Want to live longer? Here's how!

By Dr. Hoffman

A patient asked me point blank the other day: "What do I do to live longer?"

Jokingly, I said "That's sort of an essay question," but the patient kept looking at me expectantly, so I tried to answer as best I could.

"Look," I said, "It's a matter of focusing on two different aspects of longevity: the specific and the non-specific."

When the patient appeared not to understand, I explained:

Specific factors are those which prematurely curtail lifespan for the individual. These might include cancer, heart disease, stroke, and diabetes. Obviously, if you succumb in middle age to one of these ailments, your chance of achieving your full life expectancy will be compromised.

So if you want to live long, it behooves you to discover your "Achilles' heels" and address them with targeted prevention. For a woman with a family history of breast cancer, this might call for increased breast cancer surveillance, optimization of weight, reduction in alcohol consumption, aerobic exercise, and use of cancer-preventive nutraceuticals like D, Omega 3 fish oil, EGCG from green tea, flax seed lignans, and DIM from broccoli sprouts.

For a man with a strong family history of heart disease, avoiding an early death might entail optimizing ALL the risk factors associated with heart disease (not just cholesterol), such as insulin levels, homocysteine, lp(a) and C-reactive protein. A supplement program including resveratrol, vitamin K2, Omega 3 fish oil, aged garlic extract and olive leaf extract would confer additional protection.

To help us with prognostication, new genetic tests are coming on stream to help detect susceptibilities to various diseases. This is an emerging science, and some of the tests aren't quite ready for primetime; their results must be interpreted carefully by an experienced clinician, otherwise they might just provoke unwarranted hypochondriasis, without constructive action. But soon, in the near future, we might have better tools available to help direct our preventive efforts.

Already, it's possible to profile nutritional imbalances and insufficiencies that may curtail lifespan and that can be easily corrected. For example, recent studies show that higher levels of vitamin D are associated with lower mortality from all causes. A test seldom performed in standard medical practice, the essential fatty acid analysis, provides feedback on the Omega 3:6 index-a measure of your body's ratio of good to bad fats-which some studies have found to be a far better predictor of risk for heart disease and other ailments than old-fashioned cholesterol determinations. Similarly, a high percentage of the population suffers from detectable genetic glitches (MTHFR polymorphisms) that prompt the need for more methylated B vitamins.

Then there are non-specific factors that can enhance-or impair-longevity. In a recent podcast on the subject of "Blue Zones" I talked about some of these.

Diet is, of course, pre-eminent. It turns out that slight caloric restriction may help you get more ticks out of your biological clock. Lots of phytonutrients from vegetables, fruits and spices as well as wine, chocolate, beer, tea and coffee can help. And, while controversy rages over the ideal relative proportions of fats, proteins and carbs, pretty much everyone now agrees that refined sugars and starches accelerate the aging process.

Exercise is a given, as well. And then there are the intangibles like social connections and family. Spirituality may play a role, too. Unremitting stress, social isolation, anger and hostility all seem to take a toll on longevity.

Worst among all of civilization's hazards may be sleep deprivation and "chronodisruption," wrenching us from our natural circadian rhythms.

Exposure to pollution and heavy metals is life-sapping, hence the push in integrative medicine for detoxification and chelation.

Nevertheless, a dash of dirt here and there might not hurt, because the "hygiene hypothesis" tells us that germs are a natural stimulus to normal immune response.

Keep in mind that prescription drugs account for hundreds of thousands of premature deaths each year, so finding natural alternatives, where possible, can extend lifespan. Iatrogenic complications of medications and surgery and nosocomial (hospital-acquired) infections have taken their place as America's #4 killers!

Sound complicated? It is! Tracking and addressing this constellation of specific and non-specific risk factors is the job of integrative practitioners like me, and getting advice from a seasoned professional is the first step toward launching your own, unique personal longevity program.