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Saturday 13 July 2019

Pillars and Sinks of Healthy Ageing


Index of Blogs and Courses

In my previous blog, I have discussed the sorry situation in the world when a person expects to spend 10 years or more of his/her life in poor health/disability - this is despite stellar advances in medicine and much increased health-related spending. 

Last week, I had the pleasure to present my thoughts on healthy ageing at Burnbank Centre, Hamilton to a largely elderly audience.  They were really curious to learn more about lifestyle choices to ensure life without disability and disease.  I present here the slides, with added comments, from the main part of my talk.

The loss of healthy ageing is due to the steep rise in chronic diseases over the past 50 years.  The human and financial cost of disability is immense for the individual, loved ones and the society. 
To a large extent, chronic diseases may be avoided by suitable lifestyle choices.  For the best outcome, a healthy way of life ideally should start from a young age and practised through out life.  Many societies, the so-called Blue Zones, have done so for centuries and enjoy long life with minimal disability. Unfortunately, the modern industrial societies have opted for poor lifestyle choices and therefore mismanaged the art of living a happy healthy life free from disability - this needs to change.  

It is generally accepted that human lifespan has a rough upper limit of about 125 years with most centenarians managing no more than 110 years.  Such a limit might arise due to unavoidable consequences of living (primary ageing) - mediated by processes such as oxidative free radicals, glycation, insulin growth factor-1 (IGF-1), mitochondria and more.  Interestingly, most mammals appear to have a predetermined number of heartbeats - of the order of 2 billion.  This is summarised in the next slide
The human system is highly complex with 100 trillion cells - many of which are replaced frequently.  The amount of copying of such large number of cells must be done with utmost accuracy - otherwise the new cell can bring in disease and health complications.

Mistakes indeed happen in copying cells; thankfully, the body has super-efficient correction mechanisms.  Still, some defective cells may survive and accumulate over time and contribute to primary ageing.  For an in-depth discussion of ageing click here.

Secondary Ageing:  Our lifestyle accumulates cellular damage and is now the main reason for impaired health and disability.  In fact, one might look at the trends in longevity (average lifespan of a population) and notice the very significant improvements made over the past 200 years.  The slide shows the situation for United Kingdom but the situation is similar in most other parts of the world. The increases in longevity have largely been due to improved public health provisions (clean water and sanitation), antibiotics, vaccinations and access to better medical health care across the nations.
Even though life expectancy might have been going up until recently - it appears to have flattened out and even started to fall in some OECD countries.  More and more people are now living less healthily.  Living with disease and disability is not the same as living healthily.
There has been a worrying trend of many chronic and immune diseases rising at alarming rates since about 1970. The following slide gives an example:
The rise in chronic diseases has been too quick - it is not genetic - the time frame is too short.  It is estimated that our genes are responsible for only about 5 to 10% of  the chronic diseases.  Lifestyle and environmental changes have been massive since mid-twentieth century and have impacted strongly in the worsening global health. In the UK, 15 million people have been diagnosed to have one or more chronic diseases. The state of affairs in 2016, globally is shown in the slide:
Most health professionals agree that the neglect of a limited number of factors are responsible for chronic diseases (I call them pillars).  Our lifestyle should aim for these pillars.  Interestingly, avoidance of certain other lifestyle factors (I call them sinks) is essential for good health too.  Analyse the way we live now and it is quite obvious that we need to shift from the oversupply/overabundance of sinks to a sensible management of the pillars. The following two slides explain (click on a slide for bigger image)


Water and Air are vital for life and there is not a great deal that one can do about the quality of air we breathe (particularly if you live in one of the big cities) and the water we drink. How crucial they are for our immediate survival is demonstrated in the next two slides:

     
After water and air, diet is the most important pillar - our bodies receive all the nutrients through the food we eat.  Our ancestors did not have supplements, neither do the gorillas rely on them. The importance of good diet can not be over-emphasised, but this is the area where our society has spectacularly failed. Poor choices are being made - exploited and encouraged by Big Food - with catastrophic impact on global health.  We are prisoners of food addiction traps of highly refined and processed foods marketed under the illusion of 'healthy foods' - unable to escape as the advice from health practitioners and pharma companies is generally useless and misleading. The food we eat is totally unnatural - not the type that our ancestors experienced and we evolved accordingly. The result is that only humans and their pets are obese and have chronic illnesses.

Globally, people are migrating to cities and it is expected that by 2050, 70% of the world population will live in cities. Cities are economic powerhouses but at the same time, they have high levels of outdoor and indoor air pollution, they are noisy, highly stressful and it is not easy to develop a community environment in big urban complexes.  The result is that one breaths polluted air, unable to sleep but feels stressed and isolated.  This is exactly what our ancestors did not experience and evolved accordingly.  We are just going against the grain and the results are apparent.


I have discussed some of the issues in my previous blogs (sleep1sleep2airobesity) where you can find more details.  How sugar and processed foods affect our body is something that I am very interested to learn and analyse and shall discuss this in my next blog.