A 69-year-old patient asked me, “Doc, I want to live more. 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 inhabitants of Okinawa (a small island south of Japan), which is known for many people living up to 100 years and more. You will find a small Japanese inscription on a small plaque in the village of Ogimi there: “At 80, you are merely a youth. At 90, if your ancestors invite you into heaven, ask them to wait until you are 100 — then, you might consider it.”
The global debate for increasing longevity invariably centres on the inhabitants of this island. Okinawans eat fewer calories (much comes from sweet potatoes) and have plenty 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 (Okinawan ratio), unlike most of the currently trending diets. A tight social fabric and relatively hassle-free active life helps. The genetic make-up of people also contributes to good health; they have low quantity of bad genes (APOE4) and good amount of metabolism-friendly genes (FOXO3). Where can we find such clean air, idyllic settings and such genes? Unfortunately, most urban areas in India have an atmosphere to the contrary and a worsening lifestyle.
Indians have the worst metabolism
It is reasonable to state that Indians have worse metabolism compared to many other races. Our bodies harbour inflammation (“fire within”) which corrodes the liver, arteries and kidneys. Ageing molecules are activated, which lead to the withering of organs, including the brain. Within these ageing molecules reside rogue ones, which start cancer. One or multiple diseases emerge, which further cut down life years. Diabetes is one of the most important diseases, which can decrease life. Our recent research shows that even prediabetes decreases lifespan.
How can we delay ageing?
What can we do to avoid deterioration of our cells? If we cannot entirely avoid atmospheric pollution, we should at least quit smoking, including the company of smokers. We should eat lesser calories by about 10 per cent (that is what the Okinawa population eats). Green vegetables and fruits intake should increase to five-seven servings daily. Foods should be rich in polyphenols (berries, nuts, flaxseeds etc) and carotenoids (avocado, spinach, yellow-fleshed vegetables etc). Tree nuts, fish and Omega-3 fatty acids may help.
Weight must be maintained at low normal (“lean”) with little gain over the years as age progresses. Muscles must be made strong by working on resistance exercises (with weights and elastic bands). Activity must 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 lifespan?” Not likely. Pure seeds (good lifestyle) to nurture cells must be sown in childhood and the legacy will be a good and long life. Another caveat is that all lifestyle measures that are so suitable to Okinawa residents may be unsuitable to us. Unlike Okinawans, who have high carbohydrate meals, Indian bodies will respond better with low carbohydrate, high protein foods. Tailoring food and exercise to different races and environment must be taken into account.
Parameters for good health
What are the parameters which ensure good metabolic health and longevity? Fasting blood sugar below 100 mg/dL, BP below 130/80 mmHg, cholesterol below 150 mg/dl, body mass index below 23, waist circumference below 80 and 90 cms in women and men, respectively, and normal-sized liver.
Above all, the most important parameter is the fitness of the individual, which is measured only in laboratories. It is the sum total of nutrition, exercise, weight and robust functions of lungs and heart. If you achieve all the above, you will lead a healthier life without serious diseases even if a lifespan does not go beyond 100!
(Dr Misra is Padma Shree awardee and the author of the book, Diabetes with Delight).