Conway McLean, DPM, Journal columnist

Born into this world, we live our lives, all of us destined to shuffle off this mortal coil. To put it bluntly, we are born to die. In simplistic terms, aging is a time-dependent decline in function, whether it is a cell, a tissue, or the entire organism. But when that final chapter arrives is determined by a host of factors, some of which we have no control over, like genetic composition. Our chromosomal makeup is important, but less than once thought, estimated at 20% of the equation for determinants of lifespan.

Armed with the knowledge of how to experience greater longevity and acting upon it, there remain limits. Some experts claim 120 years is roughly the upper limit for the human lifespan. The explanation is summarized by the concept of cell senescence, which references the limitations in the lifespan of the individual cells composing the human body. Each cell has a biological clock telling our cells when to stop reproducing and when to die. Apparently, there is a limit, calculated to be approximately 50 times at which time they stop dividing and die (the ‘Hayflick Limit’). 

An important part of this discussion revolves around the concept of lifespan versus “health span,” which refers to how many years we remain healthy and free from diseases during our lives. People are living longer but many are burdened by chronic diseases, with heart disease, diabetes, cancer, being some of the typical candidates. A long life is not so desirable if we are bed-bound, in pain, debilitated, or in some similar state preventing us from having a fulfilling life.

On the topic of lifespan and how to lengthen it, much uncertainty exists. A hypothesis currently being proposed states aging itself is the greatest risk factor for disease. Medications targeting aging extending our lives are a subject of tremendous research. Many scientists are hopeful that a medication can be developed which targets specifically aging, extending the years of healthy living.

One potential option for such a drug is rapamycin, developed many years ago as an immunosuppressant for transplant patients. A recent discovery is its ability to extend lifespan, which it seems able to do very well in animal studies. Not yet approved for human use, many gerontologists (experts in aging and the associated disorders) see rapamycin as our best hope for a pharmacologic agent which healthfully extends lifespan.

Predictably, diet and nutrition are at the top of every list for greater longevity. Some naysayers will counter that contrasting studies can be found for most every recommendation. The problem lies in the simple truth that some studies are performed with ulterior motives. Many so-called “studies” are biased and not well constructed. Still, it would seem logical since you are what you eat. Creating new cells to create those destroyed in the wear and tear of life takes substrates, materials, and energy.

Although the overall theme of the Mediterranean diet has been proven time and again, variations can be made to work with your personal tastes. Still, plant-based foods, such as whole grains, vegetables, legumes, fruits, nuts, seeds, herbs and spices, need to be the foundation of your diet. The toughest for many Americans is avoiding fast and processed foods, both known to promote obesity, heart disease, diabetes, metabolic syndrome and more. Whole foods, the less processed, altered, manipulated, the better. Vegetables should be the foundation of your nutritional “pyramid.”

A particularly difficult one for most of us is to reduce our consumption of soluble sugars. This is referring to the hidden calories in our soft drinks, coffee drinks, kids’ drinks, and most every other prepared, packaged drink. Sugar is used in most every food that isn’t whole, things that until recently would never have been thought of as sweet. Salad dressings, soups, and so many “manufactured” foods are guilty of this nutritional sin.

Another issue is meal size, a topic of some renown internationally. American meal sizes are legendary throughout the world and rightfully so. For an individual with healthy meal sizes, the average restaurant dinner serving will sustain them for 3 or 4 meals. Something as simple as using smaller plates can help with those citizens attempting to reduce their meal size.

The next universal recommendation is similarly predictable and has been espoused in these pages on numerous occasions, that being exercise. As per that very accurate cliche, “if you don’t use it, you lose it.” This bit of folk wisdom may have been coined in reference to muscle tissue, which absolutely requires activity. The heart is composed largely of muscle, which similarly needs to be worked to be healthy.

The various forms of physical activity which qualify as exercise are nearly endless, including such options as yoga, tai chi, calisthenics, jogging, weightlifting, power walking, etc., etc., etc., although resistance exercises should be a part of everyone’s regimen. An exercise regimen, irrespective of the form, is a difficult habit to develop. Regardless, fitness is something born of repetition, it must become in some way routine. But a claim you can’t is unacceptable since there is some form of exercise for everyone, regardless of your physical condition.

Maintaining a healthy body weight helps to reduce innumerable disorders and diseases. To do this, you should refer to the previous two suggestions which can go a long way towards achieving this goal of beneficial body composition. Excess adiposity, especially around the middle, is a predictor of many potentially deadly diseases.

Avoiding cigarettes remains a common refrain from healthcare providers. The dangers are numerous with some of them experienced far from the lungs. Nicotine is one of the most powerful substances known at constricting our arteries, resulting in reduced blood flow to the feet and toes. Over time, this leads to unhealthy skin and tissues, easily injured, poorly healing.

Humans need social interaction, and the health experts recommend some form of this for psychological AND physical health. With humanity on the move, the next job carrying us across the globe, too often our neighbor is a stranger, the norm in most urban centers. This reduction in socialization has ramifications, while mental health professionals debate the consequences.

No one is suggesting these changes are easily made. Changing how and what you eat is extraordinarily difficult, especially if the rest of your household isn’t on board. Old habits die hard, a cliche apropos for any discussion of dietary changes. Having a support system is a real boon if one can be developed. How can your loved ones hinder your attempts for a healthy lifestyle and greater longevity. Perhaps, armed with knowledge, you can improve your dietary regimen and your exercise routine. Your health will improve, and your family will benefit.

EDITORS NOTE: Dr. Conway McLean is a podiatric physician now practicing foot and ankle medicine in the Upper Peninsula, having assumed the practice of Dr. Ken Tabor. McLean has lectured internationally on surgery and wound care, and is board certified in both, with a sub-specialty in foot orthotic therapy. Dr. McLean welcomes questions, comments and suggestions at drcmclean@penmed.com.