By Dr Martie Conradie, MBChB (UP), Diploma in Child Health (SA), Diploma in HIV Management (SA)
Which is more important to you – living for as long as possible in any condition or being healthy for as long as possible?
It is a question often asked now that the improvements in medicine and other fields have led to the extension of life expectancy, especially in developed countries. Unfortunately, a longer life does not necessarily mean that the years you live longer are spent in good health.
Healthspan is a topic relevant to all people. Younger people might benefit most in the long-term if they increase their focus to make decisions which are good for their health, but older people might be the first to see benefits. Therefore, it is never too late to learn about healthspan and ways to increase it. The time to act is now!
What is the difference between healthspan and lifespan?
The number of years you’ll live is your lifespan, but the number of years that you’ll be healthy and will be able to live a good quality of life, is referred to as your healthspan.
In the 1900s, 20 percent of the population died before the age of 10 from infectious diseases. Developments such as clean water, sewer systems and antibiotics improved survival. Now nearly 95 percent of infants born is expected to live to the age of 50, with 84 percent expected to live to 65 or older, in developed countries.
Caring about extending the well period of your life should be intuitive. If you are past your healthspan, it means you are chronically sick and maybe have a worsening condition. Since progress in multiple fields has made it possible for many people to live longer, interest is now growing in how to age well. Preserving physical and mental health to maximize quality of life in the elder years has become really important.
Current statistics show that we, on average, live up to 20% of our lives unhealthy. Needless to say, that is a long time. Healthcare costs are on the rise and chronic diseases are inflicting untold costs on human quality of life.
Unfortunately, healthspan is a socioeconomic issue too. Currently the gap in life expectancy in different geographic regions in the world and even different regions within a country is widening. Poorer countries cannot always afford the care needed to manage the higher healthcare costs required by an aging population. Increasing healthspan should therefore also be a focus in these countries because healthcare costs will decrease dramatically if people stay healthy for longer.
Even in developed countries, the healthcare sector is under strain due to the requirements for frail care and the costs related to ageing. This is unlikely to change unless people stay healthier for longer.
The diseases often associated with ageing include heart diseases, cancer, chronic lung diseases, musculoskeletal diseases, and cognitive disorders (dementia or Alzheimer’s). Most of these can be prevented or progression can be slowed by changing our lifestyles. If you have ever needed a reason to stand by your goals of eating well or staying active, increasing your healthspan is as good a reason as you will ever need.
In Japan, which is one of the countries where people currently have the longest life expectancy, the number of centenarians has doubled every decade since 1960. Even you could live to 100.
Changing the lifestyles of everyone will be the next major opportunity to shift from infirmity and misery to health and happiness.
Measures of health
In 1948, the World Health Organisation defined health as “a state of complete physical, mental and social well-being, and not merely the absence of disease”. Determining how healthy a person is, is therefore quite a challenge. Health status and quality of life are often used as indicators of people’s health.
Health status can generally be determined by looking at factors such as the presence of co-existing disease, blood pressures or cholesterol levels.
Quality of life, using a very simplified definition, refers to the difference between your hopes and expectations of life and your present experiences. There have been many questionnaires developed to try to measure this and to determine what the effects of different diseases on a patient’s quality of life are.
If people are encouraged to stay well from youth to old age by making good health decisions such as avoiding tobacco, maintaining a healthy body weight, eating a nutritious diet, and staying active, the calculated quality of life for whole populations will increase.
How can you increase your healthspan?
What if there was a way to help us to extend our healthspan, delay age-related health problems, repair organs that are damaged and improve our quality of life?
A quick and easy solution will be wonderful, but while scientists are trying to figure this out by looking at genes and new therapies, some of which are ethically quite controversial, you can follow this advice and steer your life into the healthiest possible direction:
- Follow a healthy diet – The Mediterranean diet has shown quite promising results and seems to be a very balanced and nutritional diet. If done correctly, under the guidance of an experienced doctor or dietician, calorie restriction and intermittent fasting also appear to increase regenerative capacity and reduce the risk of developing age-related co-morbidities. You can consider using healthy supplements if your intake of all the vitamins and minerals might be lacking.
- Reduce sugar intake.
- Exercise – For better cardiovascular health, at least let your heart beat faster three times a week for 30 minutes. Improving flexibility and strengthening certain muscle groups can dramatically improve many back problems too. Develop a good, individualised program with the help of your doctor, physiotherapist, or other healthcare providers.
- Stop smoking, vaping, or using other tobacco products. This cannot be stressed enough.
- Limit alcohol intake and avoid using recreational drugs. Use and abuse of these substances have been shown to have a big impact on mental and cognitive well-being later in life.
- Maintain your mental well-being. Seek help when needed and find ways to cope with a stressful and rushed life.
- Follow care plans developed for your specific health problems, which include taking medicine and visiting your doctor. Do not delay in seeking help.
- Stay mentally active. There are many activities that are good for brain stimulation such as chess or playing a musical instrument.
- Be part of social activities and build relationships for a good support system, in healthy ways, since certain activities definitely do not promote healthy living.
- Get enough good quality sleep – usually 7-9 hours.
- Do not ignore unhealthy habits or factors that you are exposed to at work. Many people spend long hours in their occupations, and it is easy to ignore what you are exposed to at work. Take care of your hearing and make sure you maintain a good posture. Noise-induced hearing loss and back problems cause the most disabilities related to people’s work.
These are usually easy tips to give, but very hard to follow…
The Blue Zones Project was developed to promote living well for longer. It is based on nine principles which were gleaned from the five places around the world where more people live to the age of 100. These principles include moving naturally, having purpose, downshifting, consuming a plant-slant diet, eating until 80 percent full, having wine at five (indicating rather that it is important to relax than it indicates that alcohol is good), putting family first, belonging to a right tribe (referring to a social support system), and participating in a faith-based organisation. People following these principles are reporting happier, healthier, and more productive lives.
Policy changes to reduce socioeconomic disparities, improve education, ensure a healthy environment and to improve healthcare in general will obviously be needed to make the maximum progress in population health. The current system in healthcare that allows payment for services might also be playing a role in providing the wrong aims for the healthcare industry. Many countries are starting to look at paying for good outcomes, so in the future we can expect to see many changes in the healthcare environment.
But there is a lot you can do to improve your health now…may you be successful in implementing healthy habits to extend your vitality.