Hyderabad: Death certificates don't cite old age as the cause of death. No one dies of old age; people die of diseases and injuries. This means that as we age our resistance to combat diseases and complications or ability to repair tissues post-injury wanes and we can succumb more easily to them than in our younger days.
The National Health Profile 2019 indicated life expectancy in India in the period 2012-16 as 70.2 years for women and 67.4 years for men. While life expectancy primarily indicates the average lifespan of a population group, individually one could always surpass the averages through making healthier choices. Our individual life spans depend on our genes, environment, health, attitude, and diet.
There are many aspects of our genetics that impact our health profile, however, one distinct and most important aspect of Indian 'phenotype' (unique clinical and biochemical characteristics of our body shaped by our genes) is upper body and abdominal adiposity. In simple terms, it implies that in our population, the excess fat layers up in the upper part of the body. Thus, while our overall body may not appear obese, the central obesity around the waist could still be high. This characteristic makes us more prone to diabetes (and consequently other serious problems like heart diseases and stroke) than the western races. Therefore, maintaining a healthy weight at all ages can prevent major diseases and add years to our life spans.
While genes play some role in longevity, the way we live, what we do and eat, and how we cope with life matter much more. In the prequel article, we had touched upon five longevity hotspots identified by Dan Buettner and his team of experts which they called Blue Zones. They are: Okinawa (Japan), Icaria (Greece), Sardinia (Italy), Nicoya Peninsula (Costa Rica) and Loma Linda (California -US). These Blue Zones stand out for having a healthy and longest living population. The team listed nine lifestyle practices that account for longevity in the Blue Zones and called these 'Power Nine'. Read the article here:
Applied to the Indian context, the 'Power Nine' can be cascaded as:
Right Boxes Ticked
Family Ties and Spirituality: Indians are fortunate to be part of a society and culture where family and community bonds are exceptionally robust and spirituality is deep-rooted. As per Blue Zones research, being part of a faith-based community adds about 4 to14 years to life expectancy.
Plant-Based Diet: Indian diet is predominantly plant-based owing to the influence of religions and cultures. Interestingly, while average incomes in India have tripled in the last thirty years, meat consumption has not gone up. In spite of about two-third of the population likely to be non- vegetarian, meat consumption is one of the lowest in the world. Though our diet is mostly plant-based, it tends to be more carbohydrate-dense primarily owing to the consumption of large amounts of roti or white rice. Cutting down consumption of roti/rice/white bread and substituting it with beans, lentils, tofu, and vegetables would be a much healthier alternative. Refined carbohydrates (as in pizza dough, white bread, biscuits, pastries, sweet desserts, and many breakfast cereals) have a high Glycemic Index causing a sudden spike in blood sugar levels, and are best avoided. Though learning more about the Glycemic Index and Glycemic Load of various carbohydrates is a good idea, it is much simpler to find out and remember carbohydrates as 'good' or 'bad'.
Stress Mitigation: Hardships are part of Indian life and as has been demonstrated in various demanding situations and recently in COVID-19 pandemic, our individual capacity to cope with stress is quite remarkable and is usually further augmented by our substantial family and friend networks and spiritual outlook. In group environments, our resilience is quite strong. However, beware of divisive agendas and speech, particularly on social media and TV if they cause you stress.
Need to be Aware
Alcohol Consumption: About 14.6% of Indians between 10-75 years of age drink alcohol. While 27.3% of men use alcohol, the corresponding figure for women is just 1.6%. (Source: Report "Magnitude of Substance Abuse in India 2019" by Ministry of Social Justice and Empowerment). About 60% of alcohol consumed is spirits with only 4% wine. The report also states that alcohol per capita consumption has been steadily increasing. Though there are safe alcohol consumption limits specified, there is no need to start drinking if you don't drink at all. In fact, most senior healthy Indians in the 80 years plus age category that I know of have been teetotalers all their lives.
Sense of Purpose: Okinawans call it ikigai - meaning 'a reason for living' and people in the Nicoya Peninsula put it as plan de vida meaning 'why I wake up in the morning'. Researchers believe that having a sense of purpose can add years to life. Richard Leider, a renowned Life Coach, opines that "one of the great secrets of happiness - and also of longevity - are living with a sense of purpose. People who wake up with a sense of purpose live up to seven years longer than those who don't." In the working years, it is not difficult to discover or have some sense of purpose. In post-retirement life, plan de vida could be cultivated through acquiring active hobbies, travel plans, social networks like Satsangs, and maintaining ongoing meaningful contact with friends and family.
Right Company: "Your friends should motivate and inspire you. Your circle should be well rounded and supportive. Keep it tight, quality over quantity" - Unknown. The good and right company keeps you happy and adds years to your life. Avoid known or unknown friends, particularly on social media, who promote negativity and hate.
Need Special Attention
Eating in Moderation: Most dietitians agree that large portion size and improper meal timings (particularly late dinners) in India are major issues that impact our health. Okinawans always remind themselves by saying "Hara Hachi Bu" meaning 'stop eating when you are 80% full'. A recent study has found that eating late dinners can heighten blood sugar levels and reduce the ability to burn fat thus promoting obesity. Eating early will also encourage you to sleep early and help have sufficient sleep. Moderation should also be applied to our salt and sugar consumption. WHO guidelines recommend 5g salt per person per day but Indians, on average, consume more than double that amount thus enhancing risks of heart attacks and strokes. According to this Report published in 2016 by the George Institute for Global Health, "excess salt consumption is estimated to cause about 600,000 deaths each year and to be the 5th leading cause of death in India. Likewise, sugar is dangerous too. While structural sugar in fruits is fine, free sugars in foods and drinks including fruit juices are the ones to guard against.
Physically Active life: Blue Zones Project report states - "The world's longest-lived people don't pump iron, run marathons, or join gyms. Instead, they live in environments that constantly nudge them into moving without thinking about it." While rural Indian life does facilitate physical activity as part of life, the urban lifestyle is becoming more sedentary for higher-income groups owing to convenient technology, availability of cheap labor for domestic chores, lack of suitable parks and facilities for exercise, lack of safety, alarming pollution levels, internet, and television immersion, and cultural taboo about doing manual jobs like cleaning cars and washing dishes at home. This can be easily countered by cultivating home-based hobbies and interests like gardening, cooking, dance classes, DIY projects like painting or deep cleaning, running errands, avoiding lifts, sharing various domestic chores with your spouse or family members, and taking pride in doing manual jobs. Idea is to build exercise into daily routines.
Remember, we can always achieve a biological age that is much lesser than your calendar or chronological age through a suitable diet, lifestyle choices and a resilient frame of mind. For a long happy healthy lifespan, it is biological age that actually matters rather than our actual age.
If there were one activity that incorporated many of the Power 9s, my pick would be 'Satsang' or equivalent as it takes care of spirituality, sense of purpose, good company, and stress mitigation. Add yoga or any similar exercise to 'Satsang sessions, physical activity too gets integrated. And still better, create a small like-minded group within a family and/or close friends and try to assimilate all the Power 9s. It's challenging but NOT IMPOSSIBLE.