The Lucky Years: How to Thrive in the Brave New World of Health (23 page)

Don’t underestimate those over-the-counter medications, many of which were once prescriptions. I’m glad to see the FDA strengthening the warning labels on popular OTC pain relievers. These commonly used drugs are not risk-free; they increase the risk of heart-related problems with regular use and can do so within a matter of weeks.

Over the two-week challenge, make sure to record any unexplained symptoms you have that are out of the ordinary. They can be any number of things: feelings of nausea or stomach upset, a night sweat, an achy back or sore joint, an intense thirst, or the urge to nap on a Tuesday afternoon when you never nap. These symptoms are probably absolutely nothing to worry about, but they can nonetheless clue you in to signs that make up part of your context.

How many hours of sleep a night do you typically get? Is this enough? Do you ever suffer from insomnia or rely on sleep aids?

Although we used to think for a long time that a typical adult needs between seven and nine hours of sleep a night, newer research is showing that the magic number for most might be closer to seven, which is associated with the lowest mortality and morbidity. Other recent research has shown that a bad night’s sleep, even losing a mere twenty minutes, can impair performance and memory the next day. We all know someone who claims to be fine on a few hours of sleep a night, but the research speaks otherwise, indicating that people who skimp
on sleep many nights in a row don’t perform as well on complex mental tasks as those who bank closer to seven hours a night. The research also says that getting less or much more than seven hours of sleep a night is associated with a higher mortality rate.
¹⁵
Sleep too much and you may be more prone to diabetes, obesity, and cardiovascular disease.

As we’ll see in more detail in chapter 8, every system in the body is affected by the quality and amount of sleep you get per night. In fact, sleep directs so much of your body’s physiological rhythms that you can’t reboot yourself artificially with any substance or technology. You need a regular, reliable pattern of wakefulness and rejuvenating sleep to refresh your cells and tissues, to support your hardworking immune system, and to regulate your hormones. Which is why the proven benefits are plentiful: sleep can dictate how much you eat, how fat you get, whether you can fight off infections, how creative and insightful you can be, how well you can cope with stress, how fast you can process information, and how well you can store memories. The side effects of poor sleep habits are equally plentiful: hypertension, confusion, memory loss, chronic colds, the inability to learn new things, obesity, cardiovascular disease, and depression. So much of the body’s natural rhythm that governs your health revolves around your sleep habits. When people complain of feeling tired and blue, I often start by asking them about their sleep schedule. It’s the easiest way to regulate your body and feel a positive difference in a short time.

Question is, do you know how well you sleep? You should be able to figure out your optimal amount of sleep in a matter of days. Don’t use an alarm clock. Go to sleep when you get tired. Stay off electronic devices as much as possible beforehand (and definitely keep them out of the room). If you do enjoy watching TV or videos on a device with a screen, as for some this can be relaxing prior to bedtime, get a pair of glasses that has a lens to block the brain-activating wavelengths of light. These blue-light blocking glasses are the cost of a large pizza. I put mine on when I have a chance to watch late-night comedy or the news before going to sleep. Track your sleep with a diary or a device that records your actual sleep time (lots of apps will help you track your
sleep and circadian rhythm). If you feel refreshed and awake during the day, you’ve probably found your optimal sleep time.

Over these two weeks, in addition to finding your sleep number, document your sleep experience. Is it sound? Do you dream? If you do rely on sleep aids, be they over-the-counter drugs or prescription, can you make it a goal to wean yourself off of them? (Note that discontinuing some sleep aids may require the help of a doctor.)

You already know that exercise does a body good. A daily brisk twenty-minute walk, for example, can reduce your risk of dying prematurely by a whopping 30 percent. Some studies say that a twenty-five-minute stroll can add seven years to life. How fast older people walk, in fact, is one of the most useful markers for determining future health. And it’s just recently been shown that being sedentary may be twice as deadly as being obese. But I’ll get to those details shortly. For now, it’s time to get up close and personal with your exercise habits. How much do you move each day? How many consecutive hours do you sit? How many minutes do you get your heart rate up 50 percent above your resting baseline? Are you among the 82 percent of the 53 million Americans who belong to a gym but don’t consistently use their membership?

Answer these questions over the next two weeks as you record your physical activity habits. If you work in a labor-intensive job, such as construction, or you are someone who is always on her feet running around taking care of things, you get extra points. You can track your activities using apps on your smartphone or a wearable fitness tracker (accelerometer), but this is optional. You can do just as well being tuned in to your activities and writing them down. Again, no need to try and calculate calories burned. Just write down how many minutes you were engaged in a physical activity and its intensity. Be as honest as possible. As with underestimating how much we eat, we also tend to underestimate our sedentary times while inflating our level of physical activity, and men are more likely than women to exaggerate.

One of the most powerful questions a doctor can ask a patient is simply, “How do you feel?” Which can be a surprisingly difficult question to address personally. I wonder, if people were more attuned to their changing moods, behavioral triggers, and other aspects of their daily lives, would so many people be taking powerful mind-altering medications to regulate their moods?

Not only does tracking your mood help you better understand why symptoms occur when they do, but the information can also reveal whether drugs or therapy that you may be using are actually working. Mood monitoring can also help you find useful correlations, such as being predictably moody while talking to certain people or during the first half of the workweek when your blood pressure tends to run high, too.

Plenty of online mood trackers and apps are available today, but again, you can do this the old-fashioned way just by using your intuition about how you feel and making note of that. Track your mood throughout the day or during the same times you’re testing your blood pressure.

How is your energy level today on a scale of 1 to 5 (5 being the highest)? Do you feel full of life and ready to tackle any challenge (5)? Could you barely get out of bed (1)? Or are you somewhere in between?

A confluence of factors determine your energy level: how well you slept the night before, what you’ve been eating, how stressed you are, whether you’re exercising too much or too little, and health conditions. While tracking energy levels is a little more amorphous than, say, logging your sleep time, see if you can find a pattern to your energy levels over these next two weeks. Maybe you’ll discover that your body reaches a peak in energy at ten in the morning and then slowly wanes throughout the day. Or perhaps you’ll question why your energy takes a dip at precisely four in the afternoon and then ticks up a notch again at five. All of these details fill in the blanks for your context and help you to make sense of your behaviors, and whether or not you want to change them.

Although this two-week challenge is not meant to be a scientific experiment, it can nonetheless uncover lots of things about you that you might not have known before or that you’ve simply ignored. All of this data will help you establish a new baseline for your health today, one that you can compare with future “checkpoints” during which you tune in to yourself and take stock of where you are in your overall health equation. You have listened to your body talk, and when you put each of the pieces together, there may be trends. Do you sleep better when you move more? Do you feel better when you have certain meals? And so on.

It always helps to have some lab work included in your data to create a fuller picture. And while you may not have any intention of going to the doctor today, below is an abbreviated list of the tests to ask for when you do:

• 
Fasting lipid profile:
This test, which should be taken after twelve hours of fasting, gives you cholesterol (total cholesterol, HDL, and LDL values) and triglyceride numbers. A desirable total cholesterol is between 120 and 200 mg/dL, but this can be offset by a healthy ratio of good to bad cholesterol (more good HDL cholesterol and less bad LDL cholesterol). An ideal HDL level is greater than 60 mg/dL. An optimal LDL level is less than 100 mg/dL. Anything between 100 and 129 mg/dL is borderline, 130 to 159 mg/dL is considered mildly high, 160 to 189 is deemed moderately high, and an LDL level of 190 and above is severely high. A target triglyceride level is less than 150 mg/dL, with values between 150 and 199 being borderline, 200 to 499 being elevated, and values 500 and higher being severely elevated, placing one at high risk of the potentially deadly disease, pancreatitis, as well as heart disease. The recommended numbers for each of these lipid values are more stringent if you have previously documented heart disease.

• 
High-sensitivity C-reactive protein (CRP):
This is a general marker of inflammation in the body, which can point to a number of potential problems and risk for disease. Higher levels are correlated with higher risk for a variety of illnesses and metabolic conditions, including diabetes, heart disease, and obesity. This number should be between 0.00 and 2.0 mg/L (ideally, less than 1.0).

• 
Comprehensive metabolic panel (CMP):
You’ll want this test to assess your liver, kidneys, electrolyte, and acid/base balance, and blood sugar and blood proteins.

• 
Hemoglobin A1C:
Hemoglobin A1C (also called glycosylated hemoglobin) is the protein in red blood cells that carries oxygen. It also sticks to blood sugar, which is how measuring hemoglobin A1C can determine your blood sugar levels, and whether you’re at risk for diabetes or already diabetic. This test is not a real-time measure of your blood sugar level; it reflects an “average” of your blood sugar levels over the previous ninety days (red blood cells live about that long). This is why studies of blood sugar control’s possible role in various disease processes—from diabetes and heart disease to dementia—frequently use hemoglobin A1C. An ideal hemoglobin A1C is between 4.2 percent and 5.6 percent. Values of 5.7 percent to 6.4 percent indicate an increased risk for type 2 diabetes; values greater than or equal to 6.5 percent indicate type 2 diabetes. Your hemoglobin A1C number is not fixed; you can lower it through better nutrition and more physical exercise.

There’s an inherent fear when you go look at your stock portfolio daily. But you’re probably not so nervous when you look at it monthly. You can’t look at it every day or you’d be trading too often. You need to treat your health like you treat your portfolio. You casually collect data
over time and then go to a doctor and discuss it. Remember, you’re looking at trends over time. I’ve asked you to scrutinize yourself pretty intensely for only two weeks. But you could just as easily extend that data collection period to a month or two or even three and be a little more casual about it. At the least, start to overlay blood pressure, weight, dietary patterns, sleeping habits, and so on, and see what emerges. If you give yourself more time to collect data, then you can even go so far as to play war games on yourself like I’m trying to do in the lab with a virtual tumor—a model of a cancer that can be manipulated in its environment to see what changes we can force on it to modify its behavior or growth. What if I mutated this gene? What if I exposed it to substance
X
?

Likewise, you might find yourself testing new methods in your own life. Maybe you’ll spend four days avoiding the diet soda you love so much and see if that has any impact on your sleep and how you feel. Or maybe you’ll realize that you feel your best on the days you get up at 6:15 sharp and don’t lounge in bed until 7:00. These are the small details I hope you uncover about yourself. Have fun with this experiment. Next, we will learn more about how to add depth to your context and find what’s right for you as you enter the Lucky Years.

The greater the ignorance, the greater the dogmatism.

—Sir William Osler

P
op quiz: Which of the following debates is, well, debatable?

a. Vaccines can cause neurological disorders, including autism.

b. Lifestyle habits can reverse cancer.

c. Vitamins and supplements can boost your health.

Before I get to the answer (which would probably surprise you if I told you right now), let’s take a tour of the current landscape in the dispensation of medical information. Every day I seem to encounter black-and-white, grandiose headlines in the media that I know must cause confusion and misinformation in the public. And some of the most egregious ones advertise a remedy or cure to our most difficult challenges, from depression and obesity to dementia and cancer. Or they peddle junk science, making declaratory statements and recommendations that are not backed by rigorous studies. Some of my favorites:

• Green coffee: miracle weight-loss cure in a bottle.

• Use this trick to look fifteen years younger.