Healthy for Life

Percentage of 65-year olds actively at work from 185 to 2000

The table below shows the percentage of men over the age of 65 who are still working.   Even in 1950, 50% of the men older than 65 were actively at full-time work.  Wow.

Participation in the labor force for men age 65 and up

1850	76.6
1860	76.0
1870	--
1880	78.0
1890	73.8
1900	65.4
1910	58.1
1920	60.1
1930	58.0
1940	43.5
1950	47.0
1960	40.8
1970	35.2
1980	24.7
1990	18.4
2000	17.5

Source Moen, John Essays on the labor force PhD dissertation,Univ of chicago, 1987

and Costa Dora the evolution of retirement Univ of Chicago Press, 1998

Living well while we are alive

Sure we are living longer--but should that be our primary objective?  I think not.  Our goal should be live in better health and with more meaning while we are alive.   How do we do that? 

"Better health" is quite simple and builds on the advice that your mother told you when you were a child. 

She told you, "Eat your fruits and vegetables."  To that, we should all add "all five of them and some whole grains and nuts every day and some fish a couple of times a week; cook with olive oil, and enjoy some red wine with dinner (but not breakfast)."   Everyday your mother sent you outside to play, which is not a bad way to think about exercise.   And she took you to get you "shots" which is a great example of preventive medical care, a large bucket that includes cancer screening, treatment of cholesterols and blood pressure.   And she told you to get enough sleep and enjoy life.  In reality, when all is said and done, she was right and there is not a whole lot more that you need do to stay healthy. 

Meaning.  We spent the middle 30 years of our life working for success; now is the time to work for meaning, to give back to the world.  As boomers we have always changed our world--usually, but not always--for the better.  We certainly face a world of problems, locally and globally.  What a wonderful opportunity to make a difference. 

Enough preaching about my philosophy, but I felt it important to put all of us on the same page. 

Live well while you are alive.  Dr. Bob 

The very fattest Americans are getting fatter faster

The very fattest Americans are getting fatter faster than anyone else. The number of people who are severely obese with a BMI of 40 or greater increased 50% from 2000 to 2005. This is twice as fast as the growth seen in moderate obesity, according Roland Sturm of RAND Corporation, who has been studying obesity patterns for several years.

We are talking about people who are more than 100 pounds overweight. A male with a BMI of 40 will stand 5’10” and weigh 300 pounds and a female with a BMI of 40 will stand 5’4” and weigh 250 pounds.

This is a very different population than those who are mildly overweight, say a BMI of 28, which barely has any increased mortality.

Roland Sturm found that from 2000 to 2005,

• he proportion of Americans with a BMI of 30 or more increased by 24 percent,
• the proportion of people with a BMI of 40 or more increased by 50 percent and
• the proportion of Americans with a BMI of 50 or more increased by 75 percent.

These heaviest groups have been increasing at the fastest rates for the past 20 years. A BMI of 40 shortens a life by at probably 10 years and, even more when they become diabetic, as they all will. These are the people who are the most dependent on others and have the longest period of end-of-life decline. These poor people have no chance at a normal active life expectancy, unless they seriously lose weight and start to exercise. We have a societal duty to stop this epidemic. 

Morbidly obese individuals need to start to lose weight and gain control of their lives. I have several friends who have lost 100, 150, and even 200 pounds; it can be done. To a person, they all tell me that they feel so much better and can do so much more that they wish they had lost the weight earlier. And if you are seriously obese, you must lose weight, a lot of weight, not just a few pounds.

Start now to take control of your life.  Dr. Bob

Boomers not as healthy as their parents

Who knew?  The very good Health and Retirement Study, following 20,000 Americans through middle age to retirment, is finding that boomers are not as healthy as their parents.   

I can not say it better than Rob Stein of the Washington Post who wrote, "The baby boomers were much less likely than their predecessors to describe their health as "excellent" or "very good," and were more likely to report having difficulty with routine activities, such as walking several blocks or lifting 10 pounds. They were also more likely to report pain, drinking and psychiatric problems, and chronic problems such as high blood pressure, high cholesterol and diabetes."

You should read this article (link above).  The data is not definitive, but, as Dr. Cutler of Harvard points out, the trends are certainly consistent. And then we should all remember that self-reported health is a very powerful marker of future mortality, for better or worse.      

We may smoke less, and we may take better care of our cardiovascular risk factors; but we also are  more obese, exercise less, and eat more poorly. 

There is the answer: everyone grab an apple and go outside to play.  Dr. Bob

Overweight, but not obese, is OK if over age 65

This study from the Archives of Internal Medicine looked disability and mortality rates over five years in 13,000 Americans who were over age of 65.  The study concludes with the sentence "Disability-free life expectancy is greatest among subjects [over the age of 65] with a BMI of 25 to less than 30."   

I have commented before that being "overweight" (BMI 25.0 o 29.9) is less risky, has less mortality, and less disability than conventional wisdom would have you believe.  This is especially true in people ove the age of 65.   The real health risks are seen in people of all ages with BMIs over 35.  Here is a link to a BMI calculator.   

As a society we have a real problem with real obesity--but we do not have a real problem with overweight.  We would be better served and more efficient to focus our efforts on the morbidly obese who are at very high risk of very serious and life threatening and disabling diseases.

Stay well.   

Being overweight is OK if older than 65

This study from the Archives of Internal Medicine looked disability and mortality rates over five years in 13,000 Americans who were over age of 65.  The study concludes with the sentence "Disability-free life expectancy is greatest among subjects [over the age of 65] with a BMI of 25 to less than 30."   

I have commented before that being "overweight" (BMI 25.0 to 29.9) is less risky, has less mortality, and less disability than conventional wisdom would have you believe.  This is especially true in people ove the age of 65.   The real health risks are seen in people of all ages with BMIs over 35.  Here is a link to a BMI calculator.   

As a society we have a real problem with real obesity--but we do not have a real problem with overweight.  We would be better served and more efficient to focus our efforts on the morbidly obese who are at very high risk of very serious and life threatening and disabling diseases.

Stay well.   

The math of living longer--how does living longer happen?

We know that a healthy lifestyle can help us live longer, in the prior post, I quote an article that says being active starting in middle age can help us live 12 years longer.  How does that happen?  Do we suddenly tack 12 years on the end?  Read on for an explanation.   

Being fit slows aging by 12 years

Being aerobically fit as an adult can delay significantly the impact of aging.  Here is a nice summary of an article from the April 8, 2008, British Journal of Sports Medicine.  Note the JSOnline article linked above uses ml/(kg.min) which is more commonly read as ml/kg/min or VO2 max.  You can find you VO2 max by taking the timed-mile-walk part of President's Adult Fitness Test.   

Now we have a good way to measure aerobic fitness, get accurate VO2 max results, and benchmark ourselves--and we have good evidence that this measurement matters, a lot.  Twelve years more of good health certainly meets my definition of a worthwhile goal. 

Getting in better shape does not require Spandex; getting fit starts with walking shoes.   And then keep doing more and more activity. 

We all need to incorporate more activity into our daily lives.  If you drive to the gym, exercise an hour, drive to the office where you sit for 8 hours followed by sitting for dinner and watching television, and then bed, you are not really getting fit.  Sure it is better than not going to the gym, but it is not as good as 20 minutes of stretching and calisthenics (push ups, sit ups, etc.) in the morning by the bedside, walking to work, walking to lunch or the store, carrying groceries, playing Frisbee in the afternoon before dinner and then gardening after dinner.         

Take this fitness test

I suggest that everyone--and, yes, that means you--take this simple fitness test just released by the The President's Council on Physical Fitness and Sport.  This marvelous tool will age-adjust and benchmark your strength, flexibility, and aerobic fitness. 

I, for one, found the results a nice wake-up call.  I walk marathons and do yoga, so my aerobic fitness and flexibility scores were respectable; but my core and muscular strength fell below average.  I figure that I can address these weaknesses with a few sit-ups and push-ups most days of the week.   

Is the test perfect?   Heavens no, but it certainly is a nice start.  I thank and congratulate The President's Fitness Council for publishing this.   

Over the next few weeks, I will try to find more information on the results distribution and test normograms.  Until then, take the test.  Our goals is to keep all of our parts (heart, lung, muscles, joints, brain) strong, balanced, and injury free so that we can actively enjoy all of our years of life. 

Stay well.  Dr. Bob Gleeson 

Let me explain my absence

I apologize.  For the past year I have been extremely busy--but inexcusably absent from this important writing and from your faithful readership.  I have ended one career after 27 years as Vice President Medical Director of Northwestern Mutual, the largest and best underwriter of individual life insurance in America, and, at age 60, I am starting two new careers: 1. starting September 2008 I will be the director of the lifestyle and comprehensive physical program at Froedtert and the Medical College of Wisconsin and 2. a medical underwriting and life expectancy consultation service (don't ask). 

For those who are interested, my life expectancy is at least age 92, my age of independent health with minimal limitations is 88, and my (tentative) planned age of retirement is 78, at which time I will have at least 10 healthy years to travel and do some save-the-environment work.   

So now I will return to blogging, something I learned to love when writing about bird flu, that now distant worry.  I have many articles in my files that we need to discuss.  So without further ado, it is time to write.  My first article, and a fitting start to my return, is a discussion of Tara Parker Pope's "Well" section of today's New York Times.