#2: DIET
This response surprised me because the SuperAgers’ diets frequently included fatty meats, schmaltz (rendered chicken fat), and sweets. In fact, the only complaint I ever got about the trained nurse who administered the questionnaires was that he didn’t accept the high-fat baked goods that the SuperAgers had made for their meetings. I would get phone calls saying, “He was a very nice man, but why wouldn’t he eat a piece of my cake?” Once I explained to him that he needed to accept all edible gifts and that he was free to give them away to the first takers he ran into, I got no more complaints.
But whatever the larger truth is, we certainly have our share of SuperAgers like Lilly, who take diet very seriously. “I am not letting myself eat as much as I would like to, and I’m trying to stay away from fattening things,” she says. And for her, it’s been a lifelong habit, not just something she got smart about in her later years. At sixteen, she decided that she had put on too much weight, so she cut out the cookies and lost thirty pounds. And judging by photos taken throughout her life, she consistently kept them off.
#1: GOOD GENES
Despite all the external factors that might figure into longevity—the factors that the SuperAgers have control over and often do take control over—they believe that genes are the biggest determinant of life span. And of course, I agree. Remember that exceptional longevity tends to run in families, and that’s a strong indicator that environment and lifestyle can carry most of us only so far. In chapter 2, we will explore some striking genetic similarities among people with exceptional longevity.
Do as I Say, Not as I Do
Once we knew what centenarians thought was keeping them alive, we were able to look at how their opinions compared with their lab results and health histories. And yes, we were surprised again. The results of the lifestyle factor tests made it clear that it wasn’t healthy habits keeping the SuperAgers alive and well. Even though many of them gave credit to their diets and physical activity for their extended years, most of them weren’t living these beliefs at the time of the study, nor had they lived them during their early years. Based on the National Health and Nutrition Examination Survey (NHANES-I), they had mean body mass indexes (BMI) similar to the national average, but almost half of them had been overweight or even obese for most of their lives. Sixty percent of men and 30 percent of women had been heavy smokers for more than thirty-five years, and 20 percent drank alcohol daily for much of their lives. And fewer than half of them had been physically active over the course of their lifetimes—only 43 percent of the men and 47 percent of the women. The numbers for restricting calories were even lower: 21 percent of the men and 27 percent of the women. While plant-based diets are often credited with greater health and longevity, fewer than 3 percent of the SuperAgers in our study were vegetarians.
So much for healthy lifestyles getting credit for long lives! We were astonished that our study subjects had habits that were as bad as or worse than the habits of those in the control group. It was clear that as a group, people with exceptional longevity do not have healthier practices or habits than the general population. When we completed this study, the important takeaway for us was that our third hypothesis appeared to be correct—the SuperAgers were somehow being protected by genetic differences that the general population doesn’t have. But when the results of the study were published in 2010, the media put an inaccurate spin on the story, and so did many people who saw me interviewed for a network news segment.
Shortly after the interview, I was at a coffee shop when I was stopped by a middle-aged man who recognized me from the interview. “You changed my life,” he said. “I saw your interview when I was at the gym. My grandmother is one hundred years old, so I don’t need to exercise anymore.”
It got worse. Jay Leno, then host of The Tonight Show, said, “Scientists at the Albert Einstein College of Medicine—I don’t know where that is—showed that the secret for successful longevity is eating, drinking, and not exercising … And the good thing about it is that if you die anyway, you don’t care.”
Of course, our findings applied only to centenarians, and I made sure that I said that in every interview I gave, but people didn’t want to hear that part. Even for people who inherit longevity genes, I recommend a healthy diet and regular physical activity. What was ironic was that the media had a field day with this study and all but ignored the most significant discoveries we were making. The real news was our realization that something must be protecting the centenarians, some undiscovered genetic alteration that helps, not hurts. Something that keeps these wildly different individuals living longer and far better than the rest of us. We have already identified some of these defenses, and research aimed at using them in treatments is under way. (I’ll explain these in detail in chapter 2.) When we made this discovery about centenarians’ remarkable genetic makeup, it was the first key to unlocking how we age and how we can age later and better. By that point, the study had been under way for five years, and this was our first big win.
Two
WHY WE AGE
At his annual checkup, a ninety-two-year-old man said, “Doctor, do you think I’ll make it to a hundred? I don’t drink, smoke, eat rich food, or have a lot of sex.”
His doctor asked, “So why do you want to live to be a hundred?”
Studying the biology of longevity and aging has led to some surprising and promising insights about how and why we age and, more important, how we can age later and slower. With each new discovery geroscientists make, we get closer to creating a future in which the golden years are truly golden. As a physician with a background in molecular genetics and endocrinology, I am well versed in the medical problems that plague the elderly, but until I met my wife’s grandmother Frieda, I had never deeply questioned the biology of longevity. Her vitality as she grew older was in such stark contrast with people twenty years younger, so I couldn’t help wondering: Just what is aging?
We know that our bodies, organs, and even our cells experience wear and tear, consistent with a law of physics—the second law of thermodynamics. Like appliances, all these physical objects break down over time. We also know that environmental factors like what we eat and drink, whether we exercise or smoke, and how well we sleep may slow or accelerate aging. So we have a variety of interesting theories about the root causes. One of the more controversial theories suggests that aging is programmed—that our cells receive biological signals that tell them when to deteriorate and when to die. At an event on aging at Gordon Research Conferences, I led a panel discussion about whether this is true—whether our bodies are programmed to age and, if so, whether they can be unprogrammed. Even colleagues who are typically provocateurs were subdued, with few wanting to defend the notion that the indignities of aging are inevitable. One scientist, Hong Gil Nam from South Korea, presented illuminating data showing how tree leaves are programmed to age, not because of wear and tear or external environmental factors but because the tree itself sends out a signal telling the leaves to change color, die, and drop from the branch. I can still remember the silence that blanketed the room after he delivered his conclusions. What did this mean for humans? Are we programmed to decay, too? The implications were unsettling. But as I gave it more thought, I realized that the leaves are programmed to die, but the tree itself is not, and neither are we. Although our cells can activate in response to stress and aging by way of a program to die, known as apoptosis, or stop dividing, if they are damaged and cannot be repaired, that does not directly program our death.