Biomarkers: The 10 Keys to Prolonging Vitality - Softcover

William Evans is an author, speaker, performer, and instructor known for founding the Writing Wrongs Poetry Slam and cofounding the popular website Black Nerd Problems. He has been a national finalist in multiple poetry slam competitions and was the recipient of both the 2016 Sustainable Arts Foundation Grant and the 2018 Spirit of Columbus Foundation Grant. The Callaloo and Watering Hole fellow is the author of three poetry collections and currently lives with his family in Columbus, Ohio. He is an MFA candidate at Randolph College in Lynchburg, Virginia.

CHAPTER 1

POSTPONING YOUR ENTRY INTO THE DISABILITY ZONE

Possibly the greatest misconception people have about the process of aging is that it's synonymous with illness. It's true that chronic conditions such as heart disease are more common as we move up in years. But are such conditions a natural consequence of aging? Our research at the Human Nutrition Research Center on Aging (HNRCA) provides evidence that the link between chronic disease and aging is by no means as simple and straightforward as researchers once thought.

There are two principal factors responsible for the onset and severity of most chronic degenerative conditions -- your genetic heritage, which you cannot control; and your lifestyle, which you can and should control.

The goal of our Biomarkers Program, outlined in this book, is to maintain vitality into old age. It grew out of the realization that there are specific types of exercise and eating patterns that can greatly diminish the chances that people will develop a chronic disease; or, if they're already suffering from one, could help them escape from the imprisonment of its debilitating symptoms. How? By positively altering certain key physiological functions we call "Biomarkers."

The pillars of our Biomarkers Program are three forms of exercise -- strength-building and flexibility workouts aimed at your muscles; and aerobic or endurance forms of exercise aimed at your cardiovascular system. Besides quitting smoking (if you do), we believe there's no single thing that will increase vitality at any age more than exercise. Exercise, for reasons we'll outline in this book, is the prime mover in the drive to preserve vitality.

Granted, eating the right foods in the proper amounts is important to maintain health; but good nutrition alone will not have as appreciable an impact on most of our ten Biomarkers as exercise. Combine good nutrition with regular exercise, however, and you've got an unbeatable team. We can't think of a better antidote to fast aging.

Our Biomarkers Program is designed to

* prolong vitality by retarding or even reversing the usual biological deterioration process that people past 45 often begin to experience -- such things as metabolism slowdown, glucose intolerance, and declining strength,

* postpone disability by reducing the risk for such chronic conditions as heart disease, Type II diabetes, arteriovascular disease, hypertension, and osteoporosis,

* prevent the development of a common old-age malady we call "sarcopenia."

AN AGE-OLD PROBLEM FINALLY GETS A NAME

Think for a moment about any frail elderly people you know or have known. Maybe they aren't suffering from any serious chronic illnesses such as heart disease or cancer, yet for years they've been dependent on others for care. They spend most of their day sitting, and when they bother to get out of that easy chair at all, it's a struggle. In fact, they may need assistance to accomplish just the simple feat of going from a sitting to a standing position. They walk very tentatively -- probably with the aid of a walker or cane. It's as if their muscles no longer have enough power to deal with their body weight, let alone with even the most minimal activity. While their minds may still be quite nimble and alert, their bodies are diminished. They've lost so much muscle tone, their flesh seems to droop. In layman's terms, you could say their bodies have "rusted out" like an old piece of machinery nobody uses anymore. These old people have no diagnosed disease to explain their lack of oomph and vitality, yet it's clear that they've got bodies that have long since passed their prime.

We submit to you that such people have diminished to the point where they are suffering from a disease, only it's one that's never been given a name before. We're giving it a name here in the hope that it -- like osteoporosis, arthritis, and the other degenerative conditions of old age -- will begin getting widespread public attention.

We chose the term sarcopenia because "sarco" in Greek, the language from which so much medical terminology emanates, refers to flesh, the body; "penia" means "reduction in amount or need." Hence, we're describing an overall weakening of the body caused by a change in body composition in favor of fat and at the expense of muscle.

Although relatively little attention has been focused on the high-fat/low-muscle-power condition of sarcopenia, it's an extremely common condition in the elderly. Visit any nursing home and you'll see myriad examples of sarcopenia. Indeed, it's probably the most prevalent ailment.

In all fairness, sarcopenia has been overlooked for good reason. Its deleterious contribution to other old-age diseases is complex, subtle, and in many cases still little understood. Moreover, in contrast with more dramatic chronic diseases whose cluster of painful symptoms overtake a person in a matter of months or a few years, sarcopenia is a gradual wasting away of the body over the course of decades.

As they age, potential sarcopenia victims in their middle years slip into a sedentary way of living. The more they sit around, fail to exert themselves, and are waited upon by others, the greater the amount of their body's muscle mass that is replaced by fat. This insidious weakening of body structure and gradual loss of functional capacity then becomes a good excuse for continuing the pattern of immobility.

In the best of all possible worlds, of course, we'd have a coordinated national health policy to combat sarcopenia, as we have for osteoporosis (which is sometimes called "osteopenia," i.e., too little bone). We'd have a nationwide education campaign aimed at preventing sarcopenia; and we'd segregate those already suffering from it, perhaps treating them in special sarcopenia clinics where they'd receive daily therapy to reverse their condition. Our Biomarkers Program is an example of such treatment. For a finite period in residence, the frail elderly would work toward the goal of altering their body composition in favor of muscle and at the expense of fat. Eventually, when functional capacity was restored, they'd be released -- with the understanding that they would continue active therapy at home. In short, they would continue getting well on their own time.

Unfortunately, we are not yet living in the best of all possible worlds as far as sarcopenia is concerned. Since sarcopenia, to date, isn't even recognized as a problem, most of the frail elderly suffering from it get no treatment whatsoever to reverse its debilitating consequences. Millions of old people in the United States remain in nursing homes suffering from this unheralded low-muscle-power infirmity. And, all the while, public policy-makers wring their hands worrying about how the nation will ever pay for the baby boom generation's expected decrepitude three decades hence.

It's important to understand that sarcopenia is not a necessary or normal component of aging.

THE DISABILITY ZONE AS MOTIVATOR

Sarcopenia, like such chronic conditions as cardiovascular disease, Type II (maturity-onset) diabetes, hypertension, and osteoporosis, is associated with a sedentary lifestyle, too little exertion over a long period of time. Its remedy is the converse: the type of physical activity outlined in this book -- muscle-building and aerobic exercise regimens that people undertake for the rest of their health span.

Note we used the term health span, rather than lifetime. The distinction is an important one. Your health span is that time when you're functional and able to perform everyday-life tasks for yourself. You're self-reliant and capable of independent living in a natural home environment. In other words, your "functional capacity" is good. In contrast, your functional capacity is low when you can no longer lift a full garbage can and carry it to the side of the road or even drag it there...when that one-mile walk to the nearest bus stop or climbing two flights of stairs becomes so taxing you no longer attempt it...when you notice you can't stretch up and get something from the top shelf in your closet anymore.

The notion of "functional capacity" is more qualitative than quantitative, based more on observation than on narrow scientific criteria. Although comedian George Burns, America's favorite geriatric, probably never heard the term functional capacity, he gave his comments on the subject in his epistolary book, Dear George: Advice and Answers from America's Leading Expert on Everything from A to B. One fan asks:

Dear George --

As one geriatric to another, maybe you can tell mere at what point does one graduate from elderly to old?

Another Geriatric

Dear Geri --

You'll know you're old when everything hurts, and what doesn't hurt, doesn't work; when you feel like the night after and you haven't been anywhere; when you get winded playing chess; when your favorite part of the newspaper is "25 Years Ago Today"; when you're still chasing women but can't remember why; when you stoop to tie your shoelaces and ask yourself, "What else can I do while I'm down here?"; when everybody goes to your birthday party and stands around the cake just to get warm.

(These things really happen when you get old. I know, because that's what my father keeps telling me.)

George Burns is a nonagenarian with good functional capacity despite his chronological age. He was born on January 20, 1896, and unlike many of his chronological peers whose get-up-and-go long since got up and went, he's still a contender. As of this writing, he's dispensing witty advice, similar to what you just read, both in books and on radio and TV talk shows.

In contrast with George, older people with a low functional capacity who can no longer care for themselves can be said to have entered the "Disability Zone" -- that period, usually at the end of a person's life, when he or she becomes increasingly dependent on others.

The average man-in-the-street perceives old age as a sojourn in the Disability Zone. Stop people at random on any street corner, and here's a representative sampling of what you'll hear about that dreaded Disability Zone, although no one will use the term:

"Old is when physical impairments rule your life."

Or...

"It's when you've allowed your body's weaknesses to take control of your mind and spirit."

Or...

"You know you're old when you sit and watch as other people perform the everyday rituals of life for you."

Our research shows that the states of decrepitude described in these statements can be altered through the Biomarkers Program described in this book. You could think of our Biomarkers Program as the means to slow and flatten out your descent toward the Disability Zone. As the schematic shows, making the transition to a healthier, more energetic lifestyle via our Biomarkers Program at as early an age as possible promises to add years of vitality to your life -- and postpone for decades your entry into that unfortunate Disability Zone.

Sarcopenia is one of the main ailments that forces people into the Disability Zone. Thus, we feel if sarcopenia can be avoided, a person stands a very good chance of bypassing that dreaded Disability Zone altogether. Although we have no longitudinal studies to prove it yet, we believe that middle-aged people who remain faithful adherents to an active Biomarkers lifestyle throughout their 50s, 60s, and 70s could find themselves in the fortunate position of having their health span approach their life span.

Some of you may be wondering: Can a transition to a more active lifestyle via the Biomarkers Program increase my longevity?

Based on the current research, we can state unequivocably that people who engage in mild but regular exercise have a longer life expectancy than those who are sedentary. What we don't have as yet are statistics on the life expectancy of sedentary people who begin an exercise program in their 50s or 60s. We cannot say with certainty that they will live longer than if they stayed in that rocking chair. We suspect they will, but a definitive answer must await the conclusion of longitudinal studies encompassing the sweep of a lifetime.

We can say this: If you change your lifestyle and undertake the Biomarkers Program, the quality of your remaining years will be greatly enhanced. You'll avoid that Disability Zone much longer than you would have by remaining in that easy chair.

AS MANY AGING SCHEDULES AS THERE ARE PEOPLE

Some gerontologists have likened the process of biological aging to a long, slow tide that moves upon us so gradually it may take a long time before we're aware of its presence. Certainly aging is not something that happens suddenly. It moves in on us in increments over the whole middle part of our lives. As Butch Cassidy remarks ingenuously to his sidekick, the Sundance Kid, in the film bearing their names: "Every day you get older. That's a law." What's not an immutable law, though, is the pace at which you get older. That varies enormously from one individual to the next.

The beat of your biological drummer is different from ours and the next person's. Indeed, older people are more unlike their peers than younger folk. By a long shot. Decades of studying both normal and abnormal aging -- that is, premature aging due to illness -- have convinced investigators beyond a doubt that the older people become, the less like each other they become. Some people are weak and withered and wrinkled at age 60. Others, at age 75, are energetic, eager for new adventures, and look and feel far younger than their chronological age.

This fact has certainly been brought home to us at the HNRCA, where we've recruited thousands of volunteers for research studies over the last five years. Every week we interview older people whose chronological age, appearance, and medical test results surprise us. We'd like you to meet three senior citizens, all people who volunteered for our research studies. In terms of their aging timetables, they represent different ends of the spectrum:

Frank was 66 when he came into our center for a screening interview. He was a distinguished-looking man, and his comportment indicated he knew it. Frank characterized himself as "health-conscious," but as he talked a different picture emerged.

Frank had a whole litany of minor ailments and annoyances, but he'd only gotten treatment for those visible signs of aging that showed when he looked in a mirror or that he knew other people would notice. Although he certainly understood the connection between smoking and cardiovascular disease, he felt he was somehow immune. His father had lived to a ripe old age, why shouldn't he? Frank is like a lot of people in our society. He sees health through the prism of appearance and vanity. He has little concept of what real fitness or physical well-being are all about.

In all fairness, Frank abhorred the idea of losing his youthful looks for a very practical reason. He equated the external signs of health with economic survival. Frank had spent his career in an industry where youth and attractiveness are highly prized, and aging in an ungraceful fashion could be the unspoken grounds for dismissal.

For most of his career, Frank was a salesman for several leading national magazines, making the daily rounds of advertising agencies and executive suites soliciting pages of advertising. Even though the job was high-pressure, the glamour and chance to live well on a lavish expense account appealed to him. Sometimes he found it hard to believe he was actual...