Most people would agree that that living a longer life is only worthwhile if you are healthy enough (both physically and mentally) to enjoy it. Becoming a centenarian (age 100+) is not desirable if you are in pain, too debilitated to care for yourself, or present in body but not in mind. Your lifespan (the total number of years you live) is important, but a long healthspan (the number of years you remain healthy and free from disease) is what the ultimate goal should be. How do we increase our health spans? Research indicates preventing chronic disease (heart disease, cancer, dementia, etc.), not treating the disease once it manifests, is the best strategy. Unfortunately, a seemingly larger and larger focus of our current healthcare system is on problem-based treatments and increasing a person’s lifespan.
Insurance reimbursements and productivity metrics for hospital systems arise largely from intervening and treating with medications, devices, procedures, or surgeries; while prevention of chronic disease comes from primary care in the form of an in-depth understanding patient’s personal and family histories, risk factors for disease, lifestyle habits (diet, exercise, sleep, mental health, and drug and alcohol use) and up to date knowledge of preventative screening guidelines. Understanding all this information takes time, and it takes even more time to use this information to educate patients, formulate plans to make changes and get screenings done, and follow up with the patient. Yes, insurance reimburses for the time primary care doctors spend with patients, but it is a mere fraction of what they reimburse for a 10-minute cataract surgery or specialist visit. It’s not cost effective in a hospital system to give a primary care doctor an hour with their patients. They usually get that same 10 minutes of face-to-face time to try and control things like heart disease risks to prevent cardiovascular disease and a future heart attack. You can imagine how well that goes.
When someone comes into the hospital with a heart attack, they will get all the necessary invasive and non-invasive treatments their bodies will allow to keep them living longer. But at this point, the coronary artery disease is already present. They are already living with a chronic disease, and these interventions will undoubtedly help and keep them living longer, but the impact it has on that person’s healthspan is questionable. There is no denying the many amazing medical advancements that have been developed to treat chronic disease – they all play a big role in what has extended our average lifespan over the last several decades. But health-adjusted life expectancy, an indicator used by the WHO to quantify QUALITY of life, has not increased at the same rate.
So how can you increase your healthspan? It is not as difficult as you might think. Your day-to-day habits play a powerful role in mitigating your chronic disease risk. Yes, your genes play a role that you cannot really change, but scientists estimate only about 20% of how long and healthy you live is dictated by your genes. That leaves 80% of your life and health span dictated by your lifestyle. There is an abundance of evidence that comes from studying The Blue Zones (the 5 areas in the world with the highest percentage of centenarians) and how their lifestyle impacts their longevity. To summarize the research:
- If you smoke, quit. This reduces your risk of dying early by 36% regardless of your age when you stop.
- Exercise on a regular basis. Even moderate exercise like walking or bike riding. Regular exercise is associated with a 20-58% lower risk of heart disease amongst dozens of other benefits.
- Plant based diets. This does not mean there is no room for animal protein, but a diet that consists of mostly fruits, vegetables, legumes (beans, chickpeas, lentils), and whole grains significantly decreases your risk of heart disease, cancer, and premature death.
- Avoiding processed foods and refined sugar
- Avoiding excessive alcohol consumption – More than 7 servings/week for women and 14 for men
Possibly the most important thing you can do to promote a longer healthspan is to find a primary care doctor who puts a large emphasis on prevention of chronic disease in addition to chronic disease management and has time to spend with you to help you with lifestyle changes. They should also be staying on top of your various cancer and chronic disease screenings – and avoid the trap of only going to the doctor when you are sick… we are here to help you prevent illness too!