Perhaps we should not have been surprised. He was always on the go, ate healthy meals, never smoked, and enjoyed being with friends.

He always seemed calm and collected, so on his 101st birthday, I asked how he had managed his stresses — his ship, the Canberra, was torpedoed during WWII with the loss of many of his buddies, and he was nearly killed. He had lost his daughter to cancer when she was forty, and his wife to cancer when she was 67. Yes, he had grieved greatly, but somehow, he was resilient and came back strong each time. He had been very sad but lived through his grief and always appeared unperturbed. “Well,” he said, “I guess I just let stress roll off my back.”

Organs decline about 1% per year.

One of the most important things that happens with aging, sort of like a car, “old parts wear out.” Most organ functions decline by about one percent per year. Of course, there is great variation from person to person, year to year, organ to organ, but 1% is a pretty good average to consider. We usually think of a person being in their prime through at least age 60. In many ways, that is correct, but you may be surprised to learn that the 1% decline starts in early adulthood and continues throughout life, speeding up as we age. Fortunately, most of our organs have significant redundancy so that we can tolerate these declines without any appreciable impact. But eventually, the decline may get to the point where we have a functional impairment that can be serious or at least impair our day-to-day activities.

I recently turned 84. I don’t feel “old,” but I do know I can’t do everything I used to do, or at least not as quickly. My hearing is less; my vision is reduced. My muscle mass and strength are definitely much less than they were in the recent past. My balance is OK, but not as good as it used to be, and so on. It has been a set of changes that came slowly at first but are now progressing faster. I always enjoyed splitting wood for the fireplace. I kept a woodshed filled with wood split and logs drying for a year before splitting. As time went on, I realized that I couldn’t keep at it for as long before wanting to take a break. As one friend in his early 80s told me, “I was fine until about age 78, and then it seemed that the aging process was suddenly there and moving fast.” Those declines, developing “under the radar” for decades, had accelerated and become overt.

The 1% Per Year Decline, Author’s image

Hearing decline begins at about age 25 but is not noticed until much later. Many of you will need reading glasses by age 40, even though you have had excellent vision for years; cataracts may occur later. Balance starts its inevitable decline early, although it, too, will not be noticed until much later. Meanwhile, internal organs, including the heart, lungs, and kidneys, are slowly declining, and so too is brain function, especially cognition.

This normal aging process of old parts wearing out is universal and is progressive, but you can slow it and sometimes reverse it, at least partially. Let’s use bone mineral density (BMD) as an example. BMD is easily measured to demonstrate the sturdiness of our bones — how strong they are. We start life with cartilage rather than bones. As we grow from toddlers to children to teenagers, calcium and other minerals, along with a protein-collagen matrix, are laid down in our bones, and they become increasingly strong, reaching a peak around the age of twenty. Once that age and that peak are reached, it can’t go up any further — that’s it. Then there is a plateau, and at about age thirty to forty it starts to decline at a rate of about 1% per year. At age twenty, men’s bone mineral density is, on average, higher than women’s.

Nevertheless, for women as for men, the decline is about one percent per year. Menopause changes this; the rate of loss increases to perhaps three percent per year for a few years and then returns to the one percent average decline until reaching osteopenia and then osteoporosis. There are three important points to consider. If you live long enough, your bone mineral density will decline to a level where, if you fall, a bone fracture becomes more likely. Since women start at a lower level and because they have this increased loss of BMD during menopause, they’ll reach that fracture threshold in life earlier than men. Since women tend to live longer than men, in total, more women than men will have a fracture at some point in their lives. We might just say this is one of the risks of living longer.

But why will you fall? Because your balance mechanism is likewise declining, and your muscle mass and strength are not as capable of “catching” your fall. The three combine together in a very negative manner!

Muscle mass and strength decline in a similar fashion, resulting in what doctors call sarcopenia. Most people lose perhaps 30% of their muscle mass between ages 50 and 70, and the loss continues at an even faster rate thereafter. Older individuals who exercise find it takes more effort to maintain their muscle mass and strength, but regular exercise and good nutrition have a significant beneficial impact and slow the process considerably.

Cognitive function is another example; your brain loses some of its abilities as you age. Cognitive abilities and brain volume do not decline in lockstep but do have a clear relationship. A fascinating study published in the journal Nature in April 2022, pulled together 123,984 MRI scans taken at over 100 institutions from 101,457 individuals ranging from 115 days post-conception to 100 years of age — from fetuses to centenarians. At the age of three years, the brain had reached 80% of its maximum size. The gray matter, which consists of the actual brain cells, reaches its maximum by about age 6, whereas the white matter, the inner connections between brain cells, does not reach its peak until the late 20s. The decline in brain volume thereafter is slow but accelerates after about age 50. These changes can be seen in the figure, which shows the growth trajectories of gray and white matter. The charts show volume (in mm3) across age, beginning before birth and ending at about 100 years.

If you are over 65, you have probably noted that you can’t memorize as well, recall names as quickly, etc. When I was in medical school, memorization was relatively easy; not so today! This is normal. This loss of cognitive function over time should not be confused with the disease Alzheimer’s. Nearly everyone who lives long enough will suffer from some cognitive decline, but only some will develop Alzheimer’s. As with BMD, you reach your peak cognitive function around age twenty; it plateaus for about 10 years, then starts that slow decline. Given the great redundancy in your brain, it is not noticeable for some time. Eventually, you reach a functional threshold where your cognitive function begins to impair your ability. This becomes more apparent when an older person is engaged in highly technical activities, very fast-paced activities, or stressful situations (emotional, physical, or health-related). Those cognitive challenges are less apparent in highly familiar situations.

This 1% annual loss is normal. No, it is not an exact number, nor is it the same for every person or every organ, nor is it exactly 1% in the same person at all times. But 1% is a good proxy for what is happening throughout your body throughout adulthood and into your elder years.

Slowing the aging losses

Here are some suggestions to slow that steady decline in functions. If you start at age twenty with very strong bones (i.e., a high BMD), then you have a longer way to go down before reaching that level of potential bone fracture from a fall. Perhaps too late for you if you are older, but encourage your children and grandchildren to eat a good diet, play/exercise daily, preferably outdoors, manage their stress, and get a good night’s sleep. And for their brains, do just the same (quality food, plenty of exercise, sound sleep, and managed stress) as for their other organs. Then, continually challenge their brains with new learning. Those with more years of schooling will start out with greater reserves, so the 1% decline will take much longer to cause difficulties. Muscle mass and strength are similar. Encourage them to build it up now as a teen. No need to be a muscled bodybuilder, but regular exercise and a good diet will mean more strength at the start of that long decline.

Most people seem to accept that, with age, comes a decline in function. “That is just what happens when we get older.” They may not like it, but they do not realize that they can substantially modify the downhill course. You can slow this continuing loss of body functions, including cognitive decline, and you can start at any age. It is never too late. It is not hard to do, and it does not cost money, but it does take time and persistence. It is all about how you move, what you eat, how you manage chronic stress, get adequate sleep, avoid tobacco, not too much alcohol, plus challenge your brain and keep socially engaged.

Stephen C Schimpff, MD, MACP, is a quasi-retired internist, professor of medicine, former CEO of the University of Maryland Medical Center, and author of Longevity Decoded — The 7 Keys to Healthy Aging, and is co-author with Dr. Harry Oken of BOOM — Boost Our Own Metabolism

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However, even wellness proponents of goodwill face this challenge: The relationship between lifestyle and health is not a straight line.

Yes, I know I should consume more fruits and vegetables.

But it’s complex.

A 2024 study compiled by Harvard researchers emphasizes the complexity of diet and health and the need to communicate evidence-based principles.

I’ll start with an overview before turning to the three takeaways on healthy aging from this research investigation.

TL; DR

For those of you feeling in the “too long, didn’t read” kind of mood, I’ve got you.

Here’s a summary of everything I will share about nutrition and health.

Want to be healthy at 70? Individuals who embraced a diet filled with fruits, vegetables, whole grains, and healthy fats in their 40s are far more likely to ahave a long heathspan.

The Study

A 30-year study involving over 100,000 participants has confirmed the link between healthy eating patterns and successful aging.

For the study, Harvard scientists specializing in nutrition and epidemiology assessed a database with health information on over 106,000 people going back three decades.

They evaluated eight dietary patterns:

• Alternative healthy eating (AHEI)
• Alternative Mediterranean diet (AMED)
• Dietary approaches to stop hypertension (DASH)
• Mediterranean-DASH intervention for neurodegenerative delay diet (MIND)
• A healthful plant-based diet (hPDI)
• Planetary health diet (PHD)
• Empirical dietary index for hyperinsulinemia (EDIH)
• Empirical dietary inflammatory pattern (EDIP)

Assessing Diet and Health

They assessed these diet patterns every four years (with a validated food frequency questionnaire.

The investigators defined healthy aging as surviving to age 70 or older while maintaining good self-reported cognitive and physical function, mental health, and being free of chronic diseases.

1. Yes, Mediterranean is Good, But…

I often tout the benefits of a so-called Mediterranean diet.

The Harvard study reminds me that, while the Mediterranean diet is the healthy diet most Americans know, there are other good options.

In typical Mediterranean foods, seven other diets that differ in particular food items share many components — including plant-based proteins and healthy carbohydrates.

2. Nutrition Matters (Even If I Exercise)

The Harvard study reminds me that what I eat is important, even though I exercise regularly and vigorously.

The association between diet and healthy aging appeared independent of how much people exercised.

In other words, after accounting for physical activity, the association between diet and healthy aging remained strong.

Of course, that is not to say diet is more important than exercise; rather, the study authors could not compare the association with diet to the association with exercise regarding how strongly they predict healthy aging.

3. Yes, Fruits and Vegetables (But How Much?)

Regarding fruits and vegetables, both the variety and quantity you consume are crucial for longevity and healthy aging.

While the popular saying suggests that “an apple a day keeps the doctor away,” studies indicate that aiming for two to three servings of fruit per day, along with five servings of vegetables, is more beneficial.

The study highlighted the importance of consuming various fruits and vegetables, emphasizing the benefits of antioxidant-rich berries.

Key Points

• Quantity: Aim for five servings of vegetables and two to three of fruit daily.
• Variety: Eat a diverse range of fruits and vegetables.
• Antioxidant-rich berries: These are especially beneficial for healthy aging.

In conclusion, consuming various fruits and vegetables in adequate quantities is essential for promoting longevity and healthy aging.

Am I a vegan? No. Vegetarian? No. Eat enough vegetables? Nope.

But research such as this reminds me to have those grapes nearby.

Or add a small salad to my dinner.

And you?

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Unfortunately, chronic stress causes our adrenal glands to make too much of the hormone cortisol. When exposed to excessive cortisol, we can experience negative consequences in our brain, immune system, and other organs. More specifically, you may have anxiety, depression, headaches, heart disease, and premature death.The Power of the Mind to Reduce InflammationOUR ANCESTORS EXPERIENCED very different stresses than do we today. Hunter-gatherers may have faced off against a lion…medium.com

Of course, in a perfect world, you would minimize your exposure to chronic stress agents. How can we reduce the harmful effects of chronic stress? Today we explore some history before briefly addressing the effects of mindfulness meditation on markers associated with aging.

History

First, a bit of history. The English word “meditation” stems from meditatum, Latin for “to ponder.” Getting more granular, we turn to the Online Etymology Dictionary:

c. 1200, meditacioun, “contemplation; devout preoccupation; private devotions, prayer,” from Old French meditacion “thought, reflection, study,” and directly from Latin meditationem (nominative meditatio) “a thinking over, meditation,” noun of action from past-participle stem of meditari “to meditate, think over, reflect, consider,” from a frequentative form of PIE root *med- “take appropriate measures.” Meaning “meditative discourse on a subject” is early 14c.; meaning “act of meditating, continuous calm thought upon some subject” is from late 14c. The Latin verb also had stronger senses: “plan, devise, practice, rehearse, study.”

We don’t know when people began to meditate, but the practice likely began thousands of years ago, before the birth of modern civilization.

The earliest written records about meditation are from around 1500 BCE. The mindfulness approach appears to have been an essential element of the earliest forms of Vedic (early Hindu) schools in India.

Meditation practices are a part of many religious traditions worldwide, but I associated it with Buddhism as a formal part of a spiritual path. The Buddha taught in Southeast Asia approximately 2600 years ago, opening the door to future practitioners to sit and breathe their way to peace.

Buddha’s teachings offer that meditative concentration is one of three pieces of training that result in enlightenment. The other two are the wisdom of seeing things as they indeed are and proper ethical conduct.

Modern practice

More recently, a central figure in the promulgation of mindfulness is Dr. Jon Kabat-Zinn. He founded the Center for Mindfulness at the University of Massachusetts Medical School (USA) in 1979. His Mindfulness-Based Stress Reduction (MBSR) program has “been instrumental in bringing the benefits of mindfulness practice — without any religious overtones — to the public attention and scientific communities worldwide.”

Most relevant to our discussion today is that Mindfulness-Based Stress Reduction — centered in mindfulness meditation — has evolved to encompass the management of several health disorders. These include anxiety, depression, skin diseases, pain, immune disorders, hypertension, and diabetes.

Does MBSR work? A systemic review of relevant randomized clinical trials answers in the affirmative. The reviewers concluded this:

“Although the research on MBSR is sparse, MBSR appears to improve the condition of patients suffering from chronic illnesses and helps them cope with a wide variety of clinical problems.”

Meditation and aging

But what about aging? Understanding the malleable determinants of cell aging can help us to understand human longevity better. Small pieces of genetic material on the tips of our DNA offer a starting place for understanding the aging process. These protective caps on the ends of our chromosomes are telomeres.One Key to Living LongerI GIVE YOU the most extensive population-based study examining the link between adherence to a Mediterranean diet and…medium.com

Telomere shortening and replicative senescence appear to be indicators of body aging. Researchers examined eleventh studies comparing meditating subjects with individuals in control conditions to determine the effects of mindfulness meditation on telomeres.

The individuals in the meditation groups had longer telomeres than those in control conditions. A more significant number of hours of meditation appeared associated with a more significant impact on telomere biology. This meta-analysis suggests mediation may slow telomere shortening.

My take

Meditation practice may have beneficial effects on telomere regulation, in addition to its known positive effects on anxiety and other health problems. Do you practice some form of mindfulness? I have done Vinyasa flow yoga and, more recently, very much enjoy the simple practice of box breathing. Here’s a short piece I wrote about the practice:Box BreathingLearn the steps of box breathing and discover how it can help relieve anxiety and stress. Watch a GIF that helps you…www.healthline.com

Thank you for joining me.

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