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The Power to Go On and On
By: Choong Tet Sieu
Asian Week, July 28, 2000
"I hope I die before I grow old" — a perfectly understandable sentiment from The Who in their Sixties anthem My Generation. At the time, even physicians believed that advancing years automatically brought debilitating sickness and, worse, dementia. Lusty young rock bands and just about everyone else shuddered at the prospect of bedridden helplessness and a general loss of independence. But while death (and taxes) may be inevitable, scientists now recognize that creeping infirmity in old age isn't. People like Yip Lun-ming and Miura Keizo are flesh-and-blood proof of that.
At 79, Hong Konger Yip is perhaps one of the world's oldest long-distance runners. Most days he does up to 24 km of roadwork, particularly when in training for his favorite event: the triathlon. This grueling test of stamina involves a 1.5-km swim, a 40-km bike ride and a 10-km run. Grandpa Yip, as he is affectionately known, is worried that in this year's Hong Kong event in October, he won't do as well as he did in 1999. "You have to know your limits," he says. "You should know your body and not push it to the brink. That's how you stay healthy. Still, I'm sure I'll leave plenty of young people trailing behind me."
This kind of track record has attracted attention around the world. Sportswear giant Nike supplies all Yip's shoes and running gear, and he is enough of an international celebrity to be invited to compete in races from North America to Britain and South Africa. With an enviable resting pulse rate of 45 beats per minute (the average is 50 and upward), the Iron Man scoffs at the idea of an annual medical: "Why would I need one?" he asks. "Take a look at me."
Miura is no slouch either. An off-slope skier, award-winning photographer and international tour guide, he is one of Japan's most celebrated old people. The 97-year-old leads a lifestyle that is both an inspiration and a source of shame for couch potatoes a quarter his age. For 120 days each year, Miura is on a high, tramping up mountains around the world and skiing down them. In the past two years, he has led groups aged from 60 to 78 on skiing trips to Whistler in Canada and the Southern Alps in New Zealand.
Miura stands out even in Japan, where people on average live longer than anywhere else in the world (see chart for Asia this page). Girls born this year can expect to still be alive in 2084; for boys the span is seven years less. But it is not just a case of how long you live; it's also how well you live. A key study released by the World Health Organization in June showed that Japanese people have an average healthy life expectancy (the so-called disability adjusted estimate) of 74.5 years. That puts Japan in top place, ahead of No. 2 France, with 73.2 years. (Why the steak-eating, liquor-drinking, free-smoking French should do so well is a medical mystery waiting to be solved.)
How do people live past their 70s with physical wellbeing intact — and still keep their wits about them? Having good genes is a big plus. Gerontologists have found that people who survive into their upper 90s (the so-called oldest old) are often in better shape, mentally and physically, than many others 20 years younger. Researchers suspect these long-lived seniors are endowed with a genetic resistance to many degenerative diseases. It's a form of survival of the fittest. For instance, scientists have found that centenarians tend to have a lower complement of the gene coding for apolipoprotein E4, a substance associated with Alzheimer's disease. The affliction is estimated to kill 40% of seniors over 85. Another advantage may lie in a mutation in DNA coding for proteins needed by mitochondria, the power plant in our cells, found in the oldest old. Japanese investigators suspect the genetic change may cause the mitochondria to generate energy more efficiently, and so reduce the level of free radicals, substances associated with aging.
But genetics form only part of the aging story. Dr. Thomas Perls, director of the Harvard-based New England Centenarian Study, says environmental factors play an important role too. Better lifestyles will compress the illnesses and disabilities of later years into a much shorter and later period. In others words, some seniors can have a good time almost until the very end. Evidence shows that the oldest old don't just outlive others — they usually carry on with a vigor that defies our stereotypes of the elderly. There is no reason we can't be like Miura, providing — and it is a big proviso — we put our health first.
Miura has never drunk alcohol or smoked. His main beverage is a unique concoction of ingredients deemed healthy in Japan: raw egg, sesame seeds, unpolished rice, parched bean flour, green tea leaves, vinegar and yogurt. "It works for me, but I don't think I'll try to market it," he jokes. "It tastes too disgusting." You don't have to go to Miura's lengths to stay well, but physicians generally recommend plenty of fresh fruit, vegetables and whole grains. Such diets aren't just lower in saturated fat and cholesterol, but are nutrient-packed, with plenty of vitamins and minerals vital for fighting diseases such as cancer, even failing hearing. (A lack of vitamin B12 is associated with age-related hearing loss.) In the view of Prof. Shibata Hiroshi, chairman of the Well Aging Association in Japan, the local diet (at a sensible 2,000 calories per day, 30% less than the U.S. average) has an added virtue. Protein is consumed in what he considers the ideal proportions — half from plant and half from animal sources. A study by Cornell University has linked animal protein with the low-density lipoproteins that are associated with increased risk of heart disease.
But more than switching to tofu and sushi, Shibata stresses the importance of staying lively. "The secret of an active long life is plenty of daily exercise during middle and old age," he says. "It doesn't have to be as intensive as sport or aerobics. More important is something regular such as walking, housework and gardening." It improves metabolism, with better utilization of glucose and fats in the body and higher concentrations of the high-density lipoproteins (deemed beneficial because they seem to help transport cholesterol away from the arteries into the liver). Besides boosting heart and lung function, the workout improves balance and coordination, as well as bone and muscle strength — all of which reduce the chances of falls and fractures.
This is the kind of lesson that seniors like Mary Kam have taken to heart. The 76-year-old retired Malaysian schoolteacher displayed so much vim during a recent hike through a national park in Sarawak, astonished rangers began calling her a "recycled teenager." As a retired government worker, she is entitled to free medical care at public hospitals and clinics, but the only times she has been in hospital were to give birth to her three children and once, just before retiring, to have a cyst removed. Kam swims regularly, but says what really keeps her on her toes are her weekly sessions of ballroom and line dance.
Miura goes further. During the summer, when he is in training, he spends 20 minutes each morning doing simple exercises to maintain his neck, arm and leg muscles, followed by a brisk 40-minute walk. Since his wife passed away six years ago, he has lived alone and does his own cooking, shopping and cleaning. He has a strong incentive: his passion for the mountains, which he shares with others through his tours and photographs.
"The reason I do all this exercise and have this diet is because I want to stay on the slopes for as long as possible," he says. "Skiing is my greatest pleasure." It is an attitude he has passed on to his son
Yuichiro, who earned fame in 1970 as the first man to climb Everest by the arduous direct route. In two years, father and son plan to celebrate special years in their lives with new challenges. Yuichiro aims to return to the summit of Everest for his 70th birthday. And to mark his 99th year, Miura senior has set his sights on a ski vacation at Mont Blanc in France.
For many people, retirement leaves them empty, with no purpose in life. That's how Muthu
Cumarasamy, 67, felt at first. As assistant director of Singapore's prison service, the self-confessed workaholic devoted his entire week to some 5,000 inmates under his supervision. But after opting to retire early at 53, he felt horribly "naked." He says: "One day, heels click to attention when you drive through the prison gates; the next, you become a nonentity." Despite a comfortable pension, Cumarasamy vowed not to join the ranks of the "old people who live from day to day." Instead, he took on a series of jobs, managing an electronics factory and a security firm. Today, he is manager of a string of pubs along Singapore's trendy Boat Quay. In one of the city's most ageist environments, Cumarasamy is widely respected by his young staff.
Perceptions of age vary across Asia and according to circumstances. At 65, many mainland Chinese leaders are only just getting a sense of where their political star is headed. So what is the purpose of a retirement age? Dr. Tan Poo Chang of the University of Malaya's Faculty of Economics & Administration thinks it should be scrapped. "Psychologically, it does something to you," she says. "Many think they will die soon after retirement." Says prominent Malaysian lawyer Peter Mooney: "Sixty-five used to be regarded as old, but it isn't nowadays." He objects to concepts such as a "dependency ratio"— defined as the number of people above 65 compared to those working — that planners and researchers use. "There is no basis to talk about dependency. Personality and activity are not related to age," he insists.
Lean and robust at 77, Mooney took up scuba diving at the age of 70. In 1998, three years after undergoing four coronary bypasses, he scaled the 4,165-meter Breithorn in Switzerland. Though he abandoned his partnership with a prominent law firm 12 years ago, the one-time Bar Council vice president lectures regularly to professional bodies and still acts as a consultant to his firm. But most of his time is devoted to health care for the poor (he is the chairman or director of three private hospitals) and to the hospice he co-founded. Mooney says he wants to "give back something of what I have received."
Ditto for Hedwig Anuar. The 71-year-old former head of Singapore's National Library is endlessly on the go. She is a passionate member of the Book Council, which promotes new writers. The pioneer feminist serves as a counselor on a distress hotline maintained by a local women's group. And she assists with a literacy program for older women that she helped launch just over a decade ago. Between this, family and friends, she says, "I lead a very full life." She describes herself as "careful with food and drink."
Such experiences have led gerontologists to conclude that being socially engaged is as important to successful graying as adequate exercise and diet. If nothing else, things are a lot more fun. Mooney says: "Obviously, couch potatoes become rather dull, which could lead to withdrawal and depression. If you get involved with other people, you have to use your mind."
Just like other muscles, the brain atrophies if not used. "There's evidence that people who are mentally active keep fit longer," says Dr.
M.K. Rajakumar, 68, former president of the Malaysian Medical Association. Mind exercises and doing new and different things, such as taking up a musical instrument, are thought to help improve the connections between brain cells. Besides putting in a full week at his clinic, Rajakumar lectures at several universities and stays abreast of research. And for some variety, "to keep the synapses open," he paints and plays chess.
But as public perceptions about aging change, Asia's traditionally healthy lifestyles are under threat. Protein and calorie intakes are rising as Western food becomes more popular. Surveys by Japan's Education Ministry show that fitness levels are declining among schoolchildren, who would rather twiddle with their PlayStations than swing a bat or kick a ball. "I'm pessimistic about the future," says Dr. Suzuki Takao, vice director of the Tokyo Metropolitan Institute of Gerontology. "Thanks to the convenience of electrical devices in modern homes, more and more young people are becoming sedentary."
In rural China, living standards have improved as incomes rise. Eating habits have also changed — but for the worse. Two decades ago, a peasant might have consumed just 150 gm of oil each month. Now that might be the intake in one day, says Dr. Gao
Fangkun, who has been studying dietary patterns in a village outside Beijing. Peasants are eating much more animal fat and meat. "They think it's very healthy, but the incidence of diabetes has shot up three times over the past 10 years," says
Gao, a professor at the Beijing Institute of Geriatrics.
This contrasts with what Gao calls "a change in the mindset" of Chinese city folk. In the past, it was enough to have a "full stomach," he says. "But now more and more people realize that to have good health, you must have a good diet. And they know this doesn't mean a lot of red meat." Equally, with more information available, the elderly are becoming more active and more aware of the need to seek early treatment for medical problems.
Chen Bei, a 50-something magazine editor in Beijing, has a head start. "I don't want to just sit at home, read books and watch TV," she says. "I want to be active and lead a more colorful life." When a local television station organized a modeling contest last December, Chen signed up — along with several hundred older women, some in their 70s. The amateur models looked so good, it set off a craze. Older women around the country are now lining up to take modeling classes and to join catwalk competitions.
In the past, says Chen, Chinese women her age would just cook and take care of the family. Not her. She took up dancing a decade ago and can tick off a list of Beijing nightspots that have come and gone while she has rocked on. "Why should discos be just for young people?" she asks. Or, for that matter, mountain tops or ocean depths.
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