A Roadmap to 100: Routes to a long and healthy life

by Walter M. Bortz II, M.D. and Randall Stickrod

Walter M. Bortz II is a clinical associate professor at the Stanford University School of Medicine. Widely recognized as a leading scientific expert on longevity, his research has focused on exercise as a key to healthy aging. He has served as president of the American Geriatric Society and cochair of the American Medical Association Task Force on Aging and is currently chair of the Medical Advisory Board for the Diabetes Research and Wellness Foundation.

Bortz has published more than 130 articles in medical journals and has written numerous books. His most recent work, The Roadmap to 100: The Breakthrough Science of Living a Long and Healthy Life (New York City: Palgrave Macmillan, 2010), coauthored with Randall Stickrod, brings together findings from an array of peer-reviewed studies to stake out scientifically demonstrated routes to aging with maximum physical and psychological well-being. The following excerpts offer a brief introduction to Bortz’s approach to aging and health.

We live in a world divided by health. Any large city today probably has more gyms and health clubs than gas stations. We have bike lanes and urban hiking trails, the hallmarks of an active, aware population embracing fitness and robust health. And yet, our headlines blare out chilling warnings about the epidemic of obesity and the rampaging spread of Type 2 diabetes, a disease that barely existed two generations ago. Fitness scores among school-age children continue to drop precipitously. Fast food franchises seem to be everywhere, contrasting with the increasing presence of organic foods and farmers markets. We are a population dangerously divided between the health conscious and the health averse.

Nearly every day, we read a story about a new centenarian, the fastest-growing demographic category in the country. It seems a thrilling affirmation that we are still progressing, still evolving as a species, still the pinnacle of the evolutionary food chain – masters of the universe further asserting our mastery by extending the very span of our lives. But in the same paper, there will be at least one story about our soaring healthcare costs, signs of a major national crisis. We are getting early warnings that our average life span may well decline in the next generation for the first time in the entire history of mankind.

The division between those who live long, productive lives with a real likelihood of achieving a full century and the those who merely progress deeper in the high-risk categories of medical statistics as they descend farther into middle age is increasing. What to make of all this?

Knowledge is power, it is said, and if knowledge can empower us to achieve and maintain our maximum health and enable us to live to our full potential, then we have truly accomplished something spectacular.

Yet too few are living anywhere close to their full potential. We all know the basics: Don’t smoke. Don’t drink too much. Eat your vegetables and lay off the fast foods. Exercise. The message becomes a mantra too easily ignored. We know you need more information in order to create a coherent and compelling message that can effectively cause you to modify your behavior. You need better answers: Not just what, but why? How? How much? How much should I exercise? Why should I lift weights if I’m not a bodybuilder? How much is too much? Why, exactly, should I avoid anything with high-fructose corn syrup? We are accustomed to being told what we should or shouldn’t do, but more often than not without the specifics of the reasons why. We need better, deeper, more detailed information.

Even many of our medical professionals are hard pressed to give the average person solid answers to questions like these. The typical medical school graduate is better trained to look for what’s wrong with you than to shepherd you on a preventive path with specific goals of health, not to mention longevity. Imagine a routine physical exam where the patient and the doctor ask these hard questions: What should I do to be as healthy as I possibly can? To live as long as I possibly can without loss of function? What kind of exercise should I do, how often, and how much? What should I eat? What shouldn’t I eat? Should I take vitamins? Supplements? Is there anything I should stop doing because I am now 70 years old?

The roadmap to 100 passes through points that are all health related, a critical distinction that cannot be overstated. Longevity is neither an accident nor an isolated phenomenon. It is a product of specific health behaviors, a direct consequence of health maintenance. People who live to 100 are healthy people. They make better choices, choices that directly support the maintenance of healthy life processes and ward off diseases that cut life short. Knowledge of these centenarian strategies is indeed power: the power to defy the default scenario of inevitable decline laid out by Mother Nature.

The Components of Successful Aging
We can now propose the essential components of a life program that maximizes our potential not only to live to 100 (and beyond), but also to enjoy the full measure of living – in a healthy, functional, capable way – that our evolutionary heritage has equipped us for. Here are the essential components of a healthy, long life:

Lean Muscle Mass. Our skeletal muscles are the principle drivers of our metabolic engine. The ratio of lean muscle mass to total body weight is a key health metric.

VO2Max. This is a measure of the body’s ability to transport and utilize oxygen during exercise. It is considered the best indicator of cardiopulmonary endurance, and is widely accepted as the single best measure of cardiovascular fitness and aerobic power.

Nutrition. It has been said that “You are what you eat.” While that’s not quite as true as many would like, what we consume (and how much of it) is perhaps the most controversial topic in health and longevity today. And that includes the multibillion-dollar industries of vitamins and nutritional supplements, which is justifiably controversial as a factor in health strategies.

Sex. It is remarkable that the subject of sex is so infrequently encountered in the larger discussion of longevity and aging-related health matters. We are accustomed to regular advisories to the effect that age should be no deterrent to an active sex life; what we rarely see is a deep and analytical reflection on the elemental relationship between sex and life. Sex and sexuality are – or should be – directly linked to the forces and phenomena that define youth, vitality and life itself.

A Healthy Brain. There are two dimensions to this factor. One is the physical health of our central processor, its cellular vitality and function. The other is our psychic state, that complex array of attitude, desire, will and adaptability that we sometimes label “the intangibles” and that can enhance or subvert the other factors. Stress, for example, can literally kill.

Engagement. Perhaps the most common factor among known centenarians is the presence of strong social bonds, deeply rooted relationships, and/or some form of active engagement that provides a passion for facing each day anew. This cannot be overstated.

Movement. Movement is the crux, the essence of expressing life as purposeful beings. It is both cause and effect, an enabler of health and the result of health. Muscle gives us the strength to move and the capability to perform functions that express our aliveness; oxygen provides the fuel for movement and the combustive force that drives our cells; nutrition provides continuity as well as energy; the healthy brain gives us the internal milieu that invests our lives with value, our sense of self; sex and engagement ensure that our circle of health encompasses not just our bodies but our interconnectedness with others of our species. It is a remarkable constellation of tools from which we can build our path to 100 healthy years.
 

Copyright © 2010 Walter M. Bortz II and Randall Stickrod; all rights reserved. Reprinted with permission from the publisher. For more information on the work of Walter Bortz and to order The Roadmap to 100, visit www.walterbortz.com.