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Johns Hopkins Health - Aging Successfully

Summer 2009
Issue No. 5

Aging Successfully

Date: June 24, 2009

woman holding hour glass
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You may not be able to stop the aging clock, but you can keep it from racing toward the finish

If only legendary explorer Juan Ponce de Leon really had discovered the Fountain of Youth (which, by the way, is supposedly in Florida), we might all be basking in its perpetual dew-laden glow.

Barring that dream, says Michele Bellantoni, M.D., Johns Hopkins associate professor of gerontology and geriatric medicine, the fate of getting older is hardly as cruel as some would have us believe. But if you’re laying your hopes at the feet of miracle creams and drugs that make too-good-to-be-true promises or procedures that nip, tuck and delay the inevitable, you’re ignoring a most important fact: The appearance and feeling of youth go way beyond skin-deep.

Insider Knowledge
“All the anti-aging creams and procedures in the world aren’t going to help you if you develop heart disease, diabetes or cancer,” Bellantoni says. Folks are so focused on what’s happening on the outside, they forget—or don’t know—that what’s occurring on the inside really is where the anti-aging work is done, or undone.

And heed this: Most of it begins early. Very early.

That’s because at least some of how—and how quickly—we age is determined by our genes. If you put two 40-year-old women side by side and, all other things being equal, one looks 10 years younger, those are genes. Then again, she also might be a candidate for osteoporosis, heart disease or breast cancer.

“That’s the part that you can’t control,” Bellantoni says. “These are the genetic or inherited risks to healthy aging.”

What We Can Control
Genes aren’t our only destiny, Bellantoni adds. There’s more going on, including our environment, what we eat, our physical activity, our lifestyle and behaviors, whether we get regular checkups and health screenings, and our mental health.

“Those are the controllable factors that contribute to how successfully we age,” Bellantoni says. And they have a huge impact. Consider what Bellantoni refers to as “the new longevity” in America. Between 1900 and 1990, average life expectancy in this country increased from 47 years to 76. Only 58 percent of women born in 1900 lived to age 65. Today, that number is higher than 90 percent, and at least 50 percent of us will live to age 85.

In part, there’s a sort of double-edged sword. Scientific and medical advances, and education and awareness, are helping us live longer. But the longer we live, the more likely we are to experience the impact of aging. Changes in metabolism and joint degeneration and the cumulative effects of environmental influences and bad behaviors are among those factors that can thwart successful aging and affect quality of life. Consider, for example, that 30 percent of adults between 57 and 85 years old report taking five or more prescription drugs.

“So, we’re living longer,” Bellantoni says. “The question is, are we living healthier—or as healthfully as we can?”

Start Living Healthier
One piece of advice Bellantoni imparts is to have a family doctor whose style of communication works for you. After that, she says, the key is to focus on those areas where you can have the greatest influence on how well you age: lifestyle, behavior and attitude. According to aging experts like Bellantoni, it’s not a stretch at all to grow significantly older without getting too much slower—you just have to be willing to work at it and even to somewhat ignore age as a limiting factor.

Think about people like 78-year-old financial pro Warren Buffett, 66-year-old rocker Mick Jagger or swimmer Dara Torres, who at 41 defied the odds at the Olympics. Search the Internet and you’ll find hundreds of groups for seniors who are mountain climbing, hang gliding and competing in extreme sports, often doing it better and more successfully than their younger peers.

“It’s not about stopping the aging process,” Bellantoni says. “It’s about making it better.”?

Healthy Behaviors Hit List
Maybe you’ve heard it already: Healthy aging means healthy living. Johns Hopkins aging expert Michele Bellantoni, M.D., says developing healthy behaviors early is one of the best things you can do to age successfully, including these daily habits:

  • Exercise for 60 minutes (moderate physical activity such as brisk walking or swimming).
  • Eat five servings of fruits and vegetables.
  • Drink five 8-ounce glasses of water.
  • Take 1,200 milligrams of calcium (milk, yogurt and cheese are among the highest sources).
  • Get 800-1,000 units of vitamin D (fortified sources such as milk; fish such as salmon, tuna and mackerel; and daily outdoor exposure—about 15 minutes).

Time Out for Screenings
Preventive health screenings can reveal potential problems early so they can be addressed. Aging experts recommend keeping tabs on the following:

  • Dental health
  • Vision (glaucoma, macular degeneration, cataracts, etc.)
  • Cardiovascular disease (blood pressure, cholesterol, hemoglobin A1c)
  • Osteoporosis (via FRAX assessment and/or bone-density screening)
  • Cancer (screening for breast, prostate, skin, colon and gynecologic cancers)
  • Vaccinations (influenza, pneumococcal, tetanus and herpes zoster)

Talk to your doctor about when and how often you should be screened and whether there are other regular tests or screens you should get based on your family health history.

Watch the Bones
About 44 million Americans have osteoporosis and about 68 percent of them are women, says Johns Hopkins endocrinologist Deborah Sellmeyer, M.D.

“If undetected and untreated, it can lead to fragility fractures, bone deformities and serious disability,” Sellmeyer says. Unfortunately, she adds, it’s usually not diagnosed until a fracture occurs.

You can help keep osteoporosis at bay by getting the recommended daily requirements of calcium (1,200 milligrams) and vitamin D (800-1,000 units), as well as doing bone-strengthening exercises.

The U.S. Preventive Task Force recommends bone-density testing for some younger adults at risk for osteoporosis; for men and women who have had fractures after age 50; and for all women after age 65 (age 60 with risk factors).

Visit The Metabolic Bone Center to learn more.

Waist Management
Belly fat isn’t attractive. But it’s the fat beneath the belly that poses the most risk to healthy aging, says Johns Hopkins exercise physiologist Kerry Stewart, Ed.D.

Called visceral fat, it’s rapidly absorbed by the liver, which increases the risk for cardiometabolic syndrome and puts people at higher risk for heart disease.

“It’s not part of the normal aging process to accumulate belly fat,” Stewart says. Keeping it off comes down to exercise and diet.

Bottom line: If you’re a woman whose waist measures more than 35 inches or a man measuring more than 40 inches, it’s time to trim the fat.

For more on matters of the heart, visit

Environmental Influences of Aging

  • Sun exposure—if excessive, reduces elasticity, increases risk for skin cancer
  • Sedentary lifestyle—leads to muscle weakness and decreased exercise capacity
  • Overeating—contributes to acid reflux disease, constipation, atherosclerosis, diabetes and hypertension

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