Healthy Lifestyle Equals Longevity? Maybe Not
How important is a healthy lifestyle for longevity?
I took a semi-random walk through Wikipedia the other day. What was I looking for?
I was looking for how long people tended to live during the period 1450-1600. This started because I was reading some entries on Tudor personalities and I noticed people didn’t seem to be living that long.
Of course if you hung around the Tudor court too long it could be hazardous to your health, in that you were liable to fall out of favor and under a headsman’s axe. But still…
So I started looking up people and noting down their ages. Not just Tudor court figures, because they might all be related—I moved on to France, Italy, Spain, even China, India and the Middle East. Most of the people we still know of were political types but I was also able to include some popes and artists.
I tried to make sure I didn’t include people who died in battles, accidents, suicides executions, or homicides. I excluded people who died before they reached their twenties, so as to eliminate childhood diseases and birth defects.
What I got:
Number of men (total number 62) who died in their:
20s-0, 30s-2, 40s-10, 50s-20, 60s-21, 70s-4, 80s-5
For women (total number 39)
20s-3, 30s-8, 40s-7, 50s-12, 60s-6, 70s-2, 80s-1
(There were two interesting possible trends in this small sample. One was that the older men were skewed to churchmen. The other was that very famous people, such as Michelangelo or Ivan the Terrible, tended to live longer than their contemporaries who are now less well known. It would be fascinating to see if these trends were borne out with further data, or were just an anomaly.)
One trend that jumps out at you is that if you were a woman you were temporary. They seemed to have their age curve shifted about a decade to the left. Their ages are still too old be directly reflective of acute childbirth injury (most died long after they would have started having children) but most likely does reflect the added physical burden human reproduction imposes on the female. We’ve become so spoiled in this regard that we sniff at “unnatural” childbirth or carp about “unnecessary” hysterectomies. We have forgotten that prior to modern medicine, women almost universally suffered from anemia, torn rectums and holes between the rectum, urethra and vagina from childbirth, as well as excessive bleeding from fibroids and hormone dysfunction to the point of incapacity and death. Pregnancy itself places great strain on the body, delightful though the end product may be.
A further problem for women is that they are much more prone to thyroid dysfunction as they age then men. Today thyroid failure or hyperactivity is easy to treat, but 500 years ago it was a death sentence.
But overall, actually these figures were surprising to me. If you and your immune system can survive 40 or 50 years of whatever the 16th century can throw at you, why can’t you live another 30 years at least? Instead, about half the men and over three quarters of the women didn’t make it to sixty.
After all these are the elite and the famous. They aren’t likely have been overworked or starved. Even the most indolent Elizabethans got plenty of exercise by our standards since they lived in a world without electricity or motorized transport. There was no little or now high potency alcohol for much of this time. Ditto for tobacco. There was no “fast food,” that bugaboo that gets blamed for so many health issues today. This was a world without chocolate or French fries. The elite probably ate plenty of meat, but it was almost all “free range” and “grass fed” and overall a lot leaner than today’s meat. People during this time frame also ate a lot of fish due to both dietary preferences and religious obligations, and we all think fish is healthy. There was no refined sugar and everything was of necessity “whole” grain. Everything was “organic” too. People did eat plenty of bread and other baked goods, which might offend our “paleo” enthusiasts, but overall, they were following the usual kinds of “healthy lifestyle” recommendations our internet is filled with, if only because they had no choice.
But they were still dropping like flies after age 40. What gives?
One reason is that we can worry less nowadays about some common hazards or life back then. Even if you had survived all the endemic diseases in your area, there were still periodic epidemics of things like plague or Hantavirus to contend with.
Food was “natural” without the slew of nitrites, sulfites etc., that we obsess on, but that also means it was often infected with dangerous bacteria or toxin producing fungi. Grain and oil especially could be contaminated with ergot or aflatoxins.
Even worse, because it’s hard to avoid, there were no treated water supplies. What you had to drink, to cook with, and bathe with might have come from a pond or river containing raw sewage or agricultural runoff.
And by agricultural run-off we mean feces. Animal feces, but also what do you think people used for fertilizer before our nice manufactured powders? If you said human poop, give yourself a gold star.
So it was a dangerous world, and basically people were continually frolicking in a poop-cloud at all times. So that could be part of it—but all these things were as true when a 15th or 16th century person was 25 as when they were 45 years old.
I think a lot of is due to the fact that, contrary to what the popular press/web may want to believe, heart disease, diabetes, and high blood pressure are not really caused by life style choices. This is especially true of the disease everyone blames on wrongful eating, diabetes. Diabetes is not caused by diet—you don’t wear out your pancreas by using it, anymore than you cause you stomach to atrophy by eating heavy meals, or your muscles to wither away by lifting weights, or your heart to become flabby by jogging a mile a day.
Like all your endocrine glands, your pancreas wears out on its own. Your circulatory system may be what most often kills you, but your endocrine system is what ages you. So as you get older, your pancreas (here we are talking about the part of the pancreas that is an endocrine gland) works less well. It can’t pump out the insulin like it used to. So if you continue to eat a diet that you used to be able to handle, your pancreas can’t process it as fast or as well and your blood sugar rises. But it’s not the diet itself that precipitates this change, its aging.
Similarly, blood pressure rises with age, especially systolic pressure (“the top number”) because as we age our blood vessels get stiffer. This is a process that is unrelated to adipose tissue amount, exercise ability or diet.
Heart disease is a very board term. We tend to think coronary artery disease when we hear the term but there are other kinds of “heart disease”. The use of antibiotics for streptococcal infections has greatly reduced the incidence of post-streptococcal heart valve damage. The renaissance world wasn’t so lucky.
The answer then maybe that to a large extent the contribution to longevity from lifestyle is overemphasized. This is due to human nature. We like to feel that we are in control of aging when actually we are not. We like to believe that things happen for a reason and that the universe will deal out justice in some fashion. Thus the belief that we are different from others and will be spared, if we do the “right” things.
And there is definitely one thing we have that renaissance people didn’t. We have modern medicine for chronic conditions. If you had diabetes, hypertension, heart disease, thyroid disease or kidney failure—in 1500 you would die in a few months or years. Now you can take medication to control all these conditions. If you have a bad heart valve you can have surgery and get it repaired or replaced.
So modern medicine probably plays a big role in extending our lives. Oddly enough, this was not my conclusion entering this exploration. I have, instead, tended over that past few years to feel that middle-aged and older people are on too many medications, often at the behest of our pharmaceutical company’s need for profits. So I need to rethink that. Now it looks like at least some medications are actually helpful!
(And we have to give a big shout-out to public health measures as well. I for one am happy we don’t have to eat, drink and live with everything coated in poop.)