Essentially this book is a kind of 'fountain of youth' manual for those with the discipline to follow it.
Not only is the formula designed to lengthen one's life, but maybe more importantly, improve the quality by expanding one's options of activities.
It is to change the trajectory of aging from one of progressively steeper decline to one of a gradually descending plateau.
This book is written in a tag-team style with one author writing a piece and then handing it off to the other, back and forth with the two perspectives complementing each other.
The program is provided by Henry Lodge, a physician with specialties in internal medicine and gerontology, two areas that seem particularly relevant to the subject.
Chris Crowley, a 70ish retired trial lawyer, is Lodge's patient and 'star pupil'. As such, he provides the idiosyncrasies, trials and rewards of his journey.
Lodge simplifies the science in lay terms in a manner better and more user friendly than I have seen before.
Crowley, in a colloquial humorous style, invites people along on his trip.
As might be expected this is a program to improve health. It addresses a broad component of health issues, but the primary focus is exercise, lots of it and intense, by the standards generally imagined or recommended for people entering the last third of their lives.
The recipe is formulated around 'Harry's seven rules', the first three of which involve exercise.
Fully immersed the aspirant will be working out six days a week and the seventh seems conceded as a 'day of rest'. But you feel that the seventh is given up reluctantly and expected to be devoted to some vigorous recreation.
Workouts are loosely described as 45 minutes long, but hard work.
Four of the workouts are cardiovascular with the primary goal to improve health and longevity through better circulation. The two weight training workouts are to maintain or regain muscle mass that has been withering. Bolstered muscle allows people to more intensely enjoy longevity and expand their recreational choices.
Lodge maintains that about 70 per cent of one's health is within one's control, essentially through a healthy lifestyle. The remaining 30 per cent is a combination of genetics, unforeseeable circumstances and luck.
Most people die in our society from non-contagious diseases, a high proportion of which are related to deteriorating circulation. Leading this parade are heart attack, stroke and Alzheimer's.
The circulatory system is responsible for bringing nutrients to the cells of the body and removing their waste. Impediments lead to deterioration and crises.
Lodge describes much of this through a simple duality. The body is in a continual state of decay and growth, both essential and both occurring at the same time. Deterioration occurs when the balance disproportionately favours decay and this accelerates when people are sedentary.
This book is targeted at men retiring and entering the last third of their lives. However, almost all of it applies to women, and what doesn't is a mirthful rendition of the peccadilloes, insecurities and vanities of aging men.
One way of looking at the goal is to allow one to die skiing, cycling, kayaking or hiking instead of tubed-up in a long-term care facility.
While more than a decade has passed since this book was published and science has moved along, most, to the detail presented here, is still valid.
Precis
From this point I will continue with a precis of the book in chronological order elaborating on the issues outlined above, focussing on the technical material by Lodge. This is for people who may want more information but are not yet prepared to read the book.
They will have to read it if they want to learn about pumping iron in nursing homes or old people armouring up to ski slalom on icy ruts, or why an 85-year-old abandoned plans to retire from sailing at 85 and was still doing it at 94.
Seventy per cent of premature death, says Lodge, (before mid 80s) is lifestyle related and “70 per cent of the “normal” decay associated with aging___the weakness, the sore joints, the lousy balance, the feeling crappy can be forestalled almost to the end.”
The scenario of how Chris met Harry says something about Chris' perspective. “I went to Harry because a pretty, redheaded skin surgeon named Desiree (if you can believe that name) told me to. She had just taken off half my nose with a local anesthetic, and I was still crazy about her. “
Lodge dispenses early with “dieting”. “Dieting is dumb and doesn't work.” Stop eating 'crap' like fast food, lots of fats and simple carbs and less of everything. He told Chris his weight would drift down with exercise.
The exercise program would build more muscle which would consume fat even at rest with the attendant increase in metabolism.
The importance of connection to a support system of family, friends and spouse, since we are a pack species, is mentioned early and emphasized in late chapters.
A crucial dichotomy Lodge reveals is that his patients had “good medical care, but not great health care.” He chides the medical system for over focussing on disease care and under focussing on the lifestyle of the patients. “If we had the will to do it, we could eliminate more than half of the disease in men and women over fifty.” And another prescient revelation, “normal aging isn't normal” and can be avoided.
Aging is normal, inevitable and slow, but much of that attributed to aging is decay and deterioration of function primarily related to a sedentary lifestyle and too much “bad” food.
Sometime in the 40 to 50 range the “free ride of youth” is over and our bodies default to decay mode in the absence of signals to grow. But a growth signal can be promoted, says Lodge.
Human bodies have evolved to be active, but current lifestyles don't emphasize this. Another signal that the body has evolved to perceive, is taking on more calories and becoming more sedentary. It tells the body it is heading into a famine. Both body and brain, says Lodge, are moving into a low grade depression harbouring resources that may be critical to surviving, a parallel with hibernation.
Now these signals are subjected to the standard modern day lifestyle. In nature, lack of food is the only reason to be sedentary.
Body tissues are always trying to decay and although constant, the signals are weak. They can be countered with activity everyday.
While our bodies evolved slowly over eons, our circumstances have changed rapidly such that death by starvation, cold or predator is rare. “Almost incomprehensibly, the great problem of our time is surfeit and idleness.” “Our bodies do not know how to 'read' this plenty. Without the challenges presented during our evolution “we soften to death”.
“Exercise is the only way to engage your body and your physical brain, but if you do you will get “younger”. Steady exercise rises in priority as one gets older. See it with the sense of responsibility you may have devoted to your employment, because it is now your new job and take comfort it is only 45 minutes a day, advises Crowley.
Crowley recommends people join a gym, even if it only has to be relied on when inclement weather precludes outside exercise. He advises gyms with a mixture of ages, but his preference is for a “lot of young and cute” and a few old to maintain his perspective.
It is also advisable to set a time for your workouts and stick to it. Routine is important. Crowley says sacrifices are necessary “if you're going to live forever and be cute as a button.”
Lodge highlights the decay/growth scenario stating that muscles in the thigh are completely replaced over four months, one cell at a time day and night. Emphasizing the idea all blood cells are replaced every three months, platelets ten days and bones every couple of years.
While Lodge doesn't mention it, you would expect to feel newer than you do. Declining faithfulness of replication of cells seems to be the problem. But at the same time with effort you can still build better new cells than a sedentary lifestyle has been providing you.
Exercise starts a cascade of chemicals triggers the building of new and better cells, says Lodge. Put simply, the mechanism is that exercise produces inflammation which attracts white blood cells to demolish old cells making way for the building of new ones.
Lodge introduces the term “cytokines” which are messenger molecules controlling every aspect of your biology. The key ones he focusses on are C-6 which promotes inflammation and decay and C-10 which promotes repair and growth. Exercise reverses the chemistry of decay hence the claim to get younger.
A surge of C-6 from exercise will trigger a corresponding and greater surge of C-10. However, a trickle of C-6 in a sedentary lifestyle is not enough to get a surge of C-10 and the net result is decay.
Lodge emphasizes that this explanation is extremely simplified. The science of health is far more complex than the science of disease, that physicians study, he says.
Chronic stress of life favours C-6, but the stress surge of exercise favours C-10. The effects of chronic stress augmented with dietary fat can change poor health into death, he says. In nature, chronic stress is coupled with starvation.
Half of us are killed by circulation inhibiting plaque, adds Lodge. For example a heart attack is not about a “bad heart”, the muscle may be almost perfect. The problem is bad circulation to the heart. Circulation is the key to good health and doing stuff.
Lodge says it is important to remember that exercise and mood share the same chemistry and reinforce each other. There really is a runner's high.
When starting an exercise program, cautions Crowley, make it hard enough so it doesn't bore and easy enough so it doesn't result in injury or discouragement. It is important to “show up” and do something everyday.
Initially that may be a walk that gets progressively longer. Activity at this level, below 65 per cent of your maximum heart rate, involves burning fat as the fuel. Although a few may not get past this, most can.
Crowley describes his initial trepidation with a “spin class” (organized trainer bicycle class). “Because I am very old, I am forty pounds overweight and I do not look becoming in my biking costume.” But as is his luck he is saved by the instructor, an “alarmingly pretty woman”(he freely confesses to noticing these things). And he is more inspired than discouraged as the “room fills with beautiful creatures in their 20s and 30s”. The instructor, impressed that he came out, encourages him and he comes back.
And a comforting thing is that old people 'out there doing it' are welcomed as inspirations in most activities and gyms.
On sports, Crowley says, those like tennis pull you apart. Running beats on your joints. Those that knit you together and make you feel better when you are done include swimming, biking, cross country skiing and rowing. (If he were Canadian he might include skating.) He recommends that at least one “healing sport” be in your repertoire. “There is no machine more beautiful, more perfect in the form-follows-function line, more ideally suited to your purpose than the bicycle.”
For those deluding themselves about the exercise value of golf, it isn't aerobic, but it can help you on the mood/connectiveness side. Be aware of other exercise lies you may be telling yourself.
And an encouraging note for those with no history as a “sports god”. It is easier to be the best you have ever been and improve in a new activity and maintain spirit. Former jocks are haunted and discouraged by the lesser standards they can now achieve in comparison with the gloried past.
Back to the biology again. Mitochondria, developed first by bacteria two billion years ago are the tiny engines that convert energy in muscles cells. This energy is produced with oxygen, which has the additional negative effect of “burning holes” in DNA. Antioxidants in fruit and vegetables neutralize excess oxygen.
Muscles burn fat most of the time as the most efficient fuel. However, for power and speed, glucose or blood sugar, is the fuel. At rest and light exercise the ratio is 95 per cent fat five per cent glucose.
Fat is delivered to mitochondria by blood running through capillaries (the smallest of blood vessels). Aerobic exercise demands more fuel and the body's response is to grow more capillaries to transport it.
Steady aerobic exercise over months and years, says Lodge, “produces dramatic improvements in your circulatory system, which is one of the ways exercise saves your life.”
Firmer muscles are the result of more capillaries, more glucose and more mitochondria packed into them as a result of exercise, he adds.
Your body converts from burning fat to burning glucose when your heart rate reaches about 65 per cent of your maximum. (basic rule to determine maximum heart rate is 220 minus your age beats per minute). A heart rate monitor is recommended to keep track of how hard you are working and what fuel you are using.
“You become more fit with harder exercise (above 65 per cent heart rate), but you gain more endurance and general healthiness with prolonged light exercise,” says Lodge. And “the real benefits of exercise come with months and years of sustained, steady growth. They produce long and deep currents of C-10.”
When you raise the intensity into the glucose burning zone (plus of 65 per cent heart rate) there is a major metabolic shift in most body organs. Your body prepares for more extreme activity.
A person in good physical condition stores enough glucose in their muscles for about two hours of hard exercise. Lodge relates this back to hunter/gatherer activities where glucose burning is hunting and fat burning is foraging.
Glucose burning aerobics bring out “our best and youngest biology” and is in effect until about 85 per cent of heart rate.
Anaerobic is the top gear and it utilizes no oxygen. It is the oldest, least efficient form of energy generation, but it is also the most powerful. It does not help fitness, but may be a morale booster occasionally.
Lodge points out that varied exercises and activities are better than an unvaried routine. The consistent regularity of exercise (dailyness) is more important than the intensity, he adds. Think of it as a job and show up every day. It should be “protected time”. Another suggestion is high aerobic in the gym and low aerobic outside.
Seemingly against logic “we are tired at the end of the day not because of too much exercise, but not enough.” The time spent exercising “is a bargain if you put any value at all on the quality of life”.
And for the pessimists, Crowley maintains you will get to love the regular exercise. There really is a high to be had with time in the aerobic zone.
Crowley speaks about the value of planning a challenging trip in whatever is your desired activity and then training for it. He is a big fan of treating yourself to the best equipment when you are out there doing it past the age of 50. So he has a premium quality bike, scull and skis.
On reading this some of you may identify with “there is nothing haughtier than a nice warm doctor prescribing outdoor exercise for some fat, terrified old gentleman who wants nothing more than to sit and watch TV.”
Crowley relates a story where he “impulsively” accepted an invitation to a masters ski racing clinic. A good recreational skier, he had an inkling that he would be out of his league and he was. Little old ladies in self-fashioned armour charging slalom poles on a rutted icy course. But trying stuff beyond you does have its place, he adds.
Although supportive, this was not to be his group. But he recommends having a sports group which can be a useful support group.
Earlier I mentioned Crowley's introduction to a weight training gym. It and the above ski racing clinic are two of the most humorous and sympathetic stories in the book. But the key is “regular strength training for life sounds stupid, nasty and scary. And we wouldn't even mention it if it were not one of the best pieces of advice in the whole damn book.”
Maintaining and slowing the loss of bone density is one of the main reasons for strength training. The other is slowing the loss of muscle mass as much as possible and strengthening tendons. And if you don't have much muscle you can gain some. It prepares you for emergencies like running across the street or getting in the bath tub.
Crowley advises reading a book or hiring a trainer, or both, for weight training. Learning to lift weights properly requires skill and experience. You may want to look at it like a new sport. “It's never too late to start a serious program of strength training. The later in life the more important it is.”
“Weight training is serious therapy to halt or reverse the ravages of aging. Do it early and you can skip a lot of aging altogether. Do it late and you can reverse a lot of it.” Along with arthritis amelioration, weight training can forestall deterioration in balance, says Crowley.
And the biology of strength training: most know that muscle growth is an outcome, but less well known that it is crucial in the increase in neural co-ordination, says Lodge. It is not that of hand-eye co-ordination, but that of fine muscle detail and the network of nerves that link body and brain, he elaborates. And this reaffirmation of co-ordination and reactions reduces susceptibility to injuries from other activities.
He says deterioration in this causes joints to wear as muscles “get sloppy and our ability to be physically alert and powerful begins to fade”. This is reversible by strength training.
Essentially aerobic exercise gives endurance, circulation and longevity, where strength training gives you power and neural co-ordination. Working hard enough in either aspect to turn on the growth prompting C-10 is the key, he says.
Surprisingly strength training has not shown as dramatic results in the expected sports of shot put and weightlifting, as in such co-ordination sports as figure skating and skiing.
Muscles are made up of two types of cells; slow twitch which are long on endurance and short on power and fast twitch, short on endurance but big in power. And different nerves activate each, depending on the demand.
A key element for the staging of aerobic versus strength training is that recovery from aerobic occurs overnight, but for strength there is a 48-hour repair cycle, says Lodge. Strength training is the aspect most likely to prevent you from falling down as you age.
He does support yoga as ideal “creating a more profound neurosensory and proprioceptive integration than Western exercise.” It stimulates muscle groups in different combinations, but you should be reasonably fit to start.
Stating that studies are scarce and poor, Lodge has nothing encouraging to say about supplements, protein powders etc. conceding only to a multivitamin, beyond a good diet. He is critical of refined white starch calorie foods such as rice, pasta, bread and potatoes and fast food generally.
Historically most foods were low in sugar, a rise in blood sugar suggested the completion of a large meal. Now there is no consistent message in sugar. Now your body has to rush out insulin to help you through the massive meal your body thinks you have consumed. Other gastric enzymes are commandeered for the starch.
“Dieting is the false good of the last 30 years” and should not be a focus. Most diets (weight loss) are unproven scientifically or medically. And for the food faddists out there, food is complex and there is little chemistry or biology about what happens with what food. While ideas are vague about what and how good many foods are, there is reasonable guidance on what is useless and harmful. Generally the Mediterranean diet seems to be positive.
The rate at which you burn calories goes down as you age, so reduction in intake combined with more exercise seems prudent. For those given to excess of a certain food, abstinence seems easier than moderation.
As some reassurance to people overweight, Lodge says that an overweight man who smokes a pack of cigarettes a day but exercises hard and regularly has better health prospects than a man of ideal weight who doesn't smoke, but doesn't exercise.
The fat content of our bodies varies with seasons and is deeply imbedded in our evolutionary past. Our body in the modern environment is confused by the signals from our eating. For example it reads idleness as starving to death, says Lodge. Exercise should not be looked at to burn off calories but to grow new tissue. Active fat (unsaturated) is wonderful. It is the inert (saturated) fat stored 'for winter' that does us in. “In modern life, however, in the perpetual winter we have created through sloth and gluttony, your body uses every possible trick to lay down extra calories as saturated fat and to hold on to them like grim death”, says Lodge. “Your body reads idleness, as a sign that you are starving to death as slowly as possible, no matter how much you eat.”
In our evolutionary past, animals we ate contained 10 per cent fat, mostly unsaturated. Now feedlot- produced animals have 30 per cent fat, mostly saturated.
Prostate, colon, breast and ovarian cancer are directly proportional to dietary levels of saturated fat in diets around the world. Heart disease, stroke and Alzheimer's are strongly linked to saturated fat in diets, he adds. Red meat, as it is produced today, are prime sources of this.
On the good side, are whole grains, fruits and vegetables for micronutrients and fibre. Legumes is the other important category.
Refining flour turns it into starch. Instead of white bread, he recommends heavy breads such as pumpernickel and seven and twelve grain.
Science suggests that there is a correlation between moderate drinking of alcoholic beverages and some aspects of health, but the authors say if you drink don't stop and if you don't drink, don't start.
On the limbic side, says Lodge, men do not generally do a good job of staying connected as they age.
Emotion is physically stronger than thought and that suggests a different way we conduct affairs, says Lodge. It also explains quite a bit about human behaviour and priorities. Following a good strategy on health can improve the emotions that may be guiding you. “Limbic resonance” refers to the sharing and echoing of moods and emotions in a group and it is primal in humans.
And if negative emotions are what is being shared it can cause a deterioration in health.
Lodge suggests that limbic muscles, like physical ones, have to be exercised.
When you retire from a workplace you are giving up an accustomed “pack”. There is a void to be filled by new connections. Pet owning may help.
Don't treat life like a long vacation, urges Crowley. Essentially you have to go back to work at something and your exercise routine is one component.
In retirement, says Crowley, there is a tendency to get narrower in outlook. This, he says, should be combatted by exercising, adding activities and adding and maintaining friends, remain a pack animal. It makes it easier not to become a judgemental, petulant grouch.
Lodge puts it into perspective succinctly “Exercise hard and you will grow younger. Care about people and you will grow happier.”
And Crowley “In retirement we have to rethink our ideas of success. Get over them, as a matter of fact. Most of us gave up far too much for success and got back far too little in quality of life.”