The Manual: How to Age Well

Photo credit: Getty Images
Photo credit: Getty Images

None of us are getting any younger. But that doesn’t mean we can’t do anything about it.

“You can’t help getting older, but you can help getting old,” as the comedian George Burns put it. (Burns lived to 100, his career in showbiz lasted 93 years.) All of us can extend the quality of our everyday lives – the wear and tear on our bodies, the strain on our brains – with some self-care.

Eating well, managing stress and maintaining friendships; these are the things that get results.

Genetics vs Life

First the good news. Or the bad, depending on how you look at it. No matter who you are or how well you look after yourself, a significant part of how we age is out of our hands. “Genetics plays a vital role,” says Dr Anil Budh-Raja, a London-based dermatologist and specialist in anti-ageing medicine and cosmetic dermatology. “It can account for more than 50 per cent of erosion.” The remainder, though, is something you can affect. And you can’t start too soon. “You begin ageing around 25 or 26,” says Budh-Raja. “That’s when you start losing the “fat pads” around the cheeks and the jaw. As they start to dissolve, you start to look more saggy.

“Around 28-30 is when you start to see the skeletal face skeleton start to get thinner – slowly, slowly every year,” he says. “As we get older our face skeleton shrinks, along with the collagen in the skin. It’s a bit of a double whammy.”

Photo credit: Christopher Polk
Photo credit: Christopher Polk

Eat Properly

The single best piece of advice when it comes to ageing well is to cut processed foods out of your diet, and with them refined sugar. Sugar plays a key role in how cells communicate with each other – it can affect the energy-producing mitochondria, leading to impaired cell function and eventually cell death. Hence: ageing.

How to spot processed foods? You don’t even need to read the label. As a rule of thumb “processed = packaged”, so that’s: biscuits, crisps, cakes, frozen pizzas, ice cream, etc – all the stuff you knew was bad for you anyway.

If you cut these out you will also refocus your diet on the good stuff: vegetables, lean meats, fish and whole grains. According to the Global Burden of Disease Study — the most comprehensive study of disease risk factors to date — the number-one cause of death and disability in the UK is the British diet. In an analysis of the lifestyles of 35,000 adults, their diets were scored from zero to five to see if they met a bare minimum of healthy-eating targets — which included fruit, vegetables and whole grains. About one per cent scored four out of five.

Almost any diet you care to name advocates eating more plants – defined as “real food that grows from the ground”. That’s because consuming vegetables, legumes and other antioxidant-rich natural food has been associated with longer telomeres – the “protective tip” at the end of our chromosomes that safeguards cellular ageing. Nobel Prize-winning research in 2009 showed that production of the enzyme needed to repair telomeres is boosted after only 12 weeks on a whole-food, plant-based diet.

Dr Michael Gregor, an American physician, dietician and author of the unimproveably titled book How Not to Die has identified “the daily dozen”. Foods he says protect against cellular ageing. These include berries, whole grains, cruciferous vegetables (broccoli, cabbage, kale), nuts and greens.

“Don’t get bogged down worrying about what you ate in your childhood, or through your 20s or even 30s,” he says. “What you eat for the next few decades is what counts now.”

Drink Sensibly

Newsflash: neither smoking nor drinking is good for your health. Unless you’re blessed with the genes of George Clooney, these toxins will age you. One recent scientific study showed quite how badly. Danish researchers tapped data from the Copenhagen City Heart Study to track visible ageing signs of 11,500 adults for 11.5 years. The study participants were periodically queried about how much they drank and smoked as part of a general review of their lifestyle habits. Researchers also examined their ears, eyes and hairlines.

The results revealed that hard living does indeed equal fast ageing: men who consumed 35 or more alcoholic drinks a week were more likely to develop discolouration in the eyes linked to ageing, compared to men who had less than seven drinks a week. Smoking a packet of cigarettes a day for more than 15 years significantly raised the likelihood that a man’s eyes would betray signs of ageing. However: that is quite a lot of alcohol and cigarettes to consume in a week. (The UK Government’s alcohol guidelines are 14 units a week, or seven pints of average-strength beer.)

Neither smoking nor drinking was shown to have any effect on hair loss. So, some good news there.

Get a Good Night’s Sleep

Another major one. “It’s a big deal,” says Budh-Raja. “How many hours sleep one needs is all dependent on the individual. It can range from six hours to ten hours.” Attention, dexterity and vigilance all suffer when you sleep less than seven or eight hours for more than a couple of days – you’ll also look knackered. In his hit 2017 book Why We Sleep, professor Matthew Walker cites two decades of cutting-edge clinical and epidemiological research to make the bold claim that adequate sleep is more important to health than diet or exercise. By sleeping fewer than six or seven hours a night, he says, we double our risk of cancer, demolish our immune systems and increase our risk of cardiovascular disease, stroke, congestive heart failure, and Alzheimer’s disease. Walker notes “unscientifically” that he has always found it curious that Margaret Thatcher and Ronald Reagan, both of whom were vocal about how little sleep they needed, both went on to develop Alzheimer’s.

Either way, it is a myth that older adults need less sleep. If you previously equated sleep to stopping physical activity, comparable to turning off a car’s engine and parking up the night, a more accurate way of looking at it may be taking that vehicle into the garage for a full MOT and nightly tune up.

“It’s the time when our whole body resets,” says Budh-Raja. “When melatonin levels reach their required peak. Melatonin is an anti-ageing hormone. It’s also the time serotonin levels go up and cortisol [‘the stress hormone’] levels are reduced. If you don’t have enough sleep, you’re going to get disruption of a whole load of hormones, but serotonin, dopamine and cortisol in particular. When you’re having less sleep you’re getting more frustrated and stressed, it’s a never-ending cycle. Your stress levels are going to go up, your stress levels will increase the cortisol levels, which is secreted by the kidneys, which can damage the organs and skin, as well as effect psychology. Cortisol is a real big killer, it can lead to early death.” So, get an early night.

Photo credit: Michael Ochs Archives - Getty Images
Photo credit: Michael Ochs Archives - Getty Images

Exercise Most Days of the Week

Typically, men’s proportion of body fat doubles between the ages of 25 and 75, since our metabolism slows down and our bodies need fewer calories than we usually take in and burn up. The resulting double-chin and a widening waistline are the most obvious signifiers of ageing in men.

Multiple studies have shown that even moderate exercise improves circulation, boosts the immune system and gives the skin a more-youthful appearance – if you do it regularly, at least four times a week. Ideally, you’d have started to do this young and are still doing it. But, as a report in the New York Times states:

“Even if you have neglected to exercise in recent years and are now middle-aged, it is not too late. Research shows that you still can substantially remodel your heart and make it more youthful by starting to work out in middle-age, provided you exercise often enough”.

Or, as Dr Robert Butler, founder of America’s National Institute on Ageing, noted in the 1980s: “If exercise could be packed into a pill, it would be the single most widely prescribed beneficial medicine in the nation.”

This does not necessarily mean you need to sign up to a gym or start doing half-marathons every weekend. Studies of recreational cyclists aged 55-79 suggest they have the capacity to do everyday tasks more efficiently because nearly all parts of their body are in remarkably good condition. The cyclists also scored highly on tests measuring mental agility, mental health and quality of life.

In recent years, high-intensity internal training (HIIT) has generated interest among exercise scientists, because of its success across age groups and fitness levels. In fact, a 2017 clinical study showed that older people’s cells responded better to intense exercise than the cells of young did.

If a 30-minute run is good for building muscle, strength and endurance, plus capacity in your heart and lungs, then HIIT boils this down into a few minutes, burning maximum calories in a minimum amount of time. It’s versatile too: applicable to running, cycling, swimming and aerobic exercise like squat jumps or push ups. However, by definition it’s harder work than a trot round the park in your lunch hour. It requires, as one research paper puts it, “an extremely high level of subject motivation”.

“If you can, combine regular exercise with some weights,” says Budh-Raja. “Weights really can anti-age someone. It’s not about building a huge amount of muscle but keeping the tone. Also, weight training to a certain level increases the growth hormone, serotonin and dopamine levels. Enough growth hormone can, to an extent, reverse ageing. It can definitely changes the appearance of external ageing factors like better skin quality and wrinkles, as well as general mood.”

Photo credit: GAB Archive - Getty Images
Photo credit: GAB Archive - Getty Images

Stay in Touch

One anti-ageing tactic you can employ has nothing to do with diet, exercise or sleep. It’s making sure you make time in your diary for family and friends and for making new friends. Study after study has shown how connecting with others can keep your healthier longer and may even add years to your life. “Physical changes happen to your body [with loneliness],” writes Dr Rangan Chatterjee, physician and author of The Stress Solution. “It’s as harmful to your health as smoking 15 cigarettes a day. That’s just staggering.” Research published in the American Journal of Epidemiology showed that of 7,000 men and women studied in California, people who were “disconnected from others” were almost three times likely to die than people with strong social ties.

“Let’s look at it on an evolution level,” Dr. Chatterjee explains. “Millions of years ago, if you weren’t part of a tribe and you were excluded, you were vulnerable to threat. Your stress responses kicked into gear. Your immune system would get ramped up and your body would get inflamed. All of that happened just because you are alone.”

Enjoying your life is a significant contributor to healthy ageing. A study conducted by researchers from the University College in London showed that happy people were more robust and fit. The study followed 3,199 men and women living in England over the course of 8 years. Those who are happy tend to have fewer wrinkles and lines and other outward signs of ageing. Their skin tends to be more resilient, which allows them to look much younger than they actually are. Happiness can make you younger and it can lower your biological age.

We are social creatures who’ve evolved to be together. Instagram Stories is a poor substitute. So get some dates in your diary – otherwise life takes over and it doesn’t happen.

A Word on Skincare

The structure and function of skin changes as we age. It loses some of its elastic quality and becomes looser. And it loses its ability to retain water, resulting in dryer skin. As a result eyelids may begin to droop and the lower eyelids may begin to appear baggy. Wrinkles develop on the brow, around the eyes, in cheeks and next to the mouth. Chemist-counter creams, vitamin E tablets and other supplements are unlikely to do much to help, despite wrinkle-reducing claims. (Moisturisers work by covering the skin with a water barrier which slows the loss of moisture from the skin and gives the temporary appearance of plumpness and fullness.) Regular and medically-advised use of prescription-strength retinoid – to stimulate epithelial cell growth – is more likely to produce results, but these only available from certain medical clinics.

Finally there are, of course, cosmetic solutions to making your face and skin look younger – with men being responsible for the fastest growth in the sector. “The treatments now are so effective that just a yearly top up can really make a difference,” says Dr Budh-Raja. “And the rate of increase among men is more and more compared to the women. Treatments cover everything, from high-intensity ultrasound to micro-needling – that can anti-age the skin because it stimulates more natural collagen, so it’s pretty much permanent. It can take back a few years – just like fillers can, but fillers are temporary.

“As long as you keep up a quite well-maintained jawline, not too saggy around the jowls, with a few maintenance treatments here and there, it can make a difference, definitely.”

Take it Easy

Getting older means living with more life changes, good and bad, and that’s stressful. We can become overwhelmed by a pileup of these changes, resulting in the “stress response” – the stress hormones cortisol and adrenaline being reduced into the bloodstream. This leads to all sorts of problems: from memory issues to a weakened immune system to an increased risk of diabetes.

Regular exercise that releases the stresses stored in muscles and feeds the brain with “happy hormones” will help, as will cognitive behavioural therapy (CBT) that focuses on changing thinking and behaviours. There isn’t a man among us who wouldn’t describe their life as over-busy and demanding. Simple fixes like prioritising to-do lists or setting aside a time of day to respond to emails, rather than constantly being at the mercy of a dinging inbox are proven steps to better psychological heath.

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