A 69-year-old patient asked me: “Doctor, I want to live longer. How can I add years to my life? I want my life to be long, useful and not dependent on others.” A fair question. But the answer is not easy. Take the people of Okinawa (a small island south of Japan), which is known for many people living to be 100 years old and beyond. There you will find a small Japanese inscription on a small plaque in the village of Ogimi: “At 80, you are just a young man. At 90, if your ancestors invite you to heaven, ask them to wait until you’re 100, then you might consider it.”
The global debate to increase longevity invariably focuses on the inhabitants of this island. Okinawans eat fewer calories (many come from sweet potatoes) and have lots of vegetables, including bitter melon. They eat seaweed and spices including turmeric like in India. Interestingly, the diet contains 10 parts carbohydrates and one part protein (the Okinawan ratio), unlike most current diets. A close-knit social fabric and a relatively trouble-free active life help. People’s genetic makeup also contributes to good health; they have a low amount of bad genes (APOE4) and a good amount of metabolism-friendly genes (FOXO3). Where can we find such clean air, idyllic scenery and such genes? Unfortunately, most of the urban areas in India have the opposite atmosphere and deteriorating lifestyle.
Indians have the worst metabolism
It is reasonable to say that Indians have a poorer metabolism compared to many other races. Our body harbors inflammation (“fire within”) that corrodes the liver, arteries and kidneys. Aging molecules are activated, leading to withering of organs, including the brain. Within these aging molecules are rogue molecules that trigger cancer. One or more diseases appear, which further reduce the years of life. Diabetes is one of the most important diseases that can shorten life. Our recent research shows that even prediabetes shortens life expectancy.
How can we delay aging?
What can we do to avoid damaging our cells? If we cannot avoid air pollution altogether, we should at least give up smoking, including in the company of smokers. We should eat less calories by about 10% (that’s what the Okinawan population eats). The consumption of green vegetables and fruits should increase to five to seven servings per day. Foods should be rich in polyphenols (berries, nuts, flax seeds, etc.) and carotenoids (avocado, spinach, yellow-fleshed vegetables, etc.). Tree nuts, fish and Omega-3 fatty acids can help.
Weight should be maintained at a low (“lean”) normal value, with little gain over the years as one ages. Muscles should be strengthened by working on resistance exercises (with weights and elastic bands). Activity should be maintained throughout the day and not in short bursts.
An interesting question is often asked: “If I settle in Okinawa at the age of 45, would I have a longer life span?” Probably not. The pure seeds (good lifestyle) to nourish the cells must be sown in childhood and the legacy will be a good and long life. Another caveat is that all the lifestyle measures that are so suitable for Okinawans may not be suitable for us. Unlike Okinawans, who have high-carb meals, Indian bodies will respond better to low-carb, low-protein foods. Consideration should be given to adapting food and exercise to different breeds and environments.
Parameters for good health
What are the parameters that ensure good metabolic health and longevity? Blood glucose below 100 mg/dl, BP below 130/80 mmHg, cholesterol below 150 mg/dl, body mass index below 23, waist circumference below 80, respectively 90 cm in women and respectively in men and liver of normal size.
Above all, the most important parameter is the individual’s fitness, which can only be measured in laboratories. It is the sum total of nutrition, exercise, weight, and robust lung and heart functions. If you succeed in all of the above, you will live a healthier life without serious diseases even if your lifespan does not exceed 100!
(Dr. Misra is a Padma Shree awardee and author of the book, Diabetes with Delight).