Health 2007: 7 determinants of aging you can control
AN APPLE A DAY - AN APPLE A DAY By Tyrone M. Reyes, M.D. () - January 16, 2007 - 12:00am
The old saying that "you’re only as old as you feel" turns out to have some scientific merit. As researchers probe the secrets of how we age, they continue to find ways in which our biological age influences our health and quality of life more than our chronological age. The good news is that while you can’t turn back the calendar, you can do something to affect your biological age – the tolls the years take on your body and your health. To put it another way, your lifespan – how many years you live – is important, but perhaps not as much as your health span or that period of your life when you’re functional and able to perform everyday life tasks for yourself. Isn’t that what most of us want more of in our lives – not merely years but good, independent, enjoyable years?

Here are seven determinants of aging that you can control and are essential in extending your health span.


The average middle-aged person’s problem is not excess weight as much as it is excess body fat, coupled with too little muscle. Simply losing weight is the wrong goal; the key is changing your ratio of body fat (biologically inactive energy store) to muscle (biologically active tissue). People with a greater ratio of muscle to fat enjoy a higher metabolism and don’t have to worry much about gaining weight or about how much they eat – since active tissue burns more calories.

Most people’s muscle mass declines with age, and the rate of loss accelerates after age 45. The amount of muscle you have – and which you retain – is determined in part simply by how much you use your muscles. If you use your muscles frequently, you can maintain your strength. But if you push your muscles to the limits of their capacity to exercise, you can actually increase their strength – no matter how old you are.


Even if your body weight hasn’t gone up significantly that much as you’ve gotten older, you’ve probably gained fat. As your musculature shrinks, fat tissue accumulates. Since muscle tissue weighs more than body fat, that number on your bathroom scale can be deceiving. Instead of focusing on losing weight, concentrate on gaining muscle and shedding fat.

You should also watch your waistline, as studies have shown that the distribution of the body fat may be an even better predictor of the risk of chronic disease and mortality. It’s healthier to be shaped like a pear – with more body fat stored below the hips – than like an apple, with fat stored above the hips. Developing a pot belly, in short, increases your risk. Recently, researchers using data from the worldwide Interheart study found that waist-to-hip ratio was three times more effective than BMI (Body Mass Index) in predicting cardiovascular risk. To figure your own ratio, simply divide your waist measurement by your hip measurement; so, for example, a 36-inch waist and 40-inch hips would be a ratio of 0.9. Anything over 0.85 for women and 0.9 for men indicates greater risk for heart disease, according to these findings. So, what can you do if your BMI and waist-to-hip ratio are high? The best way to attack excess body fat is a combination of exercise and moderate calorie restriction. By adding exercise to a "weight-loss" diet, you’ll maintain muscle mass while you lose fat tissue, raise your metabolic rate and, of course, burn more calories.


How much oxygen can your body process within a given time? That’s your aerobic capacity, for which you need healthy lungs, a strong heart, and an effective vascular network. Here’s another parameter that naturally declines with age in most people: In both men and women, aerobic capacity at age 65 is typically 30-40 percent less than in young adults. But older people who exercise regularly lose less of their aerobic capacity.

Researchers have found, however, that while both young and older people benefit from regular aerobic exercise – the kind that makes you huff and puff – the positive changes in older people come almost entirely in the muscles’ ability to utilize oxygen ("oxidative capacity"), rather than in the heart or cardiovascular system. That’s another reason why you need strengthening exercises as well as aerobic activity: When you build muscle, you create more muscle cells to consume oxygen. The more demand for oxygen from your muscles, the greater your utilization of oxygen and your aerobic capacity.


"Glucose tolerance" means your body’s ability to control blood sugar (glucose). Aging takes a toll on your ability to use this sugar from your blood stream. Other factors include increased body fat, inactivity, and a diet high in fat. By age 70, some 30 percent of women and 20 percent of men have an abnormal glucose-tolerance curve, increasing their risk of developing type-2 diabetes. Combining a proper diet, low in fat and high in raw vegetable and whole grains, with regular workouts can often transform what was previously an insufficient amount of insulin – which stimulates muscle cells to utilize glucose from the blood – into an adequate amount. Strength-training exercises are especially critical in reinvigorating your body’s glucose tolerance and lowering your diabetes risk; besides helping to lower body fat, strength-building exercise has been shown to increase your muscles’ insulin sensitivity.


You probably already know that not all cholesterol in the blood is bad for you; that’s why you’ll often see HDL cholesterol labeled "good" and LDL cholesterol parenthetically explained as "bad." So it stands to reason that a low total cholesterol level offers no guaranteed protection against heart disease. Your goal, rather, should be to raise HDL-cholesterol while lowering LDL-cholesterol levels in your blood.

An easy way to compute how you’re doing is to figure your total cholesterol/HDL ratio: Simply divide your total cholesterol number by your HDL count. For middle-aged and older men and women, the total cholesterol/HDL ratio goal should be 4.5 or lower. As you age, your HDL level tends to remain constant, while the harmful components of blood cholesterol increase, boosting your total cholesterol and your total cholesterol/HDL ratio. You can work to lower the harmful LDL-cholesterol by changing your diet, especially by reducing the amount of saturated fat you consume. But dieting changes can significantly improve only one side of the equation; to boost your HDL-cholesterol levels, you need to also exercise, and lower your body fat. Aerobic exercise, in particular, seems to be effective in raising HDL-cholesterol levels.


The importance of controlling your blood pressure should come as no surprise. What may surprise you is that an increase in blood pressure with age is not inevitable: Many populations around the world show no increase in blood pressure with age. In many countries however, including the Philippines, our deleterious health habits pave the way for hypertension. You can defend yourself against hypertension by reducing the salt in your diet. But regular, vigorous exercise can also help prevent and even treat high blood pressure.


With age, the mineral content of your bone declines, leaving you with a weaker, less dense, more brittle skeleton. On average, a person loses approximately one percent of bone mass per year. When this loss reaches the point where your fracture risk is substantially higher, it’s called "osteoporosis," a condition that can affect women as well as men. But osteoporosis isn’t an inevitable consequence of aging. Stress repeatedly placed on a bone causes it to grow stronger. A number of studies have shown that a prolonged span of weight-bearing exercise – such as walking or running – can reduce the rate of bone loss. One research has further shown that exercise may help foster the body’s calcium absorption. The evidence strongly suggests, in short, that a brisk daily walk can be a crucial factor in preventing the development of osteoporosis.

The ideas expressed in this column are scientifically proven to allow you to maintain a more youthful body and better quality of life even as your calendar years add up. By following such a program for the rest of your life, you can greatly improve your odds of approaching the ideal: a health span that almost matches your lifespan.

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