Lessons learnt from the Super Agers and other key ageing studies.
Annabel Streets and Susan Saunders are working mothers with backgrounds in research and with family histories of age-related diseases that include dementia, heart disease and cancer. Conscious of their own vulnerabilities, once family duties permitted, they spent their days reading medical books and journals, research reports, tomes on neuroscience and culinary histories. They spoke to doctors and scholars. Their research culminated in a book, The Age-Well Project. This is the first of two extracts from their book, detailing how diet and exercise affect healthy ageing.
The four cornerstones of healthy ageing
Our research into a happier, healthier old age threw up four areas of our lives that needed addressing: what, when and how we eat and drink; where, when and how we exercise; how best to stay engaged socially, intellectually and with the right attitude; and how best to manage stress, sleep and the environment surrounding us.
Each area has its ardent advocates, with researchers of sleep, diet, exercise or social engagement believing that their area of specialty provides more longevity than anything else.
But most scientists now realise how intimately connected these four areas are. The majority agree that these four facets are so inextricably linked that to disentangle them and to elevate one over the other is both difficult and dangerous. In particular, studies of Super Agers (a group of elderly people with the cognitive abilities of much younger people) and Blue Zoners (people who live longer than the average) from communities including Okinawa in Japan, the islands of Sardinia in Italy, and Ikaria in Greece – now known as Blue Zones) make it clear that we should be improving not only what and how we eat, but also how we move, sleep and behave. We call these our four cornerstones of healthy ageing.
The first cornerstone of healthy ageing: diet
Our Age-Well Project began with food. You are what – and how – you eat.
We read study after study revealing that our ageing bodies and brains benefit from a healthy diet. We devoured every study – metaphorically, of course – before heading to the kitchen, and cooking.
We had to navigate our way, slowly and judiciously. Every diet, from veganism to high-fat-low-carb, has advocates claiming only their way of eating can deliver a long and healthy life. But, as we sifted through the research, we realised that eating for longevity isn’t about fads or extreme diets. It’s about balance, moderation and adaptability.
One way of eating cropped up again and again: the Mediterranean diet. The Mediterranean approach to food bears little resemblance to the refined carbohydrates and processed fats of a typical UK or US diet. The term refers to the food traditionally eaten (which is not necessarily the same as the food currently eaten) in the communities of Southern Europe: locally grown vegetables and fruits, legumes, grains, olive oil, some fish, small amounts of meat and a little red wine. The diet incudes almost no processed food or refined sugars. Please note that when researchers and doctors talk about a Mediterranean diet they’re referring to a traditional, generalised Mediterranean way of eating, which is not what you’d eat on a holiday in Spain, for example.
Early research on the impact of diet on heart disease in the 1950s and 1960s showed that following the Mediterranean diet had a positive effect. More recently, a randomised control trial (the gold standard of medical research) revealed that a Mediterranean diet, supplemented with olive oil or nuts, reduced the risk of cardiovascular events when compared to a low-fat diet. The diet was also found to improve cognition and reduce the risk of breast cancer.
Every expert we spoke to in the course of writing this book eats a Mediterranean diet. Meir Stampfer, Professor of Medicine at Harvard Medical School, explained: “There’s bona fide, solid clinical evidence to support the benefits of this diet. There’s no such evidence to support diets like Paleo or keto. I go where the data is!”
As we delved deeper, we discovered the huge benefits of leafy greens, spices and berries, and the critical importance of vegetables.
This doesn’t mean being vegetarian or vegan (we’re not), but it has meant increasing the number and variety of vegetables on our plates. And with all these plants to eat, it’s easier to avoid the foods we don’t need: refined carbs, processed meats and sugar.
We’ve also added plenty of omega-3 fatty acids to our diets, mainly from oily fish and nuts. These essential fatty acids form a critical part of our cell membranes, regulating neurotransmitters (the brain’s messaging service), insulin levels and inflammation, leading in turn to fewer heart attacks, and better brain function and gut health.
The role of our microbiota (the ecological community of micro-organisms in multicellular organisms) in how we age has been a revelation, with several new studies indicating that our microbiomes might play a more significant role in longevity than previously envisaged. The trillions of microbes populating our gut affect every area of our health, from mental wellbeing to digestion, responding not only to what we eat, but how and when we eat.
We’ve adopted a version of intermittent fasting (it’s not as hard as it sounds!) and increased our fibre intake. Rest assured, cheese, red meat and chocolate are still on the menu. As are beer and red wine. What’s not to enjoy?
Key diet principles
- Learn the basics of the Mediterranean diet.
- Focus your diet on vegetables, fruit, whole grains, pulses and fish.
- Remember that olive oil is liquid gold – use it for cooking and salad dressings.
- Add vegetables to every meal. We incorporate them into breakfast, lunch and dinner.
- Be good to your gut. Understand how critically important your microbiome is for your health.
- Cut heavily processed foods from your life: they won’t help you age well.
The second cornerstone of healthy ageing: exercise
With sedentary careers like ours, we knew that more movement was imperative. Reams of research showed that lack of exercise is an important predictor of death from any cause.
Find ways of incorporating movement into your daily life
A study of the Blue Zone nonagenarians of Sardinia attributed their longevity, at least in part, to staying physically active as they aged. This was also the conclusion of a US study of 6000 women over the age of 60. Their movement – particularly low-intensity physical activity – was measured for two years. The results were clear: the most active women had the lowest risk of dying.
The experts we interviewed were equally clear. JoAnn Manson, Professor of Women’s Health at Harvard Medical School, told us: “The magic bullet for good health is staying physically active. It affects every other factor: blood pressure, insulin sensitivity, blood sugar, cholesterol levels, weight, inflammation levels. Everything is improved by regular physical activity.”
We took up the challenge and added brisk walking to our day. Every day. It’s very easy: put on comfortable shoes and head out.
Brisk walking has been found to reduce the risk of dying from cardiovascular disease by 24 per cent while increasing cognitive reserve. Walk among trees and you’ll also lower blood pressure, blood sugar and heart rate, as well as reduce stress.
When research revealed that sedentary women who fidgeted excessively had no greater risk of premature mortality than very active women, we quickly learnt to fidget. Now we stretch at our desks, keep weights by the kettle and stand up when talking on the phone. We found ways to include more movement in the time we spend with our families: walking our dogs, playing ping-pong, and dancing in the kitchen.
We also added HIIT (high-intensity interval training) to our routines. Despite its uninviting name, HIIT involves nothing more than adding short bursts of intensity to your activity. It works on a treadmill, bike or rowing machine: go a little faster for a few seconds, then allow plenty of time to recover. Repeat. HIIT has been found to increase the activity of mitochondria (the ‘batteries’ of our cells) as we age, and to improve memory. We also added weights to our routine in order to build muscle and bone. We found time to dance, to row (the best all-round exercise, according to experts) and to practise yoga for strength and mental clarity.
Key exercise principles
- Work movement into your life, every hour and every day. It doesn’t have to be power yoga or ballroom dancing. A stretch at your desk or a walk to the corner shop can make a difference.
- Keep weights by the kettle, walk to the station, dust down your bike – think about how you can introduce exercise into your daily life.
- Plan a variety of exercise: a walk one day, dancing with friends the next, a weights workout later in the week.
- Exercise in nature. Walking in the woods or lifting weights in the garden is more beneficial than the same exercise done indoors.
- Consider your constantly evolving bones. Exercise helps keep them strong.
- Always consult your GP when starting a new routine, and stop if it feels too much.
Next week: The third and fourth cornerstones of healthy ageing – staying socially engaged and the power of sleep.
This is an extract from The Age-Well Project by Annabel Streets and Susan Saunders, published by Hachette Australia.
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