Tagged Longevity

Breast-Fed Babies May Have Longer Telomeres, Tied to Longevity

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Credit Roberto Schmidt/Agence France-Presse — Getty Images

Breast-fed babies have healthier immune systems, score higher on I.Q. tests and may be less prone to obesity than other babies.

Now new research reveals another possible difference in breast-fed babies: They may have longer telomeres.

Telomeres are stretches of DNA that cap the ends of chromosomes and protect the genes from damage. They’re often compared to the plastic tips at the end of shoelaces that prevent laces from unraveling. Telomeres shorten as cells divide and as people age, and shorter telomeres in adulthood are associated with chronic diseases like diabetes. Some studies have linked longer telomeres to longevity.

The new study, published in The American Journal of Clinical Nutrition, is a hopeful one, its authors say, because it suggests telomere length in early life may be malleable. The researchers, who have been following a group of children since birth, measured the telomeres of 4- and 5-year-olds, and discovered that children who consumed only breast milk for the first four to six weeks of life had significantly longer telomeres than those who were given formula, juices, teas or sugar water.

Drinking fruit juice every day during the toddler years and a lot of soda at age 4 was also associated with short telomeres.

Socioeconomic differences among mothers can muddy findings about breast-feeding because the practice is more common among more educated mothers. However, this group of children was fairly homogeneous. All of them were born in San Francisco to low-income Latina mothers, most of whom qualified for a government food program.

“This adds to the burgeoning evidence that when we make it easier for mothers to breast-feed, we make mothers and babies healthier,” said Dr. Alison M. Stuebe, an expert on breast-feeding who is the medical director of lactation services at UNC Health Care in Chapel Hill, N.C., and was not involved in the study. “The more we learn about breast milk, the more it’s clear it is pretty awesome and does a lot of cool stuff.”

The study did not establish whether or not breast-feeding enhanced telomere length. It may be that babies born with longer telomeres are more likely to succeed at breast-feeding. A major drawback of the research was that telomere length was only measured at one point in time, when the children were 4 or 5 years old. There was no data on telomere length at birth or during the first few months of life.

“We don’t have a baseline to see if these kids were different when they came out,” Dr. Stuebe said. “It could be that really healthy babies can latch on and feed well, and they already had longer telomeres. It could be successful breast-feeding is a sign of a more robust kid.”

The researchers were following children who were part of the Hispanic Eating and Nutrition study, a group of 201 babies born in San Francisco to Latina mothers recruited in 2006 and 2007 while they were still pregnant. The goal of the research was to see how early life experiences, eating habits and environment influence growth and the development of cardiac and metabolic diseases as children grow.

Researchers measured the babies’ weight and height when the children were born. At four to six weeks of age, they gathered detailed information about feeding practices, including whether the baby had breast milk and for how long, and whether other milk substitutes were used, such as formula, sugar-sweetened beverages, juices, flavored milks and waters. Information was also gathered about the mothers.

Children were considered to have been exclusively breast-fed at 4 to 6 weeks of age if they received nothing but breast milk, as well as medicine or vitamins.

When the children were 4 and 5 years old, researchers took blood spot samples that could be used to measure the telomeres in leukocytes, which are white blood cells, from 121 children. They found that children who were being exclusively breast-fed at 4 to 6 weeks of age had telomeres that were about 5 percent longer, or approximately 350 base pairs longer, than children who were not.

The new findings may help explain the trove of benefits that accrue from breast-feeding, said Janet M. Wojcicki, an associate professor of pediatrics and epidemiology at the University of California, San Francisco, and the paper’s lead author.

“What’s remarkable about breast-feeding is its ability to improve health across organ systems,” Dr. Wojcicki said. “Telomere biology is so central to the processes of aging, human health and disease, and may be the link to how breast-feeding impacts human health on so many levels.”

There are several possible explanations for the correlation between breast-feeding and longer telomeres. Breast milk contains anti-inflammatory compounds, which may confer a protective effect on telomeres. It’s also possible that parents who exclusively breast-feed their babies are more scrupulous about a healthy diet generally.

Yet another possibility is that breast-feeding is a proxy for the quality of mother-child attachment and bonding, said Dr. Pathik D. Wadhwa, who was not involved in the research but studies early-life determinants of health at the University of California, Irvine School of Medicine. “We know from studies looking at telomere length changes in babies who came from orphanages that the quality of the attachment and interaction, and more generally the quality of care that babies receive, plays a role in the rate of change in telomere length,” he said.

When children are exposed to adversity, neglect or violence at an early age, “psychological stress creates a biochemical environment of elevated free radicals, inflammation and stress hormones that can be harmful to telomeres,” said Elissa Epel, one of the authors of the study who is a professor at the University of California, San Francisco, and director of the Aging, Metabolism and Emotions Lab.

“The idea that breast-feeding may be protective for telomeres is heartening because we don’t know much about what’s going to help protect them in children, besides avoiding toxic stress. And boy, do we want to know,” Dr. Epel said.

Although genes can’t be changed, Dr. Epel said, “This is part of the genome that appears to be at least partly under personal control.”

Being Unfit May Be Almost as Bad for You as Smoking

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Credit Getty Images

Being out of shape could be more harmful to health and longevity than most people expect, according to a new, long-term study of middle-aged men. The study finds that poor physical fitness may be second only to smoking as a risk factor for premature death.

It is not news that aerobic capacity can influence lifespan. Many past epidemiological studies have found that people with low physical fitness tend to be at high risk of premature death. Conversely, people with robust aerobic capacity are likely to have long lives.

But most of those studies followed people for about 10 to 20 years, which is a lengthy period of time for science but nowhere near most of our actual lifespans. Some of those studies also enrolled people who already were elderly or infirm, making it difficult to extrapolate the findings to younger, healthier people.

So for the new study, which was published this week in the European Journal of Preventive Cardiology, researchers from the University of Gothenburg in Sweden and other institutions turned to an impressively large and long-term database of information about Swedish men.

The data set, prosaically named the Study of Men Born in 1913, involved exactly that. In 1963, almost 1,000 healthy 50-year-old men in Gothenburg who had been born in 1913 agreed to be studied for the rest of their lives, in order to help scientists better understand lifetime risks for disease, especially heart disease.

The men completed baseline health testing in 1963, including measures of their blood pressure, weight and cholesterol, and whether they exercised and smoked. Four years later, when the volunteers were 54, some underwent more extensive testing, including an exercise stress test designed to precisely determine their maximum aerobic capacity, or VO2 max. Using the results, the scientists developed a mathematical formula that allowed them to estimate the aerobic capacity of the rest of the participants.

Aerobic capacity is an interesting measure for scientists to study, because it is affected by both genetics and lifestyle. Some portion of our VO2 max is innate; we inherit it from our parents. But much of our endurance capacity is determined by our lifestyle. Being sedentary lowers VO2 max, as does being overweight. Exercise raises it.

Among this group of middle-aged men, aerobic capacities ranged from slight to impressively high, and generally reflected the men’s self-reported exercise habits. Men who said that they seldom worked out tended to have a low VO2 max. (Because VO2 max is more objective than self-reports about exercise, the researchers focused on it.)

To determine what impact fitness might have on lifespan, the scientists grouped the men into three categories: those with low, medium or high aerobic capacity at age 54.

Then they followed the men for almost 50 years. During that time, the surviving volunteers completed follow-up health testing about once each decade. The scientists also tracked deaths among the men, based on a national registry.

Then they compared the risk of relatively early death to a variety of health parameters, particularly each man’s VO2 max, blood pressure, cholesterol profile and history of smoking. (They did not include body weight as a separate measure, because it was indirectly reflected by VO2 max.)

Not surprisingly, smoking had the greatest impact on lifespan. It substantially shortened lives.

But low aerobic capacity wasn’t far behind. The men in the group with the lowest VO2 max had a 21 percent higher risk of dying prematurely than those with middling aerobic capacity, and about a 42 percent higher risk of early death than the men who were the most fit.

Poor fitness turned out to be unhealthier even than high blood pressure or poor cholesterol profiles, the researchers found. Highly fit men with elevated blood pressure or relatively unhealthy cholesterol profiles tended to live longer than out-of-shape men with good blood pressure and cholesterol levels.

Of course, this study found links between poor fitness and shortened lifespans. It cannot prove that one caused the other, or explain how VO2 max might affect lifespan. However, the findings raise the possibility, as the scientists speculate, that by strengthening the body, better fitness may lower the risk of a variety of chronic diseases.

This study also involved men — and Swedish men at that. So whether the findings are applicable to other people, particularly women, is uncertain.

But “there is no reason not to think” that the rest of us would also share any beneficial associations between fitness and longevity, said Per Ladenvall, a researcher at the Sahlgrenska Academy at the University of Gothenburg, who led the study. Past studies involving women have found such links, he said.

Encouragingly, if you now are concerned about the state of your particular aerobic capacity, you most likely can increase it just by getting up and moving. “Even small amounts of physical activity,” Dr. Ladenvall said, “may have positive effects on fitness.”

Thriving at Age 70 and Beyond

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Credit Paul Rogers

A recently published book, “70Candles! Women Thriving in Their 8th Decade,” inspired me to take a closer look at how I’m doing as I approach 75 and how I might make the most of the years to come. It would be a good idea for women in my age cohort to do likewise. With a quarter of American women age 65 expected to celebrate their 100th birthday, there could be quite a few years to think about.

It’s not the first time I’ve considered the implications of longevity. When one of my grandsons at age 8 asked, “Grandma, will you still be alive when I get married?” I replied, “I certainly hope so. I want to dance at your wedding.” But I followed up with a suggestion that he marry young!

Still, his innocent query reminded me to continue to pursue a healthy lifestyle of wholesome food, daily exercise and supportive social connections. While there are no guarantees, like many other women now in their 70s, I’ve already outlived both my parents, my mother having died at 49 and my father at 71.

If I have one fear as the years climb, it’s that I won’t be able to fit in all I want to see and do before my time is up, so I always plan activities while I can still do them.

I book cycling and hiking trips to parts of the world I want to visit and schedule visits to distant friends and family to be sure I make them happen. In a most pragmatic moment, I crocheted a gender-neutral blanket for my first great-grandchild, but attached a loving note in case I’m no longer around to give it in person.

Of course, advancing age has taken — and will continue to take — its incremental toll. I often wake up wobbly, my back hates rainy days, and I no longer walk, cycle or swim as fast as I used to. I wear sensible shoes and hold the handrail going up and down stairs.

I know too that, in contrast to the Energizer Bunny life I once led, I now have to husband my resources more carefully. While I’m happy to prepare a dish or two for someone else’s gathering, my energy for and interest in hosting dinner parties have greatly diminished. And though I love to go to the theater, concerts, movies and parties, I also relish spending quiet nights at home with my Havanese, Max, for company.

Jane Giddan and Ellen Cole, the authors of “70Candles!,” do not tout their work as definitive research. Rather, their effort involved scores of posts to an online blog, and eight gatherings in different cities with groups of women in or near their 70s, where participants were encouraged to share their stories and generate research questions that could be explored scientifically in more detail. Such studies are important: As baby boomers age, women in their 70s, already a large group, will represent an increasing proportion of the population, and how to best foster their well-being will be a growing challenge.

What are the most important issues facing these women as they age, and how might society help ease their way into the future? Leading topics the women chose to explore included work and retirement, ageism, coping with functional changes, caretaking, living arrangements, social connections, grandparenting and adjusting to loss and death.

As members of the first generation in which huge numbers of women had careers that defined who they were, deciding when to bow out can be a challenge. Some have no choice, others never want to, and still others like me continue to work part-time. However, sooner or later, most will need to find rewarding activities to fill their now-free time.

The authors reported that “the women seemed to fear retirement before the deed was done, and then to relish their newfound opportunities afterward.” Several warned against rushing into too many volunteer activities, suggesting instead that retirees take time to explore what might be most meaningful and interesting, from taking art classes or music lessons to mentoring students, becoming a docent or starting a new career.

As one woman said, “There are many places where you are needed and can make a difference.” Another said, “It’s more like putting new tires on a car… re-tiring!”

Still, many lamented society’s focus on youthfulness and its failure to value the wisdom and knowledge of elders like themselves. Ageism abounds, they agreed. As one woman wrote, “At my institution, there’s an unstated policy that anyone over 55 won’t get a job. We’re thought to be out of touch with the younger population and assumed to be lacking in the necessary technical skills.” A practicing attorney admitted, “People might not listen to me if they knew I was 71, so I keep it to myself.”

Adjusting to physical changes that accompany advancing years is often tough. Grandchildren, though a great joy to many, can be exhausting, necessitating a restorative nap. Adjustments are needed to reduce the risk of falls and fractures. Better lighting, hearing assists, a reliance on Post-it notes and lists as well as canes and walkers can become essential for safe and effective functioning.

As Ms. Giddan and Ms. Cole wrote, “Our bodies change as we age, even when we eat healthfully, exercise and try to take good care of ourselves. Sight, hearing, bones, joints, balance, mobility, memory, continence, strength and stamina — they will never be what they once were.”

There is also the matter of attending to or accommodating various aches and pains. As one physician reassured a woman of 70, “All my patients your age who are free of pains are dead.” I’m not one to run to the doctor the moment something hurts. Rather, I give it a few weeks — maybe a month — to see if it will go away on its own. Even if fully covered by Medicare, doctor visits cost time and effort, and tests that ensue may have side effects.

Also important as women age are social connections, especially with other women. Whether married, single, widowed or divorced, participants reported that women friends were their greatest source of support and comfort.

Perhaps most important, for men as well as women, is to think positively about aging. A 2002 study by epidemiologists at Yale found that “individuals with more positive self-perceptions of aging, measured up to 23 years earlier, lived 7.5 years longer than those with less positive perceptions.”

This is the first of two columns on adjustments to aging.

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At 100, Still Running for Her Life

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100 and She Just Won’t Stop

She is a national champion, a former activist and a centenarian. And she runs.

By NOAH REMNICK and ERICA BERENSTEIN on Publish Date April 22, 2016. Photo by Elias Jerel Williams for The New York Times.

On a cloudless Sunday afternoon in April, a 100-year-old woman named Ida Keeling laced up her mustard yellow sneakers and took to the track at the Fieldston School in the Bronx. Her arrival was met without fanfare. In fact, no one in the stands seemed to notice her at all.

It is possible the spectators were distracted by the girls’ soccer game taking place on the field. Or perhaps they were simply unaware that Ms. Keeling is a reigning national champion.

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Ms. Keeling, 100, holds a record for the 60-meter dash for American women ages 95 to 99.

Ms. Keeling, 100, holds a record for the 60-meter dash for American women ages 95 to 99.Credit Elias Jerel Williams for The New York Times

When she runs, Ms. Keeling occupies a lane all her own. She has held several track-and-field records since she began racing in her late 60s, and she still has the fastest time for American women ages 95 to 99 in the 60-meter dash: 29.86 seconds. In the week to come, she plans to compete in a 100-meter event at the Penn Relays in Philadelphia, where she hopes to establish a new standard for women over 100 years old.

“You see so many older people just sitting around — well, that’s not me,” said Ms. Keeling, who is barely 4-foot-6 and weighs 83 pounds. “Time marches on, but I keep going.”

Ms. Keeling was not always such an accomplished runner. As a child growing up in Harlem, she preferred riding bikes or jumping rope. With Title IX half a century away, there were few opportunities for girls, let alone black girls, to play organized sports. When she did run, it was always to race, never to exercise.

“I was pretty fast as a girl,” she said. “What makes me faster now is that everyone else slowed down.”

When the Depression hit, Ms. Keeling’s athletic inclinations receded into memory, supplanted by a series of jobs washing windows and babysitting for neighbors. Her family, who for years lived in cramped quarters in the back of her father’s grocery, was forced into even more humbling circumstances when the store went out of business and her father began peddling fruits and vegetables from a pushcart for a living.

“I learned to stand on my own two feet during the Depression,” she said. “It taught you to do what you had to do without anyone doing it for you.”

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Shelley Keeling, left, and her mother, Ida Keeling, on a balcony in the Riverdale section of the Bronx.

Shelley Keeling, left, and her mother, Ida Keeling, on a balcony in the Riverdale section of the Bronx.Credit Elias Jerel Williams for The New York Times

Ms. Keeling’s resilience only deepened with time. After her husband died of a heart attack at 42, she was left to raise their four children on her own. She moved the family into a one-bedroom apartment in a Harlem housing project and took up work sewing in a factory, all the while contending with the abuses and indignities endured by black women in mid-20th-century America. As the civil rights movement took shape, Ms. Keeling became an active demonstrator, shuttling her children to Malcolm X speeches and boarding a predawn bus for the 1963 March on Washington.

“I always understood from mother that you die on your feet rather than live on your knees,” said her daughter Shelley Keeling.

Over time, that resolve was gravely tested. While serving overseas in the Navy, Ms. Keeling’s older son, Donald, developed a crippling drug addiction that he struggled to shed even after returning home to Harlem. His habit ensnared his younger brother, Charles, who had served in the Army. Ms. Keeling watched in horror as both boys, barrel-chested charmers who friends joked looked like superheroes, withdrew into the world of drugs.

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Ms. Keeling stretched her legs in her daughter’s living room in the Bronx last month.

Ms. Keeling stretched her legs in her daughter’s living room in the Bronx last month.Credit Elias Jerel Williams for The New York Times

In 1978, Ms. Keeling received a call from the police informing her that Donald had been hanged. Around two years later, the phone rang again: Charles was dead — beaten in the street with a baseball bat. Both killings were suspected to be drug-related; neither was ever solved.

“I’ve never felt a pain so deep,” Ms. Keeling recalled, her voice lowering to a whisper. “I couldn’t make sense of any of it and things began to fall apart.”

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A stretch to improve Ms. Keeling’s blood flow and flexibility.

A stretch to improve Ms. Keeling’s blood flow and flexibility.Credit Elias Jerel Williams for The New York Times

As Ms. Keeling fell into a deep depression, her health began to falter. Her blood pressure shot up, along with her heart rate. The image of her once-vital mother in such despair shook the younger Ms. Keeling. A lifelong track-and-field athlete whose trophies fill an entire room of her apartment, she intervened with the means of healing most familiar to her: running.

“It was trial by fire,” recalled Shelley Keeling, 64, who has coached track and field at Fieldston for 21 years. “Based on where she was emotionally, it just had to be.”

After some coaxing from her daughter, Ms. Keeling, then 67, registered for a five-kilometer race through Brooklyn. It had been decades since she had last gone running. The two women took off together, but the younger Ms. Keeling soon darted to the front of the pack as her mother drifted far behind. After a suspenseful respite, was relieved to see her mother scamper across the finish line, barely out of breath.

“Good Lord, I thought that race was never going to end, but afterwards I felt free,” Ms. Keeling recalled. “I just threw off all of the bad memories, the aggravation, the stress.”

So began the sunset career of Ida Keeling, at a time when most of her peers were settling in for a future of seated yoga or abandoning athletics altogether. In the decades since, she has traveled across the world for competitions. She often races alone, the only contestant in her age group.

“Now I’m just chasing myself — there’s no one else to compete with,” she said. “It’s wonderful, but it feels a little crazy.”

Running gives Ms. Keeling a sense of serenity, she said. Her sinewy arms urge her body forward, each stride stronger than the last as she picks up momentum. Though she has developed arthritis and occasionally relies on a cane while walking, Ms. Keeling betrays none of her ailments as she runs.

To maintain her health, Ms. Keeling adheres to a stringent regimen of diet (“I eat for nutrition, not for taste”) and exercise (“I’ve got to get my hour in every day”). On a recent afternoon, Shelley Keeling led her mother through a routine that included push-ups, wall sits, shoulder presses and sprints back and forth on the balcony of her apartment in the Riverdale section of the Bronx. Ms. Keeling lives alone and says that self-sufficiency is a key to her longevity.

“I don’t beg nobody for nothing,” she said. “I wash, cook, iron, scrub, clean, mop and shop.”

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Ms. Keeling exceeded the five push-ups that her daughter had asked of her.

Ms. Keeling exceeded the five push-ups that her daughter had asked of her.Credit Elias Jerel Williams for The New York Times

Ms. Keeling eschews food products with preservatives, favoring fresh grains and produce, along with limited portions of meat. Desserts are rarities, and a tablespoon of cod-liver oil supplements breakfast most mornings. Despite her exceptional discipline, Ms. Keeling allows herself one indulgence. “This is putting gas in the car,” she said before downing a tall shot of Hennessy.

There are days when Ms. Keeling battles a surge of arthritis or a hint of melancholy. “I never want to go backwards,” she said. “I’m a forward type of person.”

As she navigated the track at Fieldston, a nasty cramp shot up her right leg, hobbling her gait. For a moment she seemed to hesitate as she let out a deep sigh and slowed her pace. But then Ms. Keeling dispensed with the pain the only way she knew how. She ran through it.

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Simple Remedies for Constipation

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Credit Paul Rogers

Chronic constipation is an all-too-common problem rarely discussed in polite company and only reluctantly mentioned to doctors during checkups. Although it accounts for eight million doctor visits annually, only “a minority of those with constipation seek medical attention,” Dr. Arnold Wald, a leading expert on the problem, reports.

Yet this hesitance can perpetuate mistaken beliefs about its consequences, causes and treatment, and often results in failure to get effective relief. Most of the time, relatively simple treatments prove adequate. Even more complex cases, like those that involve a disorder of muscle action in the pelvis, usually respond well to currently available remedies.

Chronic constipation can accompany a long list of medical problems – mechanical ones like a stricture or tumor; neurological disorders like Parkinson’s disease or multiple sclerosis; or metabolic conditions like severe low thyroid or low blood levels of magnesium.

Constipation can also be a side effect of medications, especially opiates like Percocet and OxyContin, as well as some antidepressants, anticonvulsants and antihistamines.

As someone who has dealt with constipation, with varying degrees of success, for most of my life, I had more than an academic interest in learning more about it. Hence this column, prompted by a friend’s excruciatingly painful problem that seemed to emerge from nowhere and by a new review of studies on the topic published in JAMA by Dr. Wald, a gastroenterologist at the University of Wisconsin School of Medicine and Public Health.

Many strongly held beliefs about constipation are not based on medical evidence, Dr. Wald and his colleagues have noted.

One of the oldest yet most persistent of these unsubstantiated notions is that failure to empty one’s bowels each and every day can result in so-called autointoxication – the absorption of poisonous substances produced from partially digested food and food byproducts in the intestines. Through the years, autointoxication has been erroneously blamed for a host of ailments, including high blood pressure, arthritis, atherosclerosis, gall bladder disease, various cancers and skin disorders.

Autointoxication is often cited as a reason for the common but mistaken belief that a daily bowel movement is essential to good health. But there’s no evidence that food that sits in the intestine leads to the buildup of toxins. The medically accepted definition of constipation is “fewer than three bowel movements a week, or hard, dry and small bowel movements that are painful or difficult to pass,” often resulting in abdominal pain or bloating.

Unfortunately, as a college freshman, I met those criteria. An astute physician provided advice that has helped to minimize the problem ever since. She gave me a list of “constipating” foods to avoid – white rice and other refined grains, unripe bananas, tea, cheese and chocolate – and even more important, foods to eat regularly: beans, whole grain cereals (especially bran) and breads, vegetables, fruits (especially dried fruits) and nuts. Eating more of these and other high-fiber foods can be very effective in curbing constipation. And she recommended drinking a full glass of water before bed to help soften the stool and another after awakening to stimulate my bowel.

Following this advice I’ve never had to rely on laxatives, although those medications are associated as well with myths and misconceptions that are important to dispel. One mistaken belief Dr. Wald and others have cited is that long-term use of stimulatory laxatives like senna and bisacodyl (Senokot and Dulcolax, respectively) can impair normal function of the colon and cause dependency on the medication.

While it is true that using stimulatory laxatives for many years at more than a dozen times the suggested dosage can damage the colon’s nerves and muscles, Dr. Wald and others say that properly designed studies of these laxatives have shown no harm to the colon when they are taken in recommended amounts.

Yet many doctors still warn – inappropriately, Dr. Wald says — against taking stimulatory laxatives for more than a few days. Indeed, the website FamilyDoctor.org states, “When these laxatives are taken for a long time, the bowel can lose its muscle tone and ‘forget’ how to push the stool out on its own.” Best to forget this outdated idea as long as you stick to the recommended dose if you must take these products.

Short of potent laxatives, other milder remedies often prove helpful. One is exercise, the more vigorously done the better. Another is to establish a regular bathroom time and respond promptly to the urge to defecate. I am among many who have found that a large cup of hot coffee in the morning is often a very effective stimulus.

However, as my ability to prevent constipation has diminished with age, I’ve added two other over-the-counter aids: a daily soluble fiber supplement of psyllium dissolved in juice or water (other fiber products like methyl cellulose, calcium polycarbophil and wheat dextrin can also be effective) and a twice-daily dose of a stool softener, both of which can safely be used indefinitely.

However good dietary fiber normally is for maintaining a healthy gut, it can be harmful when the cause of constipation is muscle weakness or a nerve problem, Dr. Wald said. Such patients often do better by eating less fiber and instead taking a secretory drug like lubiprostone (Amitiza) or linaclotide (Linzess) that adds water to the colon and softens the stool.

Sometimes, too, standard remedies for chronic constipation are ineffective. None worked for my friend, a New Yorker who suddenly developed an extremely painful problem at age 73 that was finally diagnosed as a failure of her pelvic floor muscles to relax when they are supposed to and allow the stool to pass through. Instead of relaxing, the muscles around the rectum contract. “It is a learned unconscious act that can be unlearned,” Dr. Wald explained.

Despite the usual remedies of diet, exercise and a costly prescription-only stool softener, the problem has recurred every eight days or so, she said. She is now being treated with deep breathing exercises 10 times a day and abdominal massage above the colon twice a day, and has begun biofeedback to “retrain” the muscles that are responsible for normal colorectal action. Dr. Wald said that biofeedback training, when done properly, is effective in about 80 percent of cases.

My friend’s experience underscores the importance of consulting an expert when constipation persists and fails to respond adequately to self-help measures of diet, exercise and over-the-counter remedies.

st dosing oneself prematurely with widely touted substances like resveratrol, the antioxidant found in red grapes and wine, or growth hormone.

Consumers must exercise caution, he warned, because “there’s an entire industry out there trying to market the products we’re testing before they are adequately evaluated.”

He also emphasized that taking a drug found to ward off age-related ills is not a license to abandon a healthy lifestyle. Doing so “could completely negate the benefit of a compound that slows aging,” he said.

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Pursuing the Dream of Healthy Aging

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Credit Paul Rogers

Given their druthers, most people would opt for a long and healthy life. Few relish the idea of spending years, even decades, incapacitated by illness, dependent on caregivers and unable to enjoy the people, places and activities that make life worth living.

In 1980, Dr. James F. Fries, a Stanford University physician who studied chronic disease and aging, proposed that a “compression of morbidity” would enable most people to remain healthy until a certain age, perhaps 85, then die naturally or after only a brief illness.

Now, a prescient group of experts on aging envisions a route to realizing Dr. Fries’s proposal: one or more drugs that can slow the rate of aging and the development of the costly, debilitating chronic ailments that typically accompany it. If successful, not only would their approach make healthy longevity a reality for many more people, but it could also save money. They say that even a 20 percent cut in how fast people age could save more than $7 trillion over the next half-century in the United States alone.

“Aging is by far the best predictor of whether people will develop a chronic disease like atherosclerotic heart disease, stroke, cancer, dementia or osteoarthritis,” Dr. James L. Kirkland, director of the Kogod Center on Aging at the Mayo Clinic, said in an interview. “Aging way outstrips all other risk factors.”

He and fellow researchers, who call themselves “geroscientists,” are hardly hucksters hawking magic elixirs to extend life. Rather, they are university scientists joined together by the American Federation for Aging Research to promote a new approach to healthier aging, which may — or may not — be accompanied by a longer life. They plan to test one or more substances that have already been studied in animals, and which show initial promise in people, in hopes of finding one that will keep more of us healthier longer.

As Dr. Kirkland wrote in a new book, “Aging: The Longevity Dividend”: “By targeting fundamental aging processes, it may be possible to delay, prevent, alleviate or treat the major age-related chronic disorders as a group instead of one at a time.”

His colleague S. Jay Olshansky, a gerontology specialist in the School of Public Health at the University of Illinois in Chicago, said it is often counterproductive to treat one disease at a time. Preventing cardiac death, for example, can leave a person vulnerable to cancer or dementia, he explained.

A better approach, Dr. Kirkland said, would be to target the processes fundamental to aging that underlie all age-related chronic diseases: chronic low-grade inflammation unrelated to infection; cellular degradation; damage to major molecules like DNA, proteins and sugars; and failure of stem cells and other progenitor cells to function properly.

The team, which includes Dr. Nir Barzilai, director of the Institute for Aging Research at Albert Einstein College of Medicine in The Bronx, and Steven N. Austad, who heads the biology department at the University of Alabama at Birmingham, plans to study one promising compound, a generic drug called metformin already widely used in people with Type 2 diabetes. They will test the drug in a placebo-controlled trial involving 3,000 elderly people to see if it will delay the development or progression of a variety of age-related ailments, including heart disease, cancer and dementia. Their job now is to raise the $50 million or so needed to conduct the study for the five years they expect it will take to determine whether the concept has merit.

The project represents a radical departure from ordinary drug studies that test treatments for single diseases. However, the group, spearheaded by Dr. Barzilai, said the Food and Drug Administration has endorsed their idea to test a single substance for effectiveness against a range of ailments.

“If metformin turns out not to work, there are several other substances in the pipeline that could be tried,” Dr. Barzilai said. “Under the auspices of the National Institute on Aging, three research centers have tested 16 substances in different animal models and got incredible results with four of them.”

Green tea, one of those tested, bestowed no health or life span benefits, despite its popularity. But the drug rapamycin, an immune modulator used following organ transplants, was most effective among those tested, Dr. Barzilai said.

The team is starting with metformin because it is a cheap oral drug — costing about two cents a pill — with six decades of safe use in people throughout the world. Among those with Type 2 diabetes who have taken it for years, there is evidence suggesting that, in addition to diabetes, it protects against cardiovascular disease, cancer and possibly cognitive impairment, Dr. Kirkland said, adding that “it targets the fundamental processes of aging, which tend to be linked.”

Dr. Barzilai said, “Our goal is to establish the principle of using a drug, or two in combination, to extend health span. The best we can expect from metformin is two or three additional years of healthy aging. But the next generation of drugs will be much more potent.”

Dr. Barzilai is already conducting a complementary study of centenarians, the results of which could identify more drugs to delay age-related diseases. He and colleagues are isolating genes that appear to keep these long-lived men and women healthy for 20 to 30 years longer than other people and shorten the length of illness at life’s end. Several studies have already found that individuals with exceptional longevity experience a compression of morbidity and spend a smaller percentage of their life being ill, Dr. Barzilai and his colleague Dr. Sofiya Milman wrote in the “Aging” book.

By analyzing the action of genes that extend health span, “it should be possible to devise drugs that mimic the genes’ effects,” he said. Two such gene-based drugs that show early promise against age-related diseases are already being tested.

But until definitive studies are completed and substances are shown to be safe as well as effective in prolonging health, Dr. Olshansky cautioned against dosing oneself prematurely with widely touted substances like resveratrol, the antioxidant found in red grapes and wine, or growth hormone.

Consumers must exercise caution, he warned, because “there’s an entire industry out there trying to market the products we’re testing before they are adequately evaluated.”

He also emphasized that taking a drug found to ward off age-related ills is not a license to abandon a healthy lifestyle. Doing so “could completely negate the benefit of a compound that slows aging,” he said.

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