Stay Young Forever
(Or Die Trying)
By Bill Gifford
“Gifford skillfully navigates the many strands of aging research to create an entertaining narrative of the perils of getting old.” —Kirkus
“You need this book. I grabbed it like a life preserver, and that’s exactly what it is. Spring Chicken demolishes the worst hoaxes in anti-aging treatments-like crushed dog testicles, human growth hormone, and Suzanne Somers-and leaves you with the good news: by adopting a few easy-to-understand, easy-to-follow discoveries, you might just deactivate the time bombs in your fat cells and learn to follow in the springy, “successfully aging” footsteps of a 92-year-old pole vaulter.” —Christopher McDougall, New York Times bestselling author of Born to Run and Natural Born Heroes
“Spring Chicken is a masterful exploration of the fantasy and fact surrounding one of the most fundamental questions of humankind: why do we age?” —David Perlmutter, MD, #1 New York Timesbestselling author of Grain Brain: The Surprising Truth About Wheat, Carbs and Sugar-Your Brain’s Silent Killers
“Spring Chicken is an utterly marvelous book — a guided tour of a fantastic, counterintuitive landscape (that happens to be your body), and also a whip-smart guide to living a longer and healthier life. With this book, Bill Gifford joins the ranks of Mary Roach and Bill Bryson as a science writer supreme, illuminating our world in a page-turning style that is as entertaining as it is enlightening.” —Daniel Coyle, New York Times bestselling author of The Talent Code
“Bill Gifford’s terrific Spring Chicken gives us a riveting account of the most important change of the last century-the doubling of our lifespans-and an intimate vision of what it will take to not only keep that trend going, but keep ourselves healthy and vibrant as we age.” —Steven Johnson, New York Times bestseller ofHow We Got to Now
POLE VAULTING INTO ETERNITY
Why Older Athletes Defy Aging
“Flying up in the air is really, really fun. Mentally, we’re kids playing.” — Howard Booth, 70-year-old pole vaulter
On a cool, overcast Cleveland summer morning, I stood in the infield of a small college football stadium, watching some of the nation’s top athletes battle each other in an important track-and-field meet. The atmosphere was intense, and in between events I gravitated to the infield, where I met three lanky sprinters preparing for their heats. Their names were Ron Gray, Don Leis, and Bernard Ritter, and they still wore their warm-up suits against the early-morning chill. As they stretched and limbered up, they coolly assessed their competition while, like male athletes everywhere, saving a glance or two for some of the more attractive female athletes.
Ron, Don, and Bernie had all distinguished themselves in their events. Don had set national records in the triple jump, while Ron was one of the top sprinters in the country, and Bernie was competitive at the state and regional level in his native South Carolina. They had each trained for months in the hope of medaling in this national-level meet; their next stop would be world championships in Brazil later in the year. Don came from the track-and-field hotbed of Pasadena, while Ron hailed from Denver, where he had played running back for the University of Colorado football team.
Sixty years ago.
The event was the 2013 National Senior Games, a kind of biannual Olympics for older athletes (“senior” being defined as anyone over fifty). It featured the traditional track-and-field events and swimming, but also triathlon, basketball, volleyball, badminton, and Ping-Pong, to name a few. And of course shuffleboard, but the competition in pickleball, a kind of paddle tennis that is becoming hugely popular in retirement communities, was said to be especially fierce. To get here, competitors had to qualify at state and local Senior Games, which meant that Cleveland was playing host to the crème de la crème of older athletes.
I focused on track and field, because its results are quantifiable — there is a finish line to cross or a crossbar to clear — and because it takes no special skill. Anybody can run and jump. Which is why I found myself in the middle of this stadium at nine in the morning, surrounded by much older people wearing Lycra, track spikes, and very serious expressions. Also hearing aids. It was as intense as any college track meet, just a little more wrinkly.
I had come here in search of people who were “aging successfully,” in the patronizing lingo of the geriatricians, and I found way more than I bargained for. Over the course of the weekend, I watched a nearly ninety-year-old woman heave an Olympic javelin far enough to clear a double-wide. The best high jumper in the seventy-through-seventy-four age group cleared a mark that would have won him a silver medal in the 1896 Athens Olympics, and I watched a ninety-two-year-old man trot down a narrow runway and attempt to pole vault a bar set as high as my head.
This terrified me. Was he nuts? Who had allowed this to happen? I couldn’t even remember the last time I’d run a hard quarter mile. One thing these athletes all had in common was that they were breaking the rules — not the rules of track-and-field competition, but the unwritten rules governing acceptable conduct for so-called old people. Everybody claps for the grandmas shuffling through the local 5K. But when Grandma starts to smoke her middle-aged kids in the hundred-meter dash, things can get awkward. It just seems wrong, if not downright dangerous. (This seems an appropriate place to add: By purchasing this book, you have agreed to absolve the author of any responsibility for whatever happens to you while “trying this at home.”)
But these are not people who care what their kids think. There in the infield, Ron, Don, and Bernie talked about training and diet like seasoned competitors, which they were. This was Don’s eighth meet of the year, and it was only July. Today he was a bit under the weather, thanks to a black eye he had acquired while “chasing my grandkid around the playground.” Ron had the leathery complexion of a man who had spent a bit too much time in the Rocky Mountain sun; he was an avid skier. But the rest of him still looked like the University of Colorado football recruit he had been in the early 1950s, with his barrel chest and powerful forearms atop a pair of tapered, spindly legs. He had run track in college, in addition to four seasons as a running back for the Buffs. “Then nothing, for fifty-five years,” he laughed.
Four years ago, a college classmate suggested Ron enter a Masters track meet. He got hooked on the competition, which reminded him of his days in the auction business, and he loved the training. Now he works out three days a week on a local track, all by himself, plus two days in the gym with a trainer. “It makes you feel good, the heartbeat and the butterflies in your stomach, and all that,” he’d tell me later. “And beating the other guy, of course.”
One thing that struck me was that Ron and Don and Bernie all approached aging with the same discipline that they put into their training, as though aging itself were a kind of athletic event. Ron stays young, he said, by avoiding the “inflammables,” by which he seemed to mean foods containing dairy, wheat, and sugar. He’d been experimenting with this new anti-“inflammable” diet for the past six months, he said, and it seemed to be working. “I woke up one morning last year, and nothing hurt,” he deadpanned. “I thought I was dead. Now I wake up and nothing hurts because nothing hurts!”
As his start time approached, Ron went through his warm-up routine, as always. Then he stood around near the start line, in his red USA jersey and Lycra compression shorts, as the other age groups went off, one by one, until it came time for the men’s eighty-through-eighty-four age group, and he sauntered into position as his name was called. Lane 6.
“Take your marks,” said the starter.
Ron crouched down, placed his fingers on the nubby track surface, and set his feet in the starting blocks. Two of the runners didn’t bother using the blocks; at eighty, it’s a bit dicey to try and spring out of a crouch. So they stood on the line, which was easier on their hamstrings but also removed them from serious contention. That left three runners in the mix: Ron, a lean African American man named Alex Johnson who had crushed him in qualifying, and another runner named John Hurd, from Florida, who had also beaten Ron in the past.
“Set,” the starter said, and the runners froze. Down at the finish, a small knot of spectators — mostly wives and middle-aged kids of the competitors — lounged in the stands, looking a bit bored.
Ron burst out of the blocks, a move he practiced several times a week on the track near his home. Within two strides, he was fully upright, running as fast as he could, his arms slicing back and forth, his palms like knives to cut through the air while his legs whipped around like the blades of an eggbeater. He was sprinting as hard as he could, harder than most people think an eighty-year-old should. And by twenty yards out, he was winning, a stride or two ahead of both Hurd and Johnson. But Johnson gained steadily, and came past him at seventy-five meters, devouring the track with his huge strides. Ron hung on for second place, clocking a time of 16.75 seconds, nearly a second faster than he’d run at Masters Nationals three weeks previously. He was happy, as he stood in the infield and tried to catch his breath.
“I can’t wait for the next one,” he said, still panting.
Athletes understand aging better than almost anybody, because they feel its effects sooner than the rest of us. A pro football player will be considering retirement at thirty; LeBron James is getting on in years at thirty-three. Endurance sports are more forgiving, but not much. Meb Keflezighi won the Boston Marathon at age thirty-nine, which was hailed as an amazing feat. The oldest rider in the 2014 Tour de France was forty-three years old. Jamie Moyer was fifty when he became the oldest pitcher ever to start a Major League Baseball game. He pitched two innings.
For professional athletes, remaining healthy with age is vital to their livelihoods, which is why former Yankees star Alex Rodriguez and some of his colleagues frequented South Florida “anti-aging” clinics in search of human growth hormone and other chemical magic that might help prolong their careers. For Masters athletes, though, the dynamic is reversed. They are no longer victims of age but combatants, battling with it as the decades slip by.
“To become an athlete at age 47, or 50 — or 90, I’m sure — is merely a way of saying ‘Wait!’” wrote the late John Jerome in Staying With It, his wonderful memoir about taking up competitive swimming late in life. “It is a way of grabbing time by the lapels, of saying stop, wait a minute, let me understand what is happening here. Maybe the point isn’t to fight age off but to let it come on, to get inside it, to find out just what it is.”
Few Senior Gamers had gotten as far inside aging as Howard Booth, whom I met later that afternoon in the “pits,” a grassy area where the jumping events were held. The men’s long-jump competition was in full cry, with gray-haired guys charging full speed down a narrow runway and launching themselves into a pit of sand. My knees throbbed just watching them. Booth distinguished himself with a very special jumping style: When he landed, he’d turn a quick little somersault and pop right back up onto his feet. This made the spectators and even the judges laugh every time.
Booth was not only a former college gymnast — hence the tumbling — but also a professor of biology at Michigan State University, with a keen personal and professional interest in both athletics and aging. Compact yet muscular, with white hair and a clipped beard, he wore a skintight bodysuit that showed he was in enviably good shape for any age. His specialty is actually the pole vault, which is a bit odd considering he is not particularly tall, but what he lacks in height he makes up for with passion.
He had pole-vaulted in college, but quit to pursue his graduate studies. About ten years ago, a friend told him about the Senior Games, and for fun he checked out the pole-vault records for his age group. They seemed well within his reach, so he decided to pick it up again. He built a pit in his backyard, making uprights out of scrap lumber and a landing pit of trash bags filled with leaves. A maple sapling served as his pole, and another as the crossbar, and boom, he was a pole vaulter again. He’s since upgraded to a more professional-quality setup, and now his backyard pit attracts vaulters of all ages on Sunday mornings. He medals in national events on a regular basis.
“You can wake up with sore muscles and ask yourself,
Why am I doing this?”
he said. Answer: “Because flying up in the air is really, really fun. Mentally, we’re kids playing.”
There might be something to the “mentally” part. It recalls the famous experiment done by Harvard psychologist Ellen Langer, who in recruited eight older men to spend a week together in a house decorated, in every detail, in 1950s style. Even the magazines and books were from that decade. The men were then instructed to imagine themselves as they had been in 1959, when they were in their prime (all mirrors had been removed, for obvious reasons). They discussed 1950s sports and news events as if they were occurring in the present, and so on. She told them to “inhabit” their former selves in every way they could.
By the end of the week, the men had been miraculously rejuvenated, performing far better on standard tests of grip strength and endurance, and even breaking out into a spontaneous game of touch football on the lawn, like college boys. “It almost seemed like Lourdes,” Langer said later.
Hippocrates believed that exercise was medicine, and so did the physicians of ancient China. It went out of fashion in the early twentieth century, though, and was actually believed to be “dangerous” — coincidentally, just as heart disease was emerging as a leading cause of death. During the first half of the twentieth century, doctors typically prescribed bed rest for their patients with heart trouble. Oops.
That changed in the 1960s, when the massive Framingham Study found that people who exercised regularly were far less likely to suffer heart attacks than those who did not. Those who smoked, on the other hand, were at greater risk. Since then, a tidal wave of exercise data has all pointed in the same direction. A recent analysis of statistics covering more than 650,000 individuals showed that people who kept to a normal weight and exercised moderate-ishly, the equivalent of a brisk walk for an hour or so per day, lived an average of seven years longer than the non-exercisers. There is a raging debate over whether or not more intense exercise confers proportionally greater benefits, but one study of Tour de France veterans found that they, too, lived about seven years longer than their peers. (So did Olympic medalists: by three years, according to a study of more than 15,000 athletes from 1896 through 2010.)
That may be due to all the wine, at least in the cyclists’ case, but it’s more likely because of the fact that Hippocrates was right: Exercise itself is literally like medicine, as a growing body of evidence is beginning to show. In a detailed and revealing comparison, the Stanford scientist John Ioannidis paired more than three hundred randomized clinical drug trials with the results of fifty-seven studies of exercise, and found that in nearly every case, exercise proved just as effective as the medications, and sometimes better, at staving off death from heart disease, stroke, and diabetes.
“If you could put the benefits of exercise in a pill, it would be an astonishing pill,” says Simon Melov, a researcher at the Buck Institute who has studied exercise extensively. “The data is now coming out on the effects of chronic exercise, and it is astonishing in terms of its ability to prevent all sorts of age-related disease, everything from cancer through to neurodegenerative disease to heart disease, even arthritis. All of these things have vastly lowered risk in people who exercise regularly — and if that was in a pill, it would be insane.”
As a biologist, Howard Booth already knew this. After college, he’d kept active by running and biking, so he was still in relatively good shape, but he was getting bored. He took up pole vaulting at age sixty in part because he knew he would need a new challenge when he retired from teaching. “I reflect on my father’s generation, where the idea of retirement was that you’ve worked really hard all these years, and now you deserve to do nothing,” he told me. “Not something else, but nothing.”
That wasn’t for him. Neither was golf, once the sole socially acceptable pastime for men in their sixties. “Just a step up from watching paint dry,” he scoffed. Though he’s not fully retired from teaching (and coaching) at Eastern Michigan, training and competing in pole vault gave him another goal, or what the Okinawans call ikigai, a sense of purpose. The stakes are low — at the Senior Games, he stood to win a cheap alloy medal, at best — but at the same time, they couldn’t be higher. “Even if it’s a two-dollar ribbon, and you spent thousands in travel and overnights,” he said, “it makes no sense — but it makes huge psychological sense. You’re not on the sidelines, you’re really participating.”
Something similar was taking place biologically, inside him. He was participating. As he perused the results and record books, he grew curious: Just how good was it possible to get? Could an older athlete ever equal his prime? Come close?
Booth had his students survey his peers on the senior track-and-field circuit, and found that dedicated athletes in their sixties could perform about 80 percent as well as they could in their prime. That is, if they could vault fifteen feet in college, they were still hitting twelve feet in their sixties. Top-level performance drops off pretty drastically after age seventy-five, but the really interesting fact that Booth uncovered was that his “controls” — that is, average sedentary adults of the same age — had retained only 22 percent of their physical capacity. This told Booth that the stakes were much higher than simply breaking records and winning medals — both of which he did with relative ease. It was more about staying in the game, about not giving up.
“Most people just aren’t basically healthy at this age,” he said. “And the idea that well, it’s natural and you’re just an old man now — that isn’t natural! That is the default. That’s where we get to by not challenging ourselves. Exercise is a continuum: The more you do, the less you’re going to lose.”
Booth had finished his events for the day, and we were sitting in folding chairs, relaxing in the sun and talking about the science of sport. His wife, Luanne, sat nearby as he talked, nodding. “We can show it in muscle protein production; in nerve junctions, that tend to fade away; and the rate at which muscle fibers return,” he continued. “All of these basically respond to increased exercise, by slowing the rate at which they would naturally decline. And the greater intensity you can put into that package, the slower you will lose performance.”
He had chosen pole vaulting because it requires not only basic fitness, but physical skill and fine coordination, which — as large longitudinal aging studies have shown — decline even faster than aerobic capacity. The fast-twitch muscle fibers used in jumping and sprinting tend to disappear earlier than the slow-twitch fibers used by endurance athletes. But muscles that are used don’t go away as quickly. “The more you use them, for fine detail — the precision of a fine overhand in tennis, or a jump shot — the fast-twitch fibers in particular will have greater numbers of motor units [a combination of muscle fiber and the nerve that triggers it] in the areas you have used and worked on,” he said. “And if you quit doing those things, they decline.”
While I was working on this book, nearly everyone I told about it wanted to know the same thing: “So, what’s the secret to aging?”
So far, the “secret” seems to be just what Howard Booth had said:
Use It or Lose It.
Which sounds simple, even simplistic. But it kept coming up, almost like a mantra, not only in conversation but in high-level research: It applies to your cardiovascular system, your muscles, your sex life, and your brain. Howard Booth had it all figured out.
By contrast, not using it can have dire consequences. Even retiring from working — the capstone to the American Dream — can be dangerous to your health. A paper published by the National Bureau of Economic Research, a prestigious private think tank, found that “complete retirement leads to a 5–16 percent increase in difficulties associated with mobility and daily activities, a 5–6 percent increase in illness conditions, and 6–9 percent decline in mental health,” over the next six years. Although early retirement has been found to decrease mortality risk, at least in Europe, newly retired people often report a loss of their sense of purpose — the Okinawans’ ikigai, again — which can be hard to replace.
The thing about aging is that it’s inexorable, a one-way street. Physical parameters like strength ant VO2 max all tend to move in one direction with age: downward. But it’s not the same for everyone. A recent study of aged Scandinavian cross-country skiers found that the older athletes had preserved much of their aerobic capacity, relative to their youthful selves; and they were far ahead of the age-matched control group, a bunch of sedentary older guys who live in Indiana.
Which seems like the ultimate unfair comparison — Nordic ski gods versus Midwestern couch potatoes — but who would you rather be? The skiers had done a far better job preserving their ability to pump blood efficiently, the elasticity of their arteries, the suppleness of their lungs. Biologically, they were simply younger. On a practical level, this meant that they had an easier time walking around, climbing stairs, and as Howard Booth puts it, participating in life. They’d never stopped using it, so they didn’t lose it.
If you look at older athletes’ muscles and bones, the contrast with their sedentary peers becomes even more dramatic. One of the hallmarks of middle age — and one of the first things I noticed — is that it becomes much more difficult to gain and keep muscle. We begin to lose muscle mass gradually at around age forty, and as time goes on we lose it more rapidly: Between fifty and seventy, we lose about 15 percent of our lean muscle per decade. After that, it jumps to 30 percent per decade. “You could make the case that aging starts in muscle,” says Nathan LeBrasseur, a researcher at the Mayo Clinic in Rochester, Minn., who studies aging.
But even as we’re losing muscle in middle age, we don’t lose weight overall (duh). That means our muscle is gradually, insidiously being replaced by fat — in fact, fat actually invades muscle, getting in between the muscle fibers and impairing their function. More fat and less muscle means you have fewer mitochondria, which means your body becomes less efficient at burning the sugar out of your bloodstream. Not coincidentally, most new cases of diabetes appear in people in their mid-forties and older — the point in life when many people slow down and become less active, just as their existing muscle starts going squishy on them anyway.
If this muscle loss continues and accelerates, it puts us at risk for a condition called sarcopenia, or what Shakespeare — keen observer of old age — called the “shrunk shank,” where muscle mass and strength basically waste away, putting us at risk for frailty. Loss of muscle due to age is why my 14-year-old lab mix, Lizzy, now has difficulty jumping up onto the bed or into the car, where she used to clear five-foot fences on the fly. She’s lost her spring, and she walks more slowly than ever. Her haunches, once firm, have gone soft. It’s not just about pole vaulting or fence jumping, either. People (and dogs) with sarcopenia or muscle loss are at greater risk for falling, and in the frail, a simple fall can snowball into a fatal event; this is why muscle wasting is the second-leading cause of institutionalization of the elderly, after Alzheimer’s.
Nobody knows quite what causes sarcopenia; even its exact definition is controversial among scientists. The cure, too, is a subject of debate. For people like Dr. Life or Suzanne Somers, the answer is easy: Shoot up with testosterone and growth hormone. By this point in the book, you should realize what a bad idea this is. And anyway, while replacing testosterone does increase muscle size, it does not always improve muscle quality, at least not without exercise.
Half a dozen pharmaceutical companies are developing drugs to fight sarcopenia in the elderly by promoting muscle growth; the drugs are only in early-stage trials, but some of them have already appeared on the black market for athletes and bodybuilders. But there is another, simpler treatment for sarcopenia that science has largely ignored, until recently: staying active. Adults who have exercised for most of their lives keep muscle for longer, as this illustration shows rather dramatically:
These drawings are based on MRI images of the upper legs of four different men, of different ages and lifestyle habits. Each is a cross-section of someone’s upper thigh. The one on the upper left belongs to a typical fit forty-year-old, and you can see how it’s mostly muscle, with a small ring of subcutaneous fat on the outside. The one at upper right is a typical sedentary seventy-year-old American man, with the classic signs of sarcopenia: Note how it is nearly all fat, like a slice of pancetta from a very well-fed pig. But the fat has also completely infiltrated his muscle, making it look marbled and rendering it weak.
The bottom two images are just as striking: On the left, a sixty-six-year-old triathlete — looking pretty much as firm and meaty as the fit forty-year-old. (According to Nathan LeBrasseur, the differences between their muscle cells would only be visible through a microscope.) But on the right belongs to a seventy-six-year-old man who has never done a triathlon, or any other sort of running in his life. He’s an English farmer, whose job required him to stay on his feet most of his life, moving around every day. He’s got about the same “muscle age” as the forty-year-old, because his lifestyle is the closest to that of our evolutionary ancestors. We evolved to walk around, not sit in a La-Z-Boy.
By pole vaulting and jumping and sprinting into old age, Howard Booth and his fellow senior athletes are not only defying time and gravity, but imitating, in a way, the kinds of things our hunter-gatherer ancestors had to do to. Staving off sarcopenia is just a side benefit. They’ll be able to chase their grandkids around on the playground, or even just walk around, say, Paris while on vacation. The sedentary man won’t. Use it or lose it.
Use It or Lose It even applies to laboratory mice. Traditionally, mice are kept in small plastic cages no bigger than shoe boxes, with nearly unlimited access to food but no opportunity to exercise. They live alone, too, because males in captivity have a tendency to fight. About a decade ago, a man named Sandy Keith, who was an animal handler in a noted aging lab in Newcastle, England, did a small, unpublished experiment where he simply gave his mice bigger cages and more toys to play with, simple things like cardboard toilet-paper tubes. He also handled the mice every day, keeping them socially engaged. One of these “free-range” mice, a male named Charlie, lived an astounding 1,551 days, or four years and three months — which is six months longer than even the longest-lived caloric-restriction mice. He had a lot more fun, too.
To this day, Charlie remains one of the longest-lived mice ever — because he was given the opportunity to “use it.” The problem is that most older people aren’t expected or encouraged to do much of anything, and it often hurts when they do, so they don’t. “For some generations, exercise has a stigma. You say ‘exercise,’ it turns people off,” says LeBrasseur, whose research center is connected to a senior living community. “The most striking thing to me is how people are building their world around the La-Z-Boy. They have their medication around them, and the TV, and their food. They’ve engineered the physical activity out of life.”
So it’s not even “exercise,” in the sense of slogging away on the treadmill at the gym, but something closer to “just moving around,” like the English farmer. Recent studies have pinpointed the mere act of sitting, itself, as a potent risk factor for death. An analysis published in The Lancet in 2013 found that inactivity was responsible for more than 5.3 million premature deaths each year worldwide, from causes ranging from heart disease to colon cancer. The authors concluded that eliminating inactivity — perhaps by shackling people to treadmills? Banning televisions? — would reduce the instance of those diseases, as well as Type 2 diabetes and breast cancer, by 6 to 10 percent. Not only that, they claimed it would increase worldwide life expectancy, for the entire human race, by close to nine months.
Sitting is the new smoking, some scientists believe: a bad habit that leads inevitably to disease. Now go take a walk. Just be sure to hold your breath as you walk past the people who are actually smoking on the sidewalk outside the building.
At any rate, it’s clear that moving muscle does something far more profound than simply burning up calories. LeBrasseur and his colleagues recently finished a novel experiment that dramatically illustrates the metabolic power of exercise. In the lab, LeBrasseur fed mice a special diet designed specifically to mimic the nutritional content of a fast-food meal: Big Mac, fries, and a Coke. The mice had been genetically modified so that any senescent cells would bind to a special fluorescent marker that would make them glow in the dark. After a few months on the all-fast-food diet, the mice lit up bright green, because they were filled with many more senescent cells than the mice who had been fed a normal diet. But the Big Mac mice that had also exercised had many fewer senescent cells. The exercise had negated the toxic effects of the #1 Combo Meal — either by zapping the resultant senescent cells, or by preventing their formation in the first place.
“It really highlights the power of exercise,” he says. “You’re pouring this toxic substance into your body, but as long as you’re exercising, it’s not going be as bad for you.”
So it’s okay to go to McDonald’s, as long as you jog there. (Or better, jog back.)