Healthy Aging: A Lifelong Guide to Your Physical and Spiritual Well‐Being

Citation

Bowerman, J. (2006), "Healthy Aging: A Lifelong Guide to Your Physical and Spiritual Well‐Being", Leadership in Health Services, Vol. 19 No. 3, pp. 12-15. https://doi.org/10.1108/13660750610683233

Andrew Weil is a different kind of medical doctor. Although he has an MD, he has also received a degree in botany, both from Harvard University. He is internationally renowned in the areas of medicinal herbs, mind‐body interactions, and nutrition, and is presently the director of the Program in Integrative Medicine as well as clinical professor of internal medicine for the University of Tucson, Arizona. Perhaps it is this expertise as well as the fact that we are living in an aging world that makes his book about healthy aging so timely. The book speaks to a generation that is living longer than ever. The 2001 National Center for Health Statistics show that American males born in 2000 enjoyed an average life expectancy of 74.1 years, up 0.2 years from 1999. Females have an average life expectancy of 79.5 years, up 0.1 years. A seven‐year difference between the sexes recorded in 1990 was down to 5.5 years in 2000 although significant racial differences remain. Age‐adjusted mortality has continued to fall for heart disease and cancer – the top two causes of death – as well as several other leading causes, including suicide, homicide, accidents, stroke, diabetes, chronic lower respiratory disease, chronic liver disease and cirrhosis. However, mortality for diseases that disproportionately strike the elderly, such as Alzheimer's and pneumonitis have increased[1].

The fact that we are living longer, and the desire to make these years as healthy, happy and productive as ever are significant factors in making this book on aging so relevant and popular. Little wonder that it went straight to the top of the New York Times best seller list and remained there for a considerable length of time. The book speaks to a large population of aging baby boomers, anxious to maintain their health and their life styles, but at the same time becoming aware of their own mortality.

The fact is that the longer we are able to maintain our health and well being and live as independently as possible without the premature or unnecessary intervention of the pharmaceutical and medical industries, the more those services can be used for those who genuinely require them. Dr Weil is speaking to an educated generation, many members of which are willing to make life style changes to maintain health – and who desire to play a leadership role in determining their own futures. Instead of the usual mantras about the possibility of maintaining our youth, the book urges us to accept the inevitability of aging. “The best we can do – and it is a lot – is to accept the inevitability of aging and try to adapt to it, to be in the best health we can at any age … To age gracefully means to let nature take its course while doing everything in our power to delay the onset of age‐related disease, or, in other words, to live as long and as well as possible and then have a rapid decline at the end” (p. 5). Though some would dispute the inevitability of aging, the fact is, “it is not reversible”. It brings with it unpleasant physical changes including “aches and pains, decreased vigor, healing ability, sensory acuity, muscle tone, bone density, sexual energy … increased reliance on doctors and pills; and social isolation”. Denying the inevitability of aging is simply counter productive. It is, as Weil emphasizes, an important aspect of our entire life experience.

The book is written in two parts. Part One deals with the Science and Philosophy of Healthy Aging. Here Dr Weil discusses the idea of immortality through the lens of biology and introduces the reader to the latest findings of scientists who are studying the aging process. Part Two deals with the concept of aging gracefully. Here, he explicitly rejects the concept of immortality and eternal youthfulness as unworthy goals. At the same time he provides dietary and life style information aimed at protecting the immune system from the changes that time brings. All of these, are based on the scientific evidence presented in Part One of the book.

Dr Weil strongly believes that the anti‐aging movement‐ that offers the promise of eternal youth through the search for shangri la, although a major current in contemporary health care, is a false promise that strongly impedes people from coming to a healthy and positive acceptance of aging and mortality. Some of this anti‐aging movement is based on genome research where scientists are looking for genes that control aging or confer longevity. Dr Weil rejects this research – observing that “nature is very much concerned with the perpetuation of life at the species level but cares little for individuals once they have passed on their genes. It is the trade off…between sex and death. By choosing a reproductive strategy that increases the likelihood of the survival of species, nature commits to the death of individuals and does not concern itself with how individuals die” (p. 59).

He concludes that it is theoretically possible to extend the human life span, but notes that today, there are no sure methods for doing this. He then wisely asks – “even if it were possible, would it be a good thing? Would you wish to use it?” There are serious ethical questions concerning the inevitability of living longer – among them the political and economic implications of growing numbers of old people, who will be mostly white and English speaking. Following them will be the younger population made up of diverse immigrants, and an ever decreasing middle range who are required to support the rest through work and productivity. This is a formula that is out of balance with society as we presently know it and experience it.

Dr Weil's main goal is for us to learn how to reduce the risks of age‐related disease so we can enjoy health into advanced years. He also wishes for us to view aging within a different paradigm. Instead of seeing it as something to be feared or dreaded, he urges us to view it as something to be embraced and valued. He uses as his metaphors fine aged whiskies, fine wines, old cheeses, stradivarius violins, and beautiful antiques among other things. Aging can, he suggests, add richness to our lives, smooth out the rough edges of character, develop desirable aspects of personality while diminishing those less desirable. Finally it is the opportunity to develop one's voice and authority as a link to the living past (p. 119). He urges us to go beyond the unrelenting messages from the media telling us that “youth is where things are at, and that the worth of life peaks early”. A healthy attitude toward age allows us the opportunity to concentrate on our essence, to concentrate on that which gives value from within, rather than from without.

Part Two of the book is a much more practical approach toward the aspect of healthy living, through sound diet, and healthy life style using information gathered from his research and travels around the world. Emphasising the dietary principles he has developed in many of his other books, Weil walks us through the basis for a sound and healthy approach to nutrition based on the need to overcome inflammation as a common root of many chronic diseases, and reduce oxidative stress as a pro‐inflammatory influence. “Without question, diet influences inflammation. The food choices we make can determine whether we are in a pro‐inflammatory state or an anti‐inflammatory one. In the former case, abnormal inflammation is more likely as are all the diseases associated with it. In the latter case normal inflammation is unaffected; that is the body's healing responses to injury and infection are as they should be, and the risks of disease caused by abnormal inflammation remain low as we age” (p. 145).

People wishing to consume an anti‐inflammatory diet need to inform themselves about glycemic index (GI) and glycemic load (GL), and ignore obsolete information that classifies carbohydrates as simple and complex. They need to increase their consumption of low to moderate GI and GL foods through the consumption of more whole grains, beans, vegetables, fruits and berries. He recommends avoiding refined or processed food, fast food, eating fewer foods made with flour, and avoiding high fructose corn syrup (p. 152). He urges us to eat less meat and poultry, eat more vegetable protein, and to choose the varieties of fish that contain fewest toxic contaminants. Dr Weil also provides us with information on those supplements that help to reduce inflammation and build the immune system. These include ordinary culinary products such as ginger, tumeric, basil, green tea. There are others including some ordinary over the counter remedies such as simple asprin.

Finally, the book provides extensive advice on suitable exercise as we age, and on stress management techniques – especially meditation and yoga. These help to build physical, mental and spiritual flexibility – essential components of a healthy aging process. Dr Weil suggests we remember that awareness of aging and mortality can inspire us to engage more fully with life so that we can fulfill our potential for accomplishment. He reminds us of the importance of sound sleep and of the value of daily napping. He discusses taboo subjects such as human sexuality and the value of touch. He urges us to become more aware of our spiritual selves. We need to remember that any activity that makes us feel more alive, more connected to others and to nature, less isolated, more comfortable with change, is beneficial, will help us to accept the fact of aging and will help us to age gracefully.

The breadth and depth of this book on healthy aging is huge. Written for the layman, Dr Weil has an engaging style that includes honesty, compassion, and humour. He is both wise and witty, and at the same time demonstrates an enormous capacity to explain technical and scientific information so that it is easily understandable to every reader. Each chapter includes references from a multitude of sources, many of which are from the latest academic, scientific, and medical books and journals. The book is compelling both from a personal perspective and from a general societal perspective in terms of what it tells us about our general approach to life, to age, and to medicine. It stands in contrast to the traditional technical medical model of life at any cost, and a pharmaceutical drug for every condition. It also stands to emphasize that the elixir of youth can only ever be a temporary part of the human condition‐ that aging is as natural as life itself, and that we all have a role to play in the decision about just what the face of aging will be. It is not about life at any cost. Rather it is about life in all its facets and the desire for health and happiness particularly in the second half of our lives.

Perhaps a word of two is necessary at this point about just what integrative medicine is. After all Dr Weil, and many like minded practitioners stand outside the usual model of medicine, and their work is not often highly regarded by thre mainstream. It tends to fly in the face of traditional evidence based medical and pharmaceutical research which the traditional medical profession does tend to regard highly.

To quote from an appendix in the book, Integrative medicine is “healing oriented medicine that takes account of the whole person (mind, body and spirit), including all aspects of lifestyle. Emphasizing the practitioner‐patient relationship, it makes use of all therapies both conventional and alternative” (p. 257). Dr Weil founded and directs the University of Arizona's Program in integrative Medicine. Its goal is to lead a transformation in health care by educating and supporting a community of professionals…in the principles and practice of this new system.

This definitive work on healthy aging belongs directly within this framework. It is to be hoped that the book, as well as influencing and being of value to the general public so that individuals can play a greater leadership role in their own health, will also serve to bring Dr Weil's philosophy of medicine and wellness closer to a sceptical and often very technically minded medical community. In the opinion of this writer, there needs to be much more room for both traditions to work side by side.

Notes

See www.efmoody.com/longterm/lifespan.html (accessed 21 May, 2006).