More Secrets To A Longer Life

A couple of related stories caught my attention recently. The impression I got from them is that people continue to look for easy answers, tips and secrets. With all the new technology and scientific breakthroughs, they tend to abandon common sense, expecting something better and easier. This attitude drives a lot of wasteful behavior indicative of a lack of discipline and critical thinking.

 

The first was from a website called Outside with the title: “8 Simple Tips to Live Longer and Healthier.” These tips, it explains, are easy and based on scientific time-tested methods. The tips are merely to develop healthy daily living habits. This idea has been around for ages and the evidence to support it “has mounted, even as more people try to find the elixir of youth.”  A 2016 British study “found a healthy lifestyle reduces one’s chance of all-cause mortality by a whopping 61 percent.”

 

To make such a list, as the line from Casablanca goes, “round up the usual suspects.” They are easy to understand, but not so easy to adopt.

1. Exercise is good for you.
2. Watch what you eat.
3. Socialize – loneliness has surprisingly bad effects.
4. Avoid nearly all supplements – “the vast majority don’t work and may even cause harm.”
5. Get enough sleep.
6. Get outside and enjoy nature.
7. Don’t smoke.
8. Drink alcohol in moderation.

This kind of information is republished frequently by the news media and in public service announcements. By now it’s not really news! Some might add a few more such as: sunscreen, brushing and flossing, drink when you are thirsty, wash your hands and get a flu shot.  But most of this is common knowledge.

 

The one about the supplements is certainly right but not often mentioned. For example, Harvard School of Health calls claims about antioxidants “mostly hype” adding, “mostly disappointing [study] results haven’t stopped food companies and supplement sellers from banking on antioxidants.” The American Council on Science and Health (ACSH) says, “Many studies have shown antioxidants do not add health benefits nor do they play a key role in preventing cancer or heart disease.” I have covered the dangers and waste associated with dietary supplements many times in the past.

 

The related idea of looking for the easy answer came from a story early in the pandemic. Americans were hoarding not only toilet paper but also another product that made little sense. Last May a Forbes article reported, “retail sales of orange juice increased 46% in the United States in a four-week period ending on April 11.” 

They apparently believed in the power of Vitamin C to cure colds and other viruses. That this is not true should also have been common knowledge. Back in 2006 NPR ran a story, “The Vitamin C Myth.” By then there had been “at least twenty well controlled studies on the use of mega doses of vitamin C in the prevention of colds, treating the duration of colds, and in treatment of the severity of colds;” none of them showed any evidence that “vitamin C in mega doses does anything.” 

 

This vitamin C myth is just another example of what I referred to recently in “Flashback – Fear of Power Lines” on September 11: when people get an idea stuck in their heads, it takes a great deal of persuasion to get them to change their minds, even if the science is definitive.

 

Problems in discipline cause us to ignore the simple but not easy-to-follow lifestyle instead hoping for a pill or magic medical device. Problems in critical thinking cause the brain latch on to one of those ideas and never again wonder if it’s accurate.

Flashback - Health Advice

[Here is a combination of a flashback and an example of how easy it is to predict future news. In November 2013 I wrote the below essay with the title "Secrets to Good Health." This month the BBC ran an article about a BMJ (British Medical Journal) report that men can live an extra 7 years, 10 years for women, of quality life by adopting five healthy habits: never smoking, healthy diet, exercise, body mass index (BMI) between 18.5 and 24.9 and moderate alcohol use. That's substantially what I told readers over 6 years ago in the following flashback.]

As I read this information from Johns Hopkins on how to maintain good eyesight, it occurred to me that products advertised as the secret to good health must be a scam.

This article from a group of medical experts tells that other than regular checkups, to maintain good eyesight “many lifestyle factors that protect our heart health may also help keep our eyes healthy, including being active; getting enough sleep; controlling blood pressure and diabetes; not smoking; maintaining a healthy weight; and eating a diet rich in fish and leafy, green vegetables like spinach and kale. Wow, that’s almost the same advice for every other health concern, not only heart health, but also improving the effects of arthritis, preventing chronic illness , promoting memory and general mental health.

The real secret to good health is that there is no secret.  Health authorities have not been trying to hide anything from us. There is no big secret "doctors don't want you to know."  In fact they have been shouting from the rooftops at every opportunity. We are told over and over on a number of issues that if we want to avoid problems and just generally feel better we should: get enough sleep, eat healthy, drink alcohol only in moderation, stop smoking, get plenty of exercise, drink enough liquids, use sunscreen, wear work gloves or protective eyewear as appropriate, learn relaxation techniques to reduce stress, brush and floss, wash your hands and get a flu shot. This should come as a surprise to no one. We have heard all this advice or subsets of it many times for many years.

The problem with advice like this is that no one wants to hear it. Americans are looking for the easy way, one that requires little discipline. So every time a new diet book is published or the doctors on TV tell us about a miracle cure or another health secret, people want to sign up for the program (and send in their money). They can’t hold an audience by saying the same things over and over, especially when we are so desperate for secrets, so the authors and television personalities must give us secrets.

The real secret is the boring truth – that there is no secret. Like every other endeavor in life, staying healthy requires a little luck and a lot of discipline to stick to the best course of action. The rest is distraction.

Walk Faster, Live Longer?

A very interesting article in JAMA a number of years ago requires the application of critical thinking to avoid making a misinterpretation.

 A team of scientists put together a summary of nine studies over the years totaling almost 35,000 subjects over the age of 65, residents of various nursing facilities . Each study was trying to find out whether measuring a person’s walking speed could help predict how much longer they would live.

The data came from the various researchers measuring how fast people walked over a short measured course, between 8 and 20 feet long, using a stopwatch and converting the speed to feet or meters per second. They then followed up years later to see how well the measured speed at the time of the test correlated with how much longer the individuals lived. (The authors refer to it as “gait speed.”)

The published conclusion, when they put the information from all the studies together: “In this pooled analysis of individual data from 9 selected cohorts, gait speed was associated with survival in older adults.” The graphs accompanying the article show this quite clearly, and the findings held true for both men and women and for people of different races. The top group walked the course at 1.6 meters per second, which converts to about 3.6 miles per hour. (For a longer distance this would mean a pace at which someone could walk a mile in about 17 minutes.)

How is this useful? “First, gait speed might help identify older adults with a high probability of living for 5 or 10 more years, who may be appropriate targets for preventive interventions that require years for benefit.” It could help assess whether a particular medical procedure would be worth the risk – there is always a risk, especially for older people. “Second, gait speed might be used to identify older adults with increased risk of early mortality, perhaps those with gait speeds slower than 0.6 m/s.” It is a simple and informative way for “assessing expected survival to contribute to tailoring goals of care in older adults.” Furthermore, it is a simple measurement that can be easily done in a nursing home corridor by non-professionals.

How is this not useful? Correlation is not causation. Someone seeing this article and not using critical thinking might conclude that beginning to walk faster was a way to guarantee longer life. After all, the graphs on the page clearly show that those who walked faster lived longer. Except for the fact that exercise is good for anyone, this conclusion is not necessarily so; it’s not what the analysis shows.

The authors theorize that the correlation exists because, walking “requires energy, movement control, and support and places demands on multiple organ systems, including the heart, lungs, circulatory, nervous, and musculoskeletal systems.” A slower walking speed could indicate some damage or a larger than normal energy requirement for other reasons. Both could be a general indicator of lessened vitality. It makes sense that those who were going to live longer were just capable of walking faster, and did so.

Unfortunately, scientists did not prove that increasing our walking speed will increase our life expectancy. (In fact, people walking faster while texting could easily decrease their life expectancies.) Getting more exercise, including walking, and generally taking care of ourselves will. There is rarely one easy answer. The real secret to good health appeared in this space over five years ago and, unfortunately requires some degree of discipline.

Living Longer (continued) – Same Old Boring Advice

For the last two weeks, we have been looking at commonly mistaken solutions in the search for a longer life. There is no shortage of unverified exercises, tricks, potions and diets claiming to help us live longer. Many years ago a TV commercial featured some very wrinkled people living in the remote Russian steppes whose secret to a longer life was eating yogurt. These days everyone eats yogurt, and the more exotic the better, with little to show for it.

Sadly the trick to living longer is not yogurt or supplements or more vacations. It’s not being lazy to save your energy as this piece argues. Instead about every few months, like clockwork, the health-news segments present a new study or often the same old studies with the same old boring advice.

One that resurfaces every few years is a Harvard study revealing the five things anyone could do to raise the chances of living longer. (More details about the study came out in MarketWatch just last July.)

It was also published by the Harvard Gazette back in April with the headline: “Five healthy habits to live by,” and told of the five habits, if adopted in adulthood, that could add approximately 14 years to women’s life expectancy and 12 years to men’s. 

The five so-called secrets uncovered by this study were (drumroll, please) “eating a healthy diet, exercising regularly, keeping a healthy body weight, not drinking too much alcohol, and not smoking.” I hope no one paid a lot of money for a study basically telling us what everyone already knew (but most didn’t want to hear). 

But in May 2016 a source called the Thrillist reviewed a different Harvard study on the same subject. “For 75 years (and counting), researchers have been following the same 600+ people to determine what makes a long, healthy, and happy life.” This longitudinal study, following the same subjects over an extended period, came up with seven secrets. Of course there is considerable overlap: keep learning, don’t smoke, don’t abuse alcohol, exercise, maintain a healthy weight, adapt well to setbacks, and have positive relationships.

Actually, the study reported in 2016 was a combination of two simultaneous studies, one with 263 participants and the other with over 300. The first of these was reported on in the Huffington Post in August 2013 with the headline: "The 75-Year Study That Found The Secrets To A Fulfilling Life.” This one was based on an interview with the author of a 2004 book on the subject. The main differences between the studies, the focus on relationships and coping, are explained by the fact that this study was as concerned with happiness as with longevity.

So the secret to a longer life is not a secret at all. It has been publicized for well over a decade with the common-sense equivalent going back many years before. As I explained two Fridays ago, it just takes some combination of critical thinking and common sense, perspective, economic understanding - not throwing away good money on junk science - and discipline to stick to a sensible routine.

Of course, if none of that common sense advice appeals to you because it lacks tricks and secrets and requires discipline, follow the latest advice for living longer from this New York Times article, based on yet another study – play more tennis!

Living Longer (continued) – How About My Good Genes?

How often have you heard people talking about a grandparent or great grandparent living to be over 100 years old?  It seems almost like a badge of honor to have a relative who passed that hurdle, although in many cases they were alive but no longer had their wits about them. 

Not only is it a matter of pride, it also seems to be somewhat reassuring, especially in the cases where the relative smoked or drank throughout his or her life. People figure that if Aunt Polly lived to 102, it was good news for them.

For a while the nature-or-nurture question was considered a toss up. Do we live longer because of our habits, because of our genes, or is it some combination of the two? Several sets of studies on twins raised in different households tried to find out.

Results from hundreds of individual studies have been published since the early-1980’s showing that genetics, rather than upbringing held sway for many characteristics. “Minnesota researchers found that about 70 percent of IQ variation across the twin population was due to genetic differences.” In other studies genes played a larger role than environment on personality, sexual orientation as an adult, religiosity and social attitudes. 

One of the earliest and most widely publicized stories of identical twins came from a study by Lewis and Springer. One pair of twins separated just four weeks after birth and reunited  39 years later was found to have remarkable similarities. “They both had childhood dogs named Toy, married and divorced women named Linda and then married women named Betty, drove Chevys, had nearly identical smoking brands and drinking patterns, and chewed their fingernails.” Physically, they had similar problems with headaches, and they chose the same Florida beach for vacations.

Soon many people were convinced that nature, that is genes, was a driving force and could be credited or blamed for any number of good and bad outcomes. But not so fast! Leave it to science to mess up a good story.

A study specifically looking into the link with longevity published in Nature several years ago has come back into the spotlight recently. Their primary conclusion was that “genetic differences account for about a quarter of the variance in adult human lifespan.” The advantage they had in studying longevity as oppose to other traits was that they could look at the records of twins over the last 100 years with no need for observation or interviews.

Harvard conducted another study on longevity with 268 students (not twins) beginning in 1938. With almost 80 years of data available, they concluded that “how happy we are in our relationships has a powerful influence on our health,” more powerful than genes alone.

So whether a grandmother or a great aunt lived beyond the normal lifespan seems to have much less effect on individual longevity than previously thought.  (That’s good news for a couple of men I know who have already lived past the age when their fathers died, and are very grateful – that’s perspective.) 

Having ruled out yet another potential factor in the search for long life, where does it leave us? More on this next time.

Living Longer (continued) – Are Multivitamins the Answer?

Last time we investigated the headline about how taking at least three weeks vacation was the key to living longer. The bad news is that the study was seriously flawed and the conclusion seemed very questionable. Realistically, there is no need to despair as the three-week-vacation option is out of reach for most Americans anyway. But how about those vitamins so many people take daily? As I wrote last time, “Not so fast!”

Many articles and studies agree that, for the most part, taking multivitamins is a waste of time and money. This recent item from NBC puts it bluntly: “The multivitamin industry rakes in billions of dollars. But science says we're not getting healthier. Unless you have a clinically identified deficiency, the research tells us there is little reason to consume supplements.”

Remember my August 17 entry about what we think we know for sure? This is another subject that falls into that category of believing what we want to despite scientific evidence. About half of all Americans take a vitamin or other supplement with annual spending expected to grow to $300 billion within the next five years. (Reflecting on the Labor Day question of why do we work, imagine if that $300 billion could go into individual retirement accounts instead.)

So people are convinced (by the smooth-talking advertisers), but science continues to tell us the opposite, with reports citing “little evidence” and “no clear health benefit” and that “their use is not justified.” The only upside is that people who fall into the multivitamin trap tend to take better care of themselves in other ways. 

The downside is that these pills, like all other dietary supplements are under-regulated leading to consumers not getting what they pay for. In some cases, it’s not just a matter of throwing money away on ineffective pills. Instead, some contain fillers or substitute ingredients, and tests have found some containing contaminants, which may “pose serious health risks.” 

Even pure vitamins can be dangerous, especially in mega-dose amounts. High doses of vitamin E or A can be harmful, possibly increasing cancer risk. A 2017 study “noted that 20 percent of all cases of liver toxicity are caused by herbal and dietary supplements. Another study found that 23,000 emergency department visits a year are the result of adverse reactions to supplements.”

Well, now that the word is out, can we expect Americans to heed the warnings, make better choices and save their money? It’s doubtful, because this is not breaking news! Besides the fact that I have been writing about it off and on for the last five years, the headlines have rolled in for at least that long and been ignored. See the sampling below.

From earlier this summer: “The truth behind multi-vitamins: You may do more harm than good taking them.” 

“In the recent study published by the Journal of the American College of Cardiology, it says vitamin supplements aren’t doing anything for your health.”

From articles in November 2013 and November 2015: “Even though half the U.S. population pops vitamins in the belief they can help people live longer, healthier lives, a very extensive look at the studies that have been done show it may be a waste of time when it comes to preventing the diseases most likely to kill you.”

From HealthDay News in December 2013: “With three new studies finding that a daily multivitamin won't help boost the average American's health, the experts behind the research are urging people to abandon use of the supplements. The studies found that popping a daily multivitamin didn't ward off heart problems or memory loss, and wasn't tied to a longer life span.”

From WebMD around the same time: “The studies, published in the Dec. 17 issue of the journal Annals of Internal Medicine, found that multivitamin and mineral supplements did not work any better than placebo pills.” 

CBS added in 2015, “taking lots of supplements may raise a person's risk.”

The articles and studies have all stressed the futility of using vitamins and other supplements as the magic answer to better health and longevity. The consistent reminder in every one of these reports is that, unless prescribed by a doctor for a specific deficiency, they are ineffective and never a substitute for healthy eating.

So apparently the vitamins are not the answer to health and long life either. But people don’t worry about any of this if they have been blessed with good genes – not so fast! We’ll look at that idea next time.

Living Longer – The Secret To A Long Life

Everyone wants to know the secret to living longer, and many, many answers to that question are tossed around in the news media and on social media every day.  This is an important issue to most Americans. It is a matter for critical thinking, making sure the proposals pass the test of common sense, for perspective, making sure the potential gain is worth the investment, for economic understanding, knowing that a dollar spent on this pursuit cannot be spent elsewhere, and for discipline, having the ability to stick to a plan for the long term. (Note: any secret to longevity that has no long-term component doesn’t pass the critical thinking test.)

The next three or four installments of this page will cover an investigation of a few of these secrets to longevity. So where shall we start – how about with taking more vacations?

A news article about a study in Finland that, curiously enough, got to Yahoo News by way of India, tells us that men who take vacations live longer. Specifically, “compared with those who took more than three weeks, men who took three weeks or less annual leave from their regular work schedule were found to be 37 per cent more likely to die early.”

The study included 1,222 middle-aged executives, who were randomly assigned to a test group or a control group. Every four months they gave the test group advice on healthy living, including subjects like diet, exercise and not smoking. The control group was left alone. “Shorter vacations were associated with excess deaths in the [test] group,” but made no difference in the control group. They concluded: “stress reduction is an essential part of programmes aimed at reducing the risk of cardiovascular diseases.” 

Wow, where do I start? To be fair, I couldn’t find a link to the paper presented, so have no idea about how long the study lasted – hopefully, it was more than a few years, or how they defined excess deaths. But there are other flaws in the reasoning.

First, the sample was a decent size, but they cut it in half for no apparent reason. They assigned men randomly to each group. Randomization is a good course of action when you have no idea about the background of the subjects, but with more information it is preferable to assign similar people to each group to try to balance out what researchers call confounding factors. Some of those factors may have been family or work situations that could make taking vacation more stressful or impossible, such as divorce or personal/corporate bankruptcy. So randomizing into two groups is puzzling.

Then I wonder if vacation time was the only variable they tested for – that would seem odd given that they also provided healthy living information to only one group. Otherwise they may have been testing for a number of variables and found an “association” only with vacations. I have written elsewhere about how this practice can lead to some unreliable, even crazy results.

And who funded the study? Was it the Finnish tourism industry?

 Finally, the conclusions they reached cannot be applied to any large population – of Finland or anywhere else. They tested only male executives. It is comparable to a college professor testing a group of undergraduates, called a sample of convenience, and publishing the results as if they applied to ordinary citizens across the country. No can do! Do male Finnish executives have anything in common with female Detroit autoworkers? In fact, the conclusions did not even apply to their own so-called control group. How does not receiving healthy living information affect how stress-reducing a vacation is? Half their experiment backed their findings and the other half didn't!

I’m sure it made the news because everyone would like to exercise a little confirmation bias and latch on to a scientific study telling them what they want to hear: that not taking a three-week vacation can be a health hazard. Unfortunately, it’s not that simple.

So, if we want to live longer, we must look elsewhere, like to those magic pills, foods or beverages packed with vitamins and minerals – right? Not so fast! A word or two about that next time.