Sporting life

Take up a sport, suggests Dr. Goldberg. Almost any sport will do, he says. Recruit some friends to play with on a regular basis. And chances are good that you’ll still be living the sporting life all the way into your seventies, if not beyond.

A team of Swedish researchers studied the effects of regular activity throughout life on the physical ability of 233 men at age 76. The volunteers were asked to describe their involvement in competitive sports, recreational sports, occupational physical work, and household work as well as their means of transportation during five periods of their lives, beginning at age 10. The men who had the highest levels of activity after age 35 were the most mobile at 76. And the best activity for ensuring that you’ll still be brisk at three-quarters of a century is playing recreational sports.

Regular physical activity has been linked to lower rates of high blood pressure, diabetes, osteoporosis, colon cancer, anxiety, and depression. Men who get their duffs in motion for close to a half-hour most days of the week actually have about half the risk for heart disease that sedentary men can expect.

It’s never too late to start. A study of almost 10,000 men found that those who became fit during a five-year period had about half the risk of dying from any cause compared to those who stayed out of shape. “Even making small changes like walking briskly to the bus stop, mowing the lawn without a riding mower, and climbing the stairs at work can make a difference,” says Dr. Goldberg. On the other hand, by choosing absolute inactivity, you can shave almost six years off your life span, according to findings from a study of 27,000 people by researchers in California.

Finally, studies show what we’ve known since the days of the recess bell: Taking time to go out and play can sure take the edge off a stressful day.

Curiouser and Curiouser

Researchers from Menlo Park, California, who conducted a five-year study of 1,118 men between ages 60 and 86, found that those who were still alive at the end of the study had significantly higher levels of curiosity than those who had died during the same time.

Curiosity is not only a driving force that keeps your gray matter stoked, but maintained over time, it can also help you find suitable ways to cope through the myriad challenges that life throws your way as you age, says Gary E. Swan, Ph.D., director of the Center for Health Sciences at SRI International (formerly Stanford Research Institute) in Menlo Park. “Older adults should attend as many continuing education classes as possible because they provide the environmental support for you to solve problems creatively, to try new things, and to listen to new ideas,” Dr. Swan advises.

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The Heart Foundation has the role of educating doctors and the public about heart disease. It funds research, programs and events all aimed at reducing morbidity and mortality due to heart disease and stroke in Australia. The Heart Foundation also encourages food manufacturers to comply with its healthy eating guidelines through the “Tick program”. You have probably noticed the Heart Foundation logo consisting of a white tick within a red circle on the packaging of many foods in the supermarket. The tick is used to help consumers identify which foods are approved by the Heart Foundation, and supposedly healthy for the heart. Foods that have a tick are low in fat, especially saturated fat, as well as sodium and kilojoules. Some of these foods are high in fibre, and there are other categories of classification. Many foods that are high in carbohydrate and sugar have a tick; these include breakfast bars and breakfast cereals. Foods high in sugar and carbohydrate promote high blood sugar levels, high insulin, and can lead to Syndrome X. Any carbohydrate that you do not burn up for energy is stored as fat and can raise your cholesterol and triglyceride levels.

The Australian media has been telling us to eat less fat for years. A press release on the Heart Foundation web site states that this has created a nation of fat obsessed individuals. When choosing foods at the supermarket, the majority of Australians are primarily concerned with the fat content of a food. They will choose one food over another even if it only has 0.1 grams less fat. This has meant that fat consumption declined from 38 percent of energy intake in 1983, to just 32 percent in 1995. Despite this decline in fat consumption, risk factors for coronary heart disease have not gone down. “Average blood cholesterol levels remain virtually unchanged from 1980 to 1999-00 and there has been a significant increase in the proportion of overweight and obese Australians over the last 20 years”.

Clearly the obsession with reducing fat intake is not working to improve our health. Fat is not the demon it is made out to be. However, the main focus of the Heart Foundation’s dietary guidelines for Australians is to reduce fat intake. In their information brochures for the public, the Heart Foundation still clings to the out of date theory that too much cholesterol in the bloodstream causes fatty deposits in the arteries, which build up and make it harder for blood to flow through. Eventually these arteries can become totally blocked and this leads to a heart attack or stroke. This simplistic theory totally disregards the mountain of evidence implicating inflammation in the development of heart disease. Many of the recommendations made by the Heart Foundation actually increase inflammation in the body. The public are not always given the best advice.

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Historically, people have been shockingly bad at determining when their fellow human beings were dead. Things got so bad that in 1896 a group fearful of waking up in their final resting place founded the Association for the Prevention of Premature Burial. Earlier in Russia, savvy sales folk were hawking coffins with a system of flags and bells to summon help should you find yourself buried alive.

The truth is that, until relatively recently, the onset of putrefaction was the only truly reliable sign of death. “Otherwise, you’ve been considered dead when the medical folks say you’re dead,” explains Cyril H. Wecht, M.D., forensic pathologist and coroner in Allegheny County, Pennsylvania. “While that hasn’t changed, thankfully, we’ve developed better ways of determining death these days.”

A couple of centuries ago, long before the magic of medical technology, just having fainting spells could send you to your grave, recounts Kenneth V. Iserson, M.D., professor of surgery at the University of Arizona College of Medicine and director of the Arizona bioethics program, both in Tucson, and author of Death to Dust. “Many diseases like syncope (a condition that causes people to faint or suddenly lose consciousness) and typhoid could easily be mistaken for death in those times.”

As recently as 1926, medical texts were advising doctors to look for “signs of life,” using uncertain techniques such as placing an ice-cold mirror close to the person’s mouth to check for breathing, and cutting an artery to see if the person would still bleed.

They eventually discovered more advanced ways to determine death, based largely on the idea that when your heart stopped, you were dead, Dr. Wecht says. “But then CPR (cardiopulmonary resuscitation) began reviving people whose hearts had stopped. And in 1968, a South African doctor further complicated things by performing the first heart transplant,” he says. That’s when the folks at Harvard Medical School declared and promoted the idea of “brain death criteria.” When your brain has stopped working, that’s absolutely the end, explains Dr. Wecht.

Today, doctors have several surefire methods for determining when the brain dies, ranging from the simple (testing the person’s ability to breathe on his own and blinking in response to touching the cornea) to the high-tech (hooking the person to an electroencephalograph machine to monitor brain activity, electrocardiograph to measure the heart’s electrical activity, and nuclear medicine brain scans). “No one has ever failed all these tests and still regained consciousness,” Dr. Iserson says.

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There is no doubt in any doctor’s mind that stress plays a crucial role in many of today’s illnesses, both physical and mental, though just how big a role stress plays in any particular disease is difficult to assess. Undoubtedly the link between ‘type A’ behaviour (competitive and aggressive) and heart attacks is real enough and the links between stress and high blood pressure, certain bowel disease, asthma, eczema, migraine and many other conditions are all too obvious to many people.

Each of these eight headings points to what the preventive medical world calls ‘risk factors’. If you want to reduce your chances of getting a particular disease, or indeed of being unwell at all, you have to be aware of what you personally are at risk from. Only by knowing what your risk factors are can you understand the causes and set about possible risk-reducing activities.

Risk appraisal generally depends on the study of probability tables. The Robbins-Hall method of risk-factor analysis (probably the best devised so far) looks at the top twelve to fifteen causes of death, because between them they account for about two-thirds of all deaths. By comparing treated and untreated groups of people in any specific disease category a doctor can find out which intervention produces results, and can work out a ‘health appraisal’ age to compare with the patient’s actual chronological age. Let’s look at an example.

Take a 41-year-old man with a blood pressure of 180/94 mmHg and a cholesterol level of 220 mm/dl who is overweight by 15 per cent and is a non-diabetic. He also smokes twenty cigarettes a day, has eighteen drinks a week, drives 15,000 miles a year, wearing a seat-belt 75 per cent of the time, and exercises moderately each week. He has no family history of heart disease and his parents are both over 60 years old. Using the Robbins-Hall method this man’s total personal risk is 9,680. This means his chances of dying during the next 10 years are 9,680 in 100,000.

If he stops smoking, has his mild blood pressure treated and cuts his drinks to six per week, he can reduce his risk from 9,680 to 4,992. This large reduction is possible because by changing his behaviour in this way he can reduce his risk of heart attack considerably. It would also reduce his risk of cirrhosis, lung cancer, stroke and car accidents.

This man’s total personal risk before he starts his personal preventive programme translates to a risk age of 46.5 years compared with his actual age of 41 years. By using personal preventive measures he can reduce his personal risk age to 40. The Robbins-Hall printout would show that this man’s level of high blood pressure elevates his risk of heart attack by 150 per cent, and that his smoking plus his raised blood Pressure increase his stroke risk. His drinking increases his chances of both liver cirrhosis and of having a car accident.

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At age 31, Pamela Joyce Kimrey had to face facts.

Her father had died of a massive heart attack when he was just 35 years old. Pamela Joyce wondered if the same fate awaited her. After a lifetime of overeating and almost 2 decades of yo-yo dieting, she weighed 274 pounds. And she was scared.

Pamela Joyce, of Warrenville, South Carolina, traced her seemingly endless appetite to her childhood. “When I was born, I weighed a little more than 4 pounds,” she explains. “My parents left the hospital with instructions to feed me as often and as much as they could.” And they did. By the time she was in fourth grade, her weight hovered around 130 pounds.

Through high school, Pamela Joyce continued to gain. She graduated weighing close to 250 pounds, far too much for her 5-foot-2 frame. “I didn’t want to go through college overweight. I wanted to fit in,” she recalls. “So I put myself on what I considered a diet. I ate less, but I ate poorly—mostly deep-fried, sugary, and fatty foods.” Over the next year, she took off 70 pounds. “At 180 pounds, I still weighed too much for my height,” she says. “But I held steady for several years, right through my wedding in March 1987.”

As Pamela Joyce settled into married life, the pounds started | coming back. “Twenty-five pounds stuck around after I gave birth to our only child, Houston,” she says. “The rest of the weight resuited from’too many meals of fried food smothered in gravy plus thousands of calories worth of junk food and soda.” By October 1996, Pamela Joyce had reached her top weight of 1 274 pounds. “One night, I was lying in bed, feeling disgusted with myself. I started thinking about my dad, and I realized that I could die young if I didn’t take better care of myself. It was my wake-up call.”

The very next day, Pamela Joyce went to her local library and took out every nutrition, fitness, and weight-loss book that she could find. When she read them, she found three themes that came up over and over again: a low-fat diet with portion control, regular exercise, and plenty of water.

Based on the information that she had collected, Pamela Joyce put herself on a strict 1,200-calorie-a-day diet. She cut out junk food, whole milk, and butter and began grilling and baking food instead of frying it. She also invested in a kitchen scale to keep tabs on portion sizes.

Because she was accustomed to eating as much as she wanted, Pamela Joyce had to find a way to keep her stomach full throughout the day. One of her favorite tricks was to save a part of each meal for later in the day. “If my breakfast consisted of a cup of raisin bran, a half-cup of skim milk, and a banana, I’d save the banana for a mid-morning snack,” she explains. “Likewise, I’d keep half of my lunch sandwich for an afternoon snack. If I ate out, I’d have half of my entree wrapped to go before I’d even take a bite.”

This strategy helped Pamela Joyce stay within her 1,200-calorie limit without feeling hungry. Between her improved eating habits, her daily workouts (alternating aerobic exercise and

strength training), and her consumption of gallons of water a week, she managed to lose 137 pounds—exactly half of her body J£ weight—in a little more than 2 years. She’s been holding steady “» since November 1998.

“There is absolutely no way to compare the old me with the new me,” Pamela Joyce says. “I could never have imagined how wonderful I feel. I can keep up with my son and not worry about embarrassing him—except maybe when we’re inline skating in the park. Good health has become a way of life for me and my family.”

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