/bjsm.2011.085662
This article originally appeared on TheDoctorWillSeeYouNow.com.