Healthspan vs lifespan
Grandparents are increasingly involved in childcare, a physically demanding role.
Having had a significant birthday this year I’ve been thinking more about my own health, and particularly the idea of ‘healthspan’. I have been what I would call physically fit at several points in my life: age 17 when training for a kayak marathon, age 27 when I left Sandhurst, age 37 training for my first cycling 100-miler. However in between have been long, bleak spells of bad habits and poor fitness, but with my mind pretending that I was still the person I was at that last milestone. I can’t wait until 47 to try to be fit again so I’m now making some changes to improve my healthspan. Fundamental to what a GP should be doing is not just improving the length of your life but prolonging your healthy life, or healthspan, and then of course lifespan will follow.
A concept introduced by a brilliant physician in the US who specialises in longevity called Peter Attia is the Centenarian Olympics - it’s his way of thinking about ways to mitigate the decline of the body with age by backcasting. He asked himself in a similar mid-life crisis manner, “what do I want to be able to do when I’m 100?” (assuming genes allow the evasion of certain diseases along the way’). He projected the age of his children forward to when he’s 100, and then the probable age of his grandchildren, and then considered what he wants to be able to do physically to be happy at that stage. He called the 18 tasks he came up with the Centenarian Decathlon (because he didn’t know the Latin for 18!). Examples are:
being able to squat down and lift up grandchildren/great-grandchildren over his head
getting up off the floor using just one arm
being able to put hand luggage in an overhead locker
being able to get out of a pool without a ladder
walking up stairs with shopping in both hands
Peter then approximates these tasks to things you can do in the gym, or at home, and then working backwards to account for his physical decline he determines what he needs to do in the gym now (he’s 45). It’s worth mentioning that before becoming an eminent surgeon then retraining to become probably the leading medical expert on longevity, Peter also used to be a professional cyclist, and knows most of the world-leading experts in the fields of physiology and sports science with access to their labs and tests, so he’s well placed to accurately calculate and optimise his training needs. But how does a mere mortal such as me start to address this challenge?
The first thing I’ve done is gather information, because apparently information is power (although unfortunately not the kind that gets you up off the floor with one hand). I have done a range of blood tests to understand my metabolism a little better and particularly the effect my questionable diet is having on my cardiovascular health (I’ve largely got away with it, but not entirely and change is required!). I’ve started testing myself physically on my smart bike trainer and engaging with training programmes to improve my cardiovascular fitness, re-measuring my fitness at intervals. And as my fitness returns the next step is to start doing some focussed strength training.
I, like many people, am not a gym person. Gyms are great, and particularly so if you need guidance and motivation from a personal trainer (I know a great one - get in touch), but I don’t have spare time in my week to go and I don’t particularly enjoy it anyway. Instead what I’ve realised is that there are parts of my week that are sedentary and passive that can be combined with the need to exercise. So my strength training is going to be me packing up my old rucksacks with weight and striding out across the beautiful countryside we have while listening to podcasts, or spending time with my family. If you see me lunging through the fields of Sussex, or squatting beside the South Downs Way, please don’t be alarmed - it’s my healthspan training.
The other aspect of healthspan is preventing disease. It’s an alarming fact that the most common first presentation with cardiovascular disease is death, often somewhere around about your 50s, and the survivors already have heart disease and need to make the best of their health from that point on. When you have had a heart attack you’re put on medications as part of ‘secondary prevention’, ie stopping you having another, but we know that the development of heart disease is a process that takes many years, so we should be taking an earlier interest in ‘primary prevention’. There are multiple risks factors involved and the only one you can’t really do anything about is your genes, but there are many other aspects to look at beyond just a simple cholesterol check. A cholesterol level is unlikely to be deranged in your 30s, but an Lp(a) level for example will tell you if you’re heading for trouble, as will an ApoB level. These aren’t done in NHS general practice but are absolutely vital to quantify your risk and develop a plan to protect your health.
I am really keen that Lisle Medical should deliver this kind of health promotion for our area. The service is there for you if you fall ill, but we should all be engaging with our health before we get ill, and the ideal time to do that is in your late 30s and 40s. So with all the negativity in the world at the moment let’s avoid illness adding to your burdens in the coming years and let’s improve our healthspan.
