Fat grandmothers

I had none. I'm so fortunate that I had both my paternal and maternal grandparents in my life, and my great-grandparents lived just a few doors away when I was very young. My grandmothers weren't fat, or even plump or curvy. If your grandmother is a member of my generation, you probably can't say that.

Today I was reading "Aging, adiposity, and calorie restriction," by Luigi Fontana and Samuel Klein in the March 7, 2007 JAMA. It's a very cautious and conservative review of the literature from 1966 through December 2006 in PubMed (the largest and most famous medical literature database) which concludes from all the studies done on calorie restriction in the last 40 years that calorie restriction in adult men and women causes beneficial metabolic, hormonal, and functional changes, but (and here's the cautious part) the precise amount of calorie intake or body fat mass associated with optimal health and longevity in humans is not known. And after laying out all this fabulous research (139 citations), the authors take a buy-out and decide that because calorie restriction is difficult to maintain long-term, we might have to turn to a pharmacological agent for a solution. Cha-ching. There's no money in eating less, moving more.

That's what got me thinking about my grandmothers, both of whom lived to their late 80s. One was born in 1876 and the other in 1895, young enough to be the other's daughter (my great grandmother was born in 1873), a time when life expectancy at birth was about 45. Their generations benefited from better hygiene, but I doubt that either ever had a vaccination. It's possible that very late in life they might have had an antibiotic. I don't know much about their early lives, but given the times, I'm sure they were both breast fed by non-smoking mothers. They didn't give birth in hospitals. They both lived their childhood and early married life on farms a few miles from each other, but didn't work in the fields. Housework, however, was much more physical in those days. I use Grandma Mary's pressing irons as book-ends--they were heated on the cookstove and weigh 10-15 lbs. Water was pumped outside and carried in to be heated either in the stove or on it. Grandma Mary was wealthier than Grandma Bessie and did have a German woman as household help, but they would've worked side by side. And both gardened (potatoes, carrots, cabbage, tomatoes, beans, turnips) and raised chickens for meat and eggs. Root crops could be stored, and beans and tomatoes were canned for winter, but table fare was pretty bland and boring. Both women baked their own bread. Beef was not on the table in either household. Grandma Mary rarely served meat, except chicken occasionally, and Grandma Bessie would have only had fatty pork, sausage, or a tough old chicken, too old to lay. Cows were for milk (cash crop) and butter (for cooking), and when you think about it, they were much more difficult to butcher for a single family than a pig or chicken. There wasn't even much in the way of fruit, maybe a few apples, grapes for juice or berries.

According to the authors, the first calorie restriction study was done in 1935 when it was discovered that limiting calories in lab rats increased their life span by 30-60%. Food shortages during WWII in some European countries were associated with a sharp decrease in coronary heart disease, and although this article didn't mention it, I've seen reports like that on breast cancer. Again, the authors use cautious language, but say "population studies suggest that lifestyle factors, such as sedentary lifestyle, dietary intake, and adiposity, are responsible for up to 70% of chronic disease and are a major contributor to reduced longevity. . . data suggest that a BMI at the low end of normal (18.5-24.9) is associated with optimal metabolic and cardiovascular health."

Cross posted at Collecting My Thoughts.

Reduce need for drugs with massage

The Wall St. Journal on March 10 had an article about the Providence Rest nursing home which caters to retired nuns. A licensed massage therapist has cut the home's use of antipsychotic drugs for agitated patients from 30% down to 2 or 3%. Read the story here.

Don't forget your nap

Retirees can enjoy the health benefits of a nap. I was browsing my sign-in at JAMA and the archives today, and noticed this at Arch Intern Med. 2007;167:296-301, "Siesta in Healthy Adults and Coronary Mortality in the General Population." They don't have much evidence for women because very few died during the study, but for men it is clear: the habit of a regular mid-day nap lengthens their lives.

How this study was done: This study involved 23,681 men and women in Greece between the ages of 20 and 86 who volunteered to take part in the European Prospective Investigation into Cancer and Nutrition (EPIC). All those in the study were asked whether they took a midday nap and, if so, how long they napped. They were divided into groups: those who never napped, those who took naps of 30 minutes or more at least three times per week and those who took midday naps occasionally or whose naps lasted less than 30 minutes. The researchers also asked about their levels of activity and diet. The study excluded those who had previously had heart disease, stroke or cancer.

What was found: Of those in the study, 792 died, and 133 of those died of heart disease. The researchers found that the risk of dying from heart disease was 37 percent lower for those who took naps of 30 minutes or more at least three times a week than for those who took no naps. Occasional napping did not have an effect on the risk of dying from heart disease. It appeared that the effect of napping was stronger in men, and in particular, men who worked. The authors said that findings are consistent with the fact that occupational stress can increase heart disease risk. Summary

Five Healthly Resolutions for Women

Five Healthy Resolutions for Women appeared at WebMD. I've added my own comments, and not lifted large sections to post, so pop on over and read the whole article. We've heard it all before, but January 2008 is a good time to renew your resolves of 2007.

Eat, but don’t pig out. All or nothing approach will kill your resolution. When I lost 20 lbs. a year ago, I had a list of things I would avoid, like French fries and cheese, but I allowed myself my favorite restaurant meal on Friday nights--Philly Cheese steak with Fries--which had just about everything on the list!

Jump outside the box. Most workout intentions fall by the wayside by February. Like the diet, don’t be unrealistic. If you hate exercise or you aren’t athletic (like me), you won’t get there by resolving to be different. It’s just you. Park further away. Take the stairs. Take dance lessons. Volunteer to walk a neighbor’s dog. Wear a pedometer.

Guard against the bone thief. Women and osteoporosis. For postmenopausal women 1,000-1,500 milligrams daily if on menopausal hormone therapy. Exercise helps the bones too, as does good nutrition. Smoking and alcohol have to be watched too. To paraphrase Ben Stein, nothing you overindulge in when you're young is worth being disabled or an invalid when you're older.

Get an A+ in taking health exams. Mammogram. Bone density. Pap smear. The colonoscopy is the only exam we have that actually can prevent cancer--find a polyp and have it removed before it causes trouble all during the exam. Colon cancer is so nasty--and so preventable.

Take care of the caregiver. Stress can really lower your immune system. Moms and daughters seem to always be looking out for someone else. Take the time to assess your situation. Who'll take care of everyone else if you're laid up?

Besdine's Boomers

Dr. Richard Besdine uses the mnemonic "Besdine's Boomers" to remember these mid-life strategies for healthy aging.

Blood pressure -- get screened at least once a year and treat appropriately if high
Exercise -- keep the mind and body as vigorously active as possible
Smoking -- stop as soon as you can; the benefits accrue immediately
Driving -- have a physician evaluate you for driving risk
Immunizations -- get a flu shot every year and a pneumococcal vaccine once
Nutrition -- proper nutrition is critical, especially for cardiovascular health
Environment -- keep your home environment safe with smoke and carbon monoxide detectors; get rid of toxic substances under the sink
Screen for cancer regularly -- Colon cancer screening as recommended by your physician; skin should be evaluated by a physician once a year; for women a mammogram annually and a pap smear as recommended by your physician

Booze -- avoid excessive alcohol; alcohol and smoking accelerate bone loss
Osteoporosis -- women and men should get a minimum of 1500 mg. calcium a day; one-quarter of all hip fractures in the elderly occur in men
Oral health -- healthy teeth and good dentures are important for proper eating; see your dentist annually
Mobility -- stay as active as possible
Emotional health -- too little attention is paid to stress reduction in old age, when events such as the loss of work and the death of friends and spouses can cause stress and emotional upheaval
Rx drug safety -- beware of taking outdated and conflicting medicines
Social Networks -- important for stress reduction and overall emotional health

Richard W. Besdine, M.D.
Professor of Medicine and Director,
University of Connecticut Center on Aging,
University of Connecticut Health Center

Seen at Alliance for Aging Research

Unbelievably good deals

This is a terrific little reference book. "Unbelievably good deals and great adventures that you absolutely can't get unless you're over 50" by Joan Rattner Heilman, 2007-2008 edition, McGraw Hill, 2007, will set you to dreaming about what you're going to do with all that free time when you are retired. There are 19 chapters on travel, education, sports, shopping, etc. Chapters 2-12 actually deal in some way with travel--lodging or airfares, tours, cutting costs, etc. This author doesn't want you to pay sticker price for anything. Always ask about a senior discount.

If you are a single man over age 45 and a great dancer, consider being a "host". You can cruise for (almost) free, working 3-4 hours a day. All you have to do is not get romantically involved with any of the passengers.

This summer at Lakeside I met a kite-flying teacher who was wildly enthusiastic about the Evergreen bed and breakfast club, which is featured in this book. It's for people over 50, has 3,500 members and 2,000 host locations. A couple pays $15 for each overnight stay. The club dues are $60 (single) and $75 (couple). Check www.evergreenclub.com.

Recommended automobiles

Jonathan Welsh of the WSJ recommends the following cars if you've had a knee replacement: 4 door Ford 500 (Taurus), Chevrolet Impala, Buick Lucerne and Dodge Charger or Chrysler 300. Can't imagine trying to get into a Charger with bad or stiff knees.