Growing old healthily: How to do it

We all want to live as long as possible - and above all, as healthily and self-determinedly as possible. Although we are not completely in control of our own destiny, we can make a contribution towards ensuring that we do relatively well in old age.

Prof. Dr. med. Heike A. Bischoff-Ferrari and Dr. med. Katharina Geiling discuss in an interview what each and every one of us can do to increase our personal life expectancy and stay healthy for as long as possible:

1. Genes or lifestyle: Which of these has a greater influence on life expectancy?
   It's now common knowledge that our lifestyle defines most of our life expectancy. And this is very good news, because it means we can influence things ourselves to stay healthy and active for longer. What's more, it has been shown that even with a genetic predisposition, the outbreak of a disease is largely dependent on lifestyle factors. Our genes only explain around 10% to 30% of the variability regarding our longevity. Lifestyle factors such as diet, physical activity, social engagement and environmental factors have a much greater influence and can be used to explain 70% to 90% of our longevity.
2. Smoking, stress and alcohol are known factors that reduce life expectancy. Why is this so, and how strong are these effects?
   Smoking and stress can promote a chronic inflammatory reaction, which causes damage at the cellular level and makes regeneration more difficult. Stress, for example through loneliness (Healthy and active 60+: Influence of loneliness on health – USZ), also leads to an increase in the stress hormone cortisol, which is harmful to the body and can contribute to the loss of muscle mass. Alcohol often provokes controversy when discussed in literature/articles: A glass of red wine is part of the very healthy Mediterranean diet and moderate alcohol consumption is a protective factor in terms of longevity, according to studies. At the same time, however, literature/articles also show that even small amounts of alcohol can have a negative impact on certain diseases, such as the risk of breast cancer in women.
3. Obesity is considered a risk factor for many diseases. What is the connection here?
   A BMI of 18 to 25 is considered normal weight. Excess weight from a BMI of more than 25 can lead to secondary illnesses such as diabetes, cardiovascular disorders or musculoskeletal disorders. The likelihood of developing such illnesses increases as body weight rises. According to long-term studies by Harvard University ("Harvard cohorts"), normal body weight at the age of 50 is one of the decisive factors for a healthy life expectancy. What is also relevant is that a healthy body weight should not be achieved by "fasting", but instead by changing to a healthy diet together with daily exercise.
   
    
4. It has been proven that exercise has a positive effect on health. What kind of exercise is healthiest and how much exercise is necessary to achieve a positive effect?
   The WHO suggests 150 minutes of moderate physical activity (for example walking), or 75 minutes of demanding physical activity per week. We recommend a mixture of strength and endurance training three times a week, as well as a regular basic activity, such as at least 6,000 steps, or even better 10,000 steps, each day. Literature/articles show that even a small amount of exercise, such as 20 minutes of walking a day, has a significant and positive impact on longevity. If you manage 10,000 steps a day, literature/articles show a reduction in premature mortality of up to 40%.
   
   To make daily activity more than just a good resolution, it's important to incorporate exercise into your daily life naturally and according to your own preferences. We are therefore also developing digitally supported concepts, as part of our research, to help people implement several smaller lifestyle adjustments permanently.
5. According to the Federal Statistical Office, around 40% of all people over the age of 90 in Switzerland are affected by dementia. What can I do to prevent this?
   The risk of dementia increases with age, and is thus a focal point of prevention for healthy longevity. There's good news here, as well: With a comprehensive risk analysis, 40% of all dementia cases could be avoided through prevention.
   There are six factors that protect against dementia:
   1. sufficient sleep: (7-8 hours);
   2. stress regulation with awareness exercises;
   3. avoiding loneliness, maintaining social interactions;
   4. daily exercise, 150 minutes per week;
   5. learning new things; and
   6. a healthy diet. A little tip: Eat a handful of berries and nuts each day, which are so-called "superfoods" for maintaining memory function.
6. What role do mental health and social factors play in relation to life expectancy?
   Mental health and social factors play a key role in life expectancy in general. People who maintain friendships into old age, are open to new things and support others have a higher quality of life and a higher life expectancy.

What is your personal tip for a healthy, long life?
Dr. Katharina Geiling: Based on my last trip to the Japanese island of Okinawa, I personally see the greatest commonality in the "mindset" of people who do not just grow older passively, but remain physically and socially active well into old age. A certain level of serenity and being able to deal with stress are certainly also a part of it. 

Prof. Dr. med. Bischoff-Ferrari: Staying active together, eating healthy and being open to new things.