I’m still standing

Abstract

What is the secret of longevity? Colin Currie is mildy entertained by a television documentary that sought to find out

Centenarians are still exceptional, though rapidly becoming less so. For How to Live to 101 the BBC’s Horizon team tracked down some of the most exceptional of them all, with intriguing rather than conclusive results: interesting enough to make good television, though perhaps not quite good enough for Ben Goldacre or for a respectable peer reviewed journal like this. And as good television often does, How to Live to 101 took us on a journey: from Okinawa to Sardinia, to California and then—of all places—to Glasgow.

With a population of around a million, Okinawa has 900 centenarians, or four times the numbers expected at UK rates. In a remote village among damp, green mountains—not quite Shangri-La, but clearly hog heaven for a gerontologist—Dr Bradley Wilcox explains that here the 90 year olds look like 60 year olds; and a 100 year old villager tells us that when, even at his age, the angel of death comes calling, “You say, I have to discuss that with my family,” then chuckles to show he means it.

Diet has a lot to do with it, with much of local life centred on the fruit and vegetable shop. An old lady prepares a formidable vegetarian meal in readiness for a visit from her octogenarian children. Everyone eats soya the way the West eats junk food. But moderation comes into it too. Helpfully, Dr Wilcox translates a common Okinawan saying: “ Eat only to 80% full”.

It all seems to work, and work as if the clock of ageing really has been slowed down: hence the 90 year olds going on 60, and the impressively low rates of ischaemic heart disease, and of breast, prostate, and colon cancer. But there may be proper science in there as well, with evidence that levels of DHEA—a precursor of oestrogen and testosterone—drop more slowly with the passing years in this population than elsewhere. Cause, effect, or what? Next please.

To Sardinia, where in another remote, picturesque, and agreeable community the seriously extended Vacca family celebrates something with roast pig and red wine. But here too is a cohort of healthy centenarians: one that is remarkable also for its gender balance. As many men as women? Really? Yes. Spry old men joke and smile, and all seem to be related to each other. Again we find an enthusiastic gerontologist. The long lived families here, he explains, have a minor but seemingly useful genetic abnormality (something to do with G6PD), which is perhaps helped along by the Mediterranean diet and a little gentle inbreeding. They all look very well on it,

Another location, another elixir of life. In California we meet a 92 year old cardiothoracic surgeon still doing three or four major procedures a week; but since he’s only 92 we move swiftly on to a residential facility where a 103 year old lady is taking her customary daily six mile bicycle trip (safely, you understand, on her exercise bike). She is a Seventh Day Adventist. The theological details of her creed—conjured up in mid-19th century America—need not detain us here, but it is quite sound on lifestyles and health. Smoking and drinking are out, and meat features little. And while all serious churchgoers, it seems, enjoy a modest longevity advantage, the Adventists do particularly well.

No endocrinological or genetic markers here; instead, a sermon on the possible role of religious faith in dealing with stress. Can the cumulative effects of lifelong stress be countered by strong and reassuring beliefs, perhaps the more absurd the better? Interesting, but for many reasons a convincing randomised controlled trial is clearly still a long way off.

Next stop Glasgow, for the bad news. Some of the lowest life expectancy figures in Europe are to be found here. We meet a 52 year old taxi driver, a decent, thoughtful man who has survived a big myocardial infarction at 47, the age at which his father died from one. Through him and his wife, who has an arthritic hip though she is not yet 50, we learn of disadvantage that runs, alas, in families. A Glasgow doctor explains how a sequence of rapid industrialisation, gross overcrowding in abysmal housing, and serial childhood epidemics may have delivered a survivor gene pool favouring high inflammatory response levels—with consequences today in the form of cardiovascular disease, arthritis, and much else as grim.

There was worse news to end with: from Okinawa, where we started our journey. Its genes do not travel well. Okinawans abroad don’t just do badly on the high fat, high calorie, low exercise regimes of allegedly more civilised cultures; they do very badly indeed, going from lean and ageing only slowly to—well, you know the rest—in just a couple of generations. Quite. There is so little in Darwin about the survival of the fattest.