BY CIRIL GODEC
BOROUGHWIDE — The New Year is here and most people make New Year’s resolutions: what to do and also what not to do; what should be different in their lifestyle to be more productive; what bad habits to drop (if smoker, stop!) and what new habits to develop.
We are all aging and searching for anything that we can do to slow down aging. News media and multiple books on aging are suggesting that aging is not an inevitability that we have to accept as it comes.
Yes, everything is aging — our houses, our cars, our possessions, animals and, unfortunately, homo sapiens. That’s us, the final biological outcome of a long evolutionary process that started four billion years ago. The New Year is a good time to ask ourselves if we can do anything about the aging process itself. Accept the challenge.
The human lifespan is getting longer and longer, especially during the last 100 years; from 1900 to now, it is about 40 years longer, almost double. The fastest growing group of today’s population is centenarians, people 100 years or older.
In New York, currently, we have about 5,000 centenarians, more than any other place on this planet. However, demographers have found the highest percentage of centenarians in a few discrete areas on Earth. They marked these on a map with a blue pen, hence their term “blue zones” — Okinawa (Japan), Nicoya (Costa Rica), Ikaria (Greece) and Sardinia (Italy).
What do the inhabitants of these areas have in common? They have fewer chronic diseases of aging, they remain active late into their eighties, they have strong social ties with each other, they are active and move a lot, they eat lots of vegetables and not much meat, and they consume alcohol in moderation.
So, can we do anything about aging next year? Yes, we can. The best tool we can use to prolong, prevent, slow down or even reverse aging is our lifestyle, which affects us on both clinical and cellular, microscopic levels.
First, few people want to live longer if they are miserable, in pain or afflicted with neurodegenerative disorders like Alzheimer’s and Parkinson’s diseases. Most of us want to have not just a longer lifespan but a healthy lifespan. We don’t wish to live longer when we are a major burden to our family, our children and society.
Indeed, when we get older we are more prone to develop diseases of old age — cancer, cardiovascular disease, arthritis, dementia. We become frail. The common denominator of diseases of old age is aging itself, which we don’t yet recognize as a disease. Hopefully, this will soon change in order to attract dollars for research into the causes and delaying of aging.
Two thirds of our healthcare budget is spent to treat the chronic diseases of old age. Our healthcare budget is about 18 percent of our GDP, about $3½ trillion, more than any other developed country, where they spent only nine to 10 percent of GDP on healthcare.
We are ranked by UNESCO as #37 in the world for the quality of comprehensive delivery of healthcare, which is not a very enviable place for the richest country on this planet. We spent most of our healthcare dollars on treatment, much less for prevention of diseases.
The U.S. has the highest number of Nobel prize winners in the world at 93. The United Kingdom is second with 29, and Germany is third with 16. Unfortunately, we don’t translate this highest achievement into comprehensive healthcare. We should do better.
Let’s go back to our daily reality. What could our health resolutions be for 2020? You have to address your diseases with the best care available, but you can do lots for your health with your preventative lifestyle.
How? First, if we have any bad habits — like smoking or too much alcohol — you should stop them today. Now, let’s address the new and improved lifestyle habits included in your New Year resolutions.
That’s what I suggest to most of my patients who come to see me for urological care. The American Medical Society suggests that all physicians, regardless of their specialty, should discuss with their patients their lifestyle.
So, here are my suggestions:
• Nutrition: The overwhelming advice — whatever you eat, eat less. I advise my patients to eat slowly. It takes 20 minutes for the brain to get the message that the stomach is full; if you eat fast, you will have overeaten before the message reaches your brain.
You can eat everything you like. Just reduce, not eliminate, sugar and red meat, especially hot dogs, salami and processed meat in general. Chicken is okay, and so is fish, especially salmon and sardines.
You can eat as many vegetables and fruits as you like. Olive oil is better than butter. Alcohol is okay but keep it in moderation — two glasses of wine for men and one for women. Women have less alcohol dehydrogenase in their stomach so they get tipsy sooner and stay tipsy longer.
• Exercise: I advise my patients to do some every day. It does not need to be in one activity or all at once, but the total combined should be for at least 30 minutes. When you have to go up three flights, don’t use the elevator; take the stairs. Exercise has a major impact on a cellular level — it prolongs our telomeres, thus prolonging our healthy lifespan and improving function of our mitochondria.
• Sleep is another pillar in maintaining good health and prolonging a healthy life span. Seven to eight hours is the recommended time for sleep, enough to clean the brain from the toxic substances that accumulate during the day. Sufficient sleep prolongs our telomeres and keeps our mitochondria in good shape. Sleep deprivation can open the door for cancer, neurodegenerative diseases (Alzheimer’s and Parkinson’s diseases) and especially cardiovascular diseases.
• Attitude. View your life as a glass half full, not half empty. Optimists live longer than pessimists. Optimists get longer telomeres and fewer cancers and cardiovascular diseases; they are also less prone to Alzheimer’s and Parkinson’s diseases.
• Spirituality is very important. Statisticians tell us that people who attend religious services (any religion) live longer and have fewer age-related chronic diseases. Some patients tell me, “Doc, I don’t give a damn about religion!” It’s fine, I reassure them, then tell them, “Then close your eyes for 20 minutes every day and meditate.” We all need spirituality in our lives.
• Finally, I would advise you in the New Year to cultivate social interaction with your family, friends and community. Loners die sooner. Talk to your friends and family as often as you can.
A brief summary of basic science will help you to understand better why lifestyle is important to stay healthy. If you remember, we have 46 chromosomes, 23 from each parent — each containing tightly coiled DNA.
Most of our DNA (99.9 percent) is in our cell nuclei; the remaining DNA (0.1 percent) is in our mitcochondria. Genes we cannot change but we can activate or silence genes responsible for our health, diseases and aging.
And the most important news is that the activation or silencing of the different genes is regulated by epigenomes (special proteins within the cells) that are under our control, as well as our lifestyle and the environment we live in, our thoughts, our emotions and our exposure to radiation.
Finally, our genes are not our destiny. It matters if your parents or grandparents had a long lifespan, but only 10 percent. The other 90 percent is your doing, your lifestyle. In the language of artificial intelligence, genes are our hardware and epigenomes are our software. In other words, genes load the gun and the epigenomes pull the trigger.
Now that you have enough ammunition at your disposal, you can make sensible and smart decisions when thinking about your New Year’s resolutions.
Ciril Godec, MD is a urologist at Maimonides Medical Center and professor of urology at Downstate Medical School.