The fantastic four? Sure! But go beyond… to the heavenly seven

By Dr. Franco


How to age healthily remains one of the most important and least answered questions for researchers and society in general. Many have dedicated entire careers to discover the secrets of eternal youth but have been unable to unearth them by wrongly searching for chimeras in “el dorado”.

Although eternal youth is perhaps as real as the existence of chimeras and hydras, ageing healthily is a realistic Ithaca to where we all can embark if we follow the adequate trajectory of a healthy lifestyle as demonstrated in a recent report published in the Archives of Internal Medicine.

A team of American and German investigators from the CDC in Atlanta and the German Institute of Human Nutrition in Potsdam gathered to evaluate factors that could help to permit a life free from major chronic diseases such as cardiovascular disease, diabetes and cancer.

The authors identified four key factors that could substantially reduce the future risk of these deleterious conditions. These fantastic four included: I) never smoking, II) no obesity III) at least moderate levels of physical activity and IV) a healthy diet. Following these fantastic four could represent a 78% less chance of developing major chronic diseases.

Surely following the fantastic four is the adequate trajectory to a healthy life, but while following this path why conform with less, when adding three more factors could provide an even better route to our beloved Ithaca of ageing. Adequate sleep patterns, sufficient sun exposure, and no or low alcohol consumption, have also been shown to improve our chances of healthy ageing. Four might be fantastic, but seven is like heaven!

Reference:
Ford ES, Bergmann MM, Kröger J, Schienkiewitz A, Weikert C, Boeing H. Healthy living is the best revenge: findings from the European Prospective Investigation Into Cancer and Nutrition-Potsdam study. Arch Intern Med. 2009 Aug 10;169(15):1355-6

Marital Metamorphosis

By Dr. Franco,

In 2004 I found myself in a different continent and unexpectedly changing my marital status. I must confess that before this time I used to smoke, did not sleep more than 5 hours per day and had neglected my physical activities since I started my medical career. But with the unexpected changes came unforeseen - but very much needed!- transformations. My wife’s tender regime radically altered my lifestyle. Without noticing, my smoking habit, lack of sleep and absence of physical activity were eradicated.

It is therefore with no surprise that I recently read the results of a report published in the American Journal of Epidemiology evaluating the effects of marital status on mortality. Scientists from Duke University (Durham, NC) followed US adults over more than ten years (1992 – 2006) to evaluate the impact of marital status on mortality.

Summarizing, the authors found that the number of years one is married was strongly related to survival. The study also showed that different marital trajectories can have very different effects, for example marrying as a teenager was actually related to a lower survival. The authors suggest further research to clarify the mechanisms that lead from specific marital status and family structure to mortality and other health outcomes over the life course,

Besides this paper a large body of work is available that shows that being married is related to better survival. In general I am not a friend of taking or giving advice, but in this case -based on my personal experience and scientific evidence- I can strongly advice anyone without a partner to find one, and if you already have one, make it last. We say faith can move mountains, but love can move continents… and it certainly made me move!

References:
Matthew E. Dupre, Audrey N. Beck, and Sarah O. Meadows. Marital Trajectories and Mortality Among US Adults . American Journal of Epidemiology Advance Access published on July 7, 2009. Am. J. Epidemiol. 2009 170: 546-555
Invited Commentary: Toward a More Comprehensive Social Epidemiology of Marital Trajectories and Mortality. Patrick M. Krueger. Am. J. Epidemiol. 2009 170: 556-558

Women under pressure

By Dr Franco

Happy new year from Colombia! Since ladies come always first, we start 2010 talking about women and the findings of the Nurses Health Study.

The Nurses Health Study is one of the largest and most influential epidemiological studies in the world. Conducted by investigators from Harvard University, this study started in 1976 with more than 120,000 nurses aged 30 to 55 years that have been followed every 2 years ever since. A second cohort, the Nurses Health Study II started in 1989 with over 110,000 registered nurses aged 27 to 44 years. These two studies have provided substantial information to improve the knowledge and understanding of women’s health and process of ageing.

Emanating from this second cohort, recent results have been published in the JAMA (Journal of the American Medical Association) evaluating how hypertension develops in women and how dietary and lifestyle factors influence or prevent the appearance of hypertension in women.

Hypertension is a factor that generates great burden in women contributing to more excess deaths than any other preventable factor. Treatment of hypertension can be cumbersome as pharmacological interventions imply high investments and efforts and can have substantial adverse effects. Avoiding the appearance of hypertension is therefore an important strategy and dietary and lifestyle factors could hold the key to successful prevention as shown in this report.

The authors found that six lifestyle factors were important in lowering the risk of developing hypertension in women: not being overweight or obese, 30 minutes of daily physical activity, a healthy diet, modest alcohol intake, use of non-narcotic analgesics less than once per week, and intake of supplemental folic acid. Following these six factors could represent a 78% reduction in the risk of developing hypertension in the future while following 5 or just 4 factors a 72% or 58% lower risk.

The effects of healthy lifestyle (as indicated by this study) are not only of a large magnitude but also come with little adverse effects. Medicaments to treat hypertension on the other hand often come with deleterious side effects. Following a healthy lifestyle seems definitely the route to follow!

Reference:
Forman JP, Stampfer MJ, Curhan GC. Diet and lifestyle risk factors associated with incident hypertension in women. JAMA. 2009 Jul 22;302(4):401-11