The Doctors 5-Minute Health Fixes

Rare Book

Chapter One

Take 5

In 2005, a very scary article was published in the prestigious medical journal The New England Journal of Medicine. Written by 10 of the best- respected researchers in epidemiology--the study of which factors affect the health and illness of entire human populations--the article's title was "A Potential Decline in Life Expectancy in the United States in the 21st Century."

The researchers analyzed data from numerous studies that together involved hundreds of thousands of people and found that, contrary to the upward trend in longevity that has been the norm for centuries, the average person born today might actually die sooner than his or her parents or grandparents did. Despite all the huge advances in medical research and technology--vaccines, antibiotics, organ transplants, mapping the human genome--all of our predicted gains in longevity might be undone by one condition: obesity.

Sure, in the 21st century, we don't have to chop wood for the fire. Or haul water from the well. Or stalk and kill a wild buffalo for meat.

But by sparing ourselves this routine physical labor and feeding ourselves low-quality, easily acquired fast foods, we may have actually time-saved our way into a shorter life here on earth.

From Time-Savers to Time-Creators

The researchers who performed this landmark review cited some other factors that might also trim our country's longevity rate. Sure, a pandemic flu would do the trick. And, of course, pollution could take its toll. Or hospital-acquired antibiotic-resistant pathogens--such as MRSA--could gang up on us and take over.

But not all of the factors they identified were scary apocalyptic outbreaks beyond our individual control. The researchers also cited the significant risks that accompany a lack of regular exercise and ineffective blood pressure screening. They listed tobacco use. Excess stress.

In other words, like obesity, things we can do something about. Things we can take control of. Things we need only become aware of so we can implement changes to make our lives better, healthier, happier, and most likely, longer.

When we look carefully at what this research tells us, it's clear that the solution to turning around this negative trend is not to go back to the Stone Age. The solution is to look at the changes we've made and then reclaim the activities that have the greatest health benefits--doing yard work, tending a kitchen garden, eating home-cooked meals, walking to school or work--while we also take advantage of the brand-new advances in medical science that can make us even healthier.

That's right: We're going to reverse some of those unhealthy time-savers. But we're also going to adopt something new: healthy time-creators.

The Secrets of Vibrant Health

We're so focused on the immediate--Twitter updates, drive-thrus with 60- second guarantees--we can forget each of those individual moments combine to become, hopefully, a very long life. If we take a different perspective on our lives--the long view--we'll see how the choices we make in each of those seconds really do accumulate.

PLAYING THE ODDS

How Many Years?

Every one of our behaviors can be a net positive or negative in terms of our longevity--and the quality of those years. Take a look at the impact of some of the health behaviors at both ends of the health spectrum.

|Behavior or |How many years? | |condition | | |Smoking |-5 years | |High blood |-5 years | |pressure | | |Diabetes |-5 years | |Obesity |-5 years | |Regular exercise |+5 years |

Most of us say we'd make better health choices if we had more time. But perhaps opting for the quick and easy Big Mac or Big Gulp a few too many times in your life has left you with some physical souvenirs--extra £ds, inches, or units of blood sugar. Perhaps skipping routine tests, such as a mammogram, cholesterol test, flu shot, or yearly physical (as the Centers for Disease Control and Prevention says 80 percent of women and 60 percent of men do), may have saved you an hour here or there, but now you're left with an even more serious problem--a lump, the pain of angina, or a dangerous case of pneumonia--to contend with.

But here's the good news: Just as those negative choices can accumulate and snowball into something larger, so can positive ones. And by making one small choice--what we call a health fix--and then another, and then another, your very small choices can add up to big changes.

Live Long and Prosper

We all want to live for a long time--but what fun is it to live a long life if you're stricken with debilitating diseases that cause you pain and suffering?

With this thought in mind, rather than look exclusively for things that prolong life, we also looked at research on what enhances overall health-- what makes people healthier and happier, not just live longer.

We looked at dozens of longevity and healthy-aging studies from all over the world. We looked for patterns of behavior and outcomes that transcended all cultures. Luckily, the medical literature abounds with helpful information--most of it underscoring the same points over and over.

One of the most interesting studies helped us by defining this longest, healthiest life as "exceptional aging." The researchers described exceptional aging as living to an advanced age without cognitive or physical impairment or having any of six major chronic diseases--coronary heart disease, stroke, cancer (excluding nonmelanoma skin cancer), chronic obstructive pulmonary disease, Parkinson's disease, and treated diabetes. The researchers chose these six diseases primarily because they are among the most common age-associated chronic conditions. The study, published in JAMA: The Journal of the American Medical Association, followed a group of 5,820 men for 40 years. Researchers found one out of every two men who avoided the big-six conditions made it to age 85--but among those who didn't, only one in 10 lived that long.

The exceptional survivors had many things in common. They were more likely than those who'd died earlier to have:

. greater grip strength . a healthy weight . lower blood sugar levels . lower triglyceride levels . healthy blood pressure . no history of smoking . no history of heavy drinking . a spouse . more than 12 years of education

This list gave us a great jumping-off point. Considering that many men never make it to age 85--by that age, women outnumber men by 2.2 to 1 in the United States--we agreed that those were findings we should pay attention to.

We looked at many studies just like that one. As we examined their areas of overlap, we zeroed in on 10 key factors that kept rising to the top as the most critical to a long life of health and vitality.

Healthy heart: Since cardiovascular disease is the number one cause of death in America, it stands to reason that the world's healthiest people avoid heart disease--and most do this by adopting lifestyle choices that also benefit the other nine key factors of health.

Healthy brain: Through what scientists believe is a combination of good genes and those same smart lifestyle choices that protect the heart, the world's healthiest people are able to avoid neurological damage, cognitive decline, and Alzheimer's disease.

Healthy lungs: The world's healthiest people safeguard their respiratory health, primarily by avoiding smoking--still the leading preventable cause of death in the world--as well as steering clear of environmental and industrial pollution.

Healthy gut and immune system: The healthiest people in all cultures eat fresh, whole foods, mostly vegetables and fruits, and enjoy healthy digestion--which leads to enhanced immunity and lower incidences of cancer.

Healthy bones, muscles, and skin: The world's healthiest people take pains to prevent skin cancer, protect their bones (lessening the likelihood of developing osteoporosis and the debilitating frailty that can spell disaster for older folks), and maintain the muscle mass that allows them to enjoy higher activity levels as they get older (which, in turn, benefits all systems of the body).

Healthy hormones: In seeking balance in their lifestyle--with those smart diet, exercise, and stress management choices that also protect their heart and brain--and by negotiating life's hormonal milestones without extreme interventions, the world's healthiest people maintain a normal hormonal equilibrium, especially avoiding diabetes.

Healthy weight: The world's healthiest people maintain a stable, healthy weight for most of their lives, preventing excessive fluctuations (either gaining or losing)--especially avoiding childhood obesity and staving off weight gain during middle age.

Healthy relationships: Perhaps more importantly than any other factor, the world's healthiest people have loving relationships with their family, friends, and themselves, and they tend to avoid harmful negative emotions such as hostility and hopelessness. Instead they are, by nature or by choice, optimistic people who tend to surround themselves with similarly positive, proactive people.

Healthy pregnancies: The healthiest people on earth are the products of safe, well-cared-for mothers who had access to good nutrition during their relatively stress-free, healthy pregnancies--which, naturally, start with strong sperm and eggs. While we may not be able to turn back the hands of time to affect our own fetal experiences, we can have a huge impact on our children's futures by taking care of our own reproductive health today.

PLAYING THE ODDS

One shocking study, published in the Archives of Internal Medicine, looked at 2,357 doctors who were part of the Physicians" Health Study, 970 of whom had lived to age 90. (Naturally, we were especially curious about these findings!) The study concluded that if the doctors had avoided smoking, diabetes, obesity, hypertension, and a sedentary lifestyle by age 70, they had a 54 percent chance of making it to 90.

If they had two of these factors, their odds wavered somewhere between 22 and 36 percent. If they had five, they basically had no shot--their odds of living to 90 were a nearly nonexistent 4 percent.

Hmmm . . . in one scenario, your odds of living to age 90 are better than one in two. In another scenario, your odds drop to one in 25.

What to do?

We'll tell you what: Start today. Once you've quit smoking (you will, won't you?), you can start addressing the other four factors with one simple remedy: daily exercise.

Healthy childhood: The world's healthiest people are born into conditions that support a healthy childhood, such as access to high-quality food, low levels of environmental toxins, and ample love and support--all of which set them up for a lifetime of good health.

Each of these 10 factors is a powerful health predictor in itself--and when added together, they can improve the quality and extend the length of your life by many years.

How many, you might wonder?

Well, once we had assembled this group of factors, we took a moment to look at studies on twins. We were looking for the differences between genes and environment and how much impact our lifestyle choices make. These studies revealed that our expected life span is likely determined 30 percent by our genes and 70 percent by our lifestyle. And, based on the typical American lifestyle, we're robbing ourselves of an average of 10 years.

Ten years!

That's a lot of time!

Small Change: It's Worth Collecting

Okay--be honest. Do you think making changes in these 10 areas of health sounds like a lot of work?

We were concerned that you might think that, so we went and found the studies to back up what our 78 years of collective medical experience have shown us. The long-term studies suggest we can make significant gains in our longevity and future vitality by making very small changes.

Here's what you need to know: All the factors we just mentioned can be impacted today, in the next 5 minutes, to change the course of our health both for ourselves and for future generations.

Consider these findings.

Trade one piece of candy for an apple--and save your own life. Researchers found that if every person in the United Kingdom swapped just one single unhealthy snack (such as chips or candy) for a healthy one (such as a piece of fruit) every day, 6,000 deaths from cardiovascular disease could be prevented every year.

Slowing down a mere 1.8 miles per hour can add a week and a half to your life. Yes--driving slower can be a health choice. In a study published in the journal Medical Decision Making, scientists found that 1 hour spent behind the wheel of a car was equal to 20 minutes of lost life expectancy due to the potential for a crash--and every 0.6 miles per hour of speed decreases your life expectancy. Why? Any time you save by traveling faster is more than offset by the risk of a crash. Just decreasing your speed by 1.8 miles per hour could save you 3.6 hours each year, which adds up to a week and a half over the average lifetime.

Make nuts your daily snack at work--and live an extra 2 years. A study from Loma Linda University in California of more than 34,000 people found that those who ate nuts five or more times a week lived an extra 1.5 to 2.5 years. Other studies have found that people who eat nuts have 35 to 50 percent lower rates of coronary events such as heart attacks, probably due to nuts" cholesterol-lowering effects and immunity-enhancing antioxidant content.

Trade some chips for an apple. Slow down less than 2 miles per hour. Eat a handful of nuts.

We don't know--does that sound like too much?

If so, let's talk about those 10 years again.

Are you willing to do without them?

ask our Doctors

How much more time do I have?

When we speak with our patients about making small steps to gain more years of life, we're often surprised that some folks don't seem to "get" it--they act as if they are the exceptions.

"My mom smoked until she was 85. I'm not going to get lung cancer."

"I hate vegetables. I'd rather die early than eat them."

Really? You'd give up time on earth simply to avoid some broccoli now and then? Well, in that case, take a look at where you stand right now. Try this life expectancy calculator developed by professors from the University of Pennsylvania in Philadelphia and Singapore Management University: http://gosset.wharton.upenn.edu/mortality/perl/CalcForm.html.

You'll learn about some fascinating trade-offs.