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12 Guides to Health, Happiness, and Longevity (with Apologies to P.J. O'Rourke)

2008; Elsevier BV; Volume: 121; Issue: 7 Linguagem: Inglês

10.1016/j.amjmed.2008.03.032

1555-7162

Joseph S. Alpert,

Obesity, Physical Activity, Diet

Patients are always asking me for strategies to enable them to live longer and feel happier during their journey to old age. I have constructed the list below as an answer to this request. The flavor of this essay is somewhat tongue-in-cheek (hence the apology to P.J. O'Rourke), although I am willing to defend any of the 12 guides as being reasonable and likely to succeed.Guide #1: Try to be born into a family with a history of longevity. There is no replacement for good genes. This is the single factor that one cannot influence with a change in lifestyle or attitude. Nevertheless, disobeying the other 11 guides can negate any hereditary propensity for long life.Guide #2: Never smoke! If you are unlucky enough to be a current smoker, quit the moment you finish reading this article.Guide #3: Only exercise on the days that you eat. In other words, exercise everyday. The form of exercise is not the most important aspect of this guide, nor is the intensity of your workout. Exercise for 40-60 minutes each day at a level that produces sweating. Don't bother to count your heart rate unless you are training for competition.Guide #4: Avoid extreme diets such as the transiently popular starvation diet. This diet has never been shown to prolong life in human beings. It works for inbred mice in the setting of laboratory experiments, and, in my opinion, is not a good strategy for humans.Guide #5: Eat a healthy diet, low in saturated (animal) fats and high in monounsaturated and polyunsaturated fats with 5-8 servings of fruits and vegetables each day.1Alpert J.S. What diet should we recommend to patients?.Am J Med. 2006; 119: 715-716Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar Hold back on the “white carbohydrates” (ie, sugar, white flour, white rice, white potatoes).Guide #6: Don't get fat.2Alpert J.S. Powers P.J. Obesity: a complex public health challenge.Am J Med. 2005; 118: 935Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar It is okay to be a few pounds (and only a few pounds) over your ideal weight. If you are 15 pounds or more over your ideal body weight, start a program of dieting and exercise. Consult your doctor or nutritionist about a reasonable program, and check out the reliable, online resources on weight management and fitness.3Hwang K.O. Farheen K. Johnson C.W. Thomas E.J. Barnes A.S. Bernstam E.V. Quality of weight loss advice on Internet forums.Am J Med. 2007; 120: 604-609Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar Avoid fad diets—see Guides #4 and #5.Guide #7: Be moderate in your use of alcohol. Some studies have demonstrated improved longevity with moderate alcohol consumption. However, the benefit disappears at more than 2 drinks per day. So drink moderately. Whether or not red wine is the healthiest form of alcohol to drink has not been definitively decided unless you work for the French or the California winegrowers association!Guide #8: Periodically consult your doctor for preventive health measures such as cholesterol, blood sugar, and blood pressure checks; cancer screenings; and flu vaccinations. If you are a woman, get regular Pap smears, mammograms, and bone density scans once you are in the age range for these to be useful.Guide #9: Cultivate family and friends. Enjoy conversation, dining, and recreation with people whom you like (for example, your spouse). Spend as little time as possible with folks you don't like or who make you uncomfortable.Guide #10: Cultivate an avocation that occurs away from your work day. For example, play a musical instrument alone or with someone; engage in sports such as golf or tennis; read interesting books, etc. If you can do this with someone who you like (see Guide #9), so much the better.Guide #11: Be informed, but try not to be overwhelmed by current events as portrayed by the popular media (ie, television and newspaper news reports). Remember the part of your high school US history course that discussed “yellow journalism” in the US in the 19th century? In my opinion, nothing has changed since then except the subtlety of the media's messages. Most of the daily news is comprised of stories of murder, rape, terrorism, pollution, vandalism, and other acts of violence—along with celebrity updates. If you don't believe me, watch Fox News for 5 minutes (if you can stand it) and see how much of what is portrayed pertains to the topics just enumerated. It is far better to spend the time doing what is suggested in Guides #3, #9, and #10; also, watching less television can help you with Guide #6. If you are watching television and the daily news comes on, change the station!Guide #12: Do your best to avoid being irritated by little things. Every one of us experiences small daily irritations that can eventually lead to surprising degrees of anger and depression. Try to put things into perspective. As one of my patients recently told me about some minor irritations occurring at his home, “At least it is not cancer!”Very few of us can consistently adhere to every one of these 12 guides. However, the person who manages to achieve success with 8 or 9 of them should increase the likelihood that her/his life will be longer, happier, and healthier. Patients are always asking me for strategies to enable them to live longer and feel happier during their journey to old age. I have constructed the list below as an answer to this request. The flavor of this essay is somewhat tongue-in-cheek (hence the apology to P.J. O'Rourke), although I am willing to defend any of the 12 guides as being reasonable and likely to succeed. Guide #1: Try to be born into a family with a history of longevity. There is no replacement for good genes. This is the single factor that one cannot influence with a change in lifestyle or attitude. Nevertheless, disobeying the other 11 guides can negate any hereditary propensity for long life. Guide #2: Never smoke! If you are unlucky enough to be a current smoker, quit the moment you finish reading this article. Guide #3: Only exercise on the days that you eat. In other words, exercise everyday. The form of exercise is not the most important aspect of this guide, nor is the intensity of your workout. Exercise for 40-60 minutes each day at a level that produces sweating. Don't bother to count your heart rate unless you are training for competition. Guide #4: Avoid extreme diets such as the transiently popular starvation diet. This diet has never been shown to prolong life in human beings. It works for inbred mice in the setting of laboratory experiments, and, in my opinion, is not a good strategy for humans. Guide #5: Eat a healthy diet, low in saturated (animal) fats and high in monounsaturated and polyunsaturated fats with 5-8 servings of fruits and vegetables each day.1Alpert J.S. What diet should we recommend to patients?.Am J Med. 2006; 119: 715-716Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar Hold back on the “white carbohydrates” (ie, sugar, white flour, white rice, white potatoes). Guide #6: Don't get fat.2Alpert J.S. Powers P.J. Obesity: a complex public health challenge.Am J Med. 2005; 118: 935Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar It is okay to be a few pounds (and only a few pounds) over your ideal weight. If you are 15 pounds or more over your ideal body weight, start a program of dieting and exercise. Consult your doctor or nutritionist about a reasonable program, and check out the reliable, online resources on weight management and fitness.3Hwang K.O. Farheen K. Johnson C.W. Thomas E.J. Barnes A.S. Bernstam E.V. Quality of weight loss advice on Internet forums.Am J Med. 2007; 120: 604-609Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar Avoid fad diets—see Guides #4 and #5. Guide #7: Be moderate in your use of alcohol. Some studies have demonstrated improved longevity with moderate alcohol consumption. However, the benefit disappears at more than 2 drinks per day. So drink moderately. Whether or not red wine is the healthiest form of alcohol to drink has not been definitively decided unless you work for the French or the California winegrowers association! Guide #8: Periodically consult your doctor for preventive health measures such as cholesterol, blood sugar, and blood pressure checks; cancer screenings; and flu vaccinations. If you are a woman, get regular Pap smears, mammograms, and bone density scans once you are in the age range for these to be useful. Guide #9: Cultivate family and friends. Enjoy conversation, dining, and recreation with people whom you like (for example, your spouse). Spend as little time as possible with folks you don't like or who make you uncomfortable. Guide #10: Cultivate an avocation that occurs away from your work day. For example, play a musical instrument alone or with someone; engage in sports such as golf or tennis; read interesting books, etc. If you can do this with someone who you like (see Guide #9), so much the better. Guide #11: Be informed, but try not to be overwhelmed by current events as portrayed by the popular media (ie, television and newspaper news reports). Remember the part of your high school US history course that discussed “yellow journalism” in the US in the 19th century? In my opinion, nothing has changed since then except the subtlety of the media's messages. Most of the daily news is comprised of stories of murder, rape, terrorism, pollution, vandalism, and other acts of violence—along with celebrity updates. If you don't believe me, watch Fox News for 5 minutes (if you can stand it) and see how much of what is portrayed pertains to the topics just enumerated. It is far better to spend the time doing what is suggested in Guides #3, #9, and #10; also, watching less television can help you with Guide #6. If you are watching television and the daily news comes on, change the station! Guide #12: Do your best to avoid being irritated by little things. Every one of us experiences small daily irritations that can eventually lead to surprising degrees of anger and depression. Try to put things into perspective. As one of my patients recently told me about some minor irritations occurring at his home, “At least it is not cancer!” Very few of us can consistently adhere to every one of these 12 guides. However, the person who manages to achieve success with 8 or 9 of them should increase the likelihood that her/his life will be longer, happier, and healthier.