As you’ve probably picked up on by now, remaining healthy and active throughout life will make you look and feel younger when you’re older. A good diet, exercise, sleep, and well-managed stress can keep years off your face and body. The trick is establishing those habits early enough, and in a sensible way, so they stick and have time to make a difference.
But other aspects of aging—those often considered more cosmetic and less important to health—are, in fact, very important. A few purposeful changes can help stave off some of the other not-so-welcome characteristics of aging, such as wrinkles, tooth decay, hearing loss, and vision loss.
It’s not vanity; it’s humanity.
Having more wrinkles than you think you should, for example, can affect the way you feel about yourself. Gum disease, a common ailment in the elderly, can make you sick—literally. But it’s a manageable condition. Losing your hearing in your 70s or 80s can be very isolating, and it becomes hard to stay connected to the life you know. Yet being socially connected is a key component of preventing cognitive decline. If you develop vision problems, you’ll end up living with the constant frustration of not being able to drive or read, which can lead to clinical depression.
Who spends time envisioning a future with wrinkles, dentures, hearing loss, and low vision? Few people worry about these aspects of growing old because they certainly don’t seem to be health problems on par with getting Alzheimer’s or losing the ability to walk—the kinds of age-related ailments many people do worry about. But these are concerns that should be right up there with keeping your brain, your heart, and your muscles healthy. They are, in fact, central to your future quality of life.
Saving Your Skin
Ask any dermatologist about the best way to prevent skin aging, and the answer will be instantaneous: avoid sun damage. But we’re not getting the message.
The American Academy of Dermatology conducted an online survey of adults age 18 and older, released in May 2012, about spending time in the sun and tanning. The study proved that cultural messages die hard, even in the face of irrefutable scientific evidence. In this case, the American ideal of beauty still includes a tan, even though it’s been proven and publicized that sun exposure causes wrinkles and skin cancer.
“The American ideal of beauty still includes a tan, even though it’s been proven and publicized that sun exposure causes wrinkles and skin cancer.”
According to the study, 58 percent of adults 18 to 29 thought people looked better with a tan and 71 percent thought that sun exposure was “good” for your health.
This helps explain, at least in part, why Medicare claims for treatment of nonmelanoma skin cancers doubled between 1994 and 2006.
Of course, the sun does have important health-promoting properties and shouldn’t be shunned. The body uses sunshine to make vitamin D, an important nutrient essential for the body to absorb calcium, making it critical to bone health. Vitamin D also has been shown in studies to help protect people from various kinds of cancer (ironically), autoimmune diseases, and high blood pressure. (See the later “Ageless Advice” chapter for more guidance about getting enough vitamin D from the sun; it varies enormously based on your skin type and where you live.) Sunshine also means being outside, which is good for exercise and stress reduction.
But without the right understanding of the risks and rewards sun-shine offers, people often don’t take the time to protect their skin from the powerful age-inducing effects of the sun. They will stay out in the sun, unprotected, knowing they’re likely to get a sunburn—much the way they might decide to eat an ice cream even when they’re trying to lose weight. It’s a classic example of the present self being unable to relate to, and worry about, the experiences and feelings of the future self.
But understanding the science behind a sunburn will help you appreciate the long-term damage it can cause. When you stay in the sun too long and your skin turns red, there’s a lot going on inside your skin cells.
Ultraviolet (UV) light from the sun is an extremely strong form of energy, and when it passes through your skin, it hits water molecules inside your cells. This energy causes some of the oxygen molecules in that water to lose an electron and become free radicals. When a radical bounces around inside a cell, it damages anything in its path in a desperate attempt to find a second electron to bind to so it can become stable again. With prolonged sun exposure, this constant exposure to UV light means a tremendous number of radicals are zooming around inside your cells, damaging them from the inside.
Your body does the best it can to defend itself. It marshals its antioxidant resources to squelch as many radicals as it can. Some research suggests people with diets high in antioxidants are better able to fight off these kinds of assaults—another reason a diet high in fruits and vegetables is good for your skin. But when antioxidants can’t keep up with the havoc wreaked by free radicals, your immune system is mobilized to start repairing the damage. That immune response causes inflammation, just as it does when your body tries to repair the damage from a twisted ankle or a bruise. When it happens inside your skin cells, your skin becomes visibly red, swollen, and painful. That’s a sunburn.
Over time, sun damage like this accumulates in your cells. Every time your body repairs cell damage from a sunburn, the impact appears to go away. But with repeated cycles of damage, your cells can’t recover to their original state, much the way a cracked wall is never quite the same after it’s been repaired. It may look just as good for a while, but cracks will gradually appear where the repairs were made. The same is true for your skin cells: the more sun exposure they get, the weaker they are from the constant cycle of damage and repair. In the end, they lose structure and elasticity, which shows up on your skin as wrinkles—or worse.
“There’s a chain reaction that occurs and leads to damage,” explains Tom Slaga, pharmacologist at the University of Texas Health Science Center in San Antonio and an expert on skin cancer. “Too much of it, and the damage builds up and eventually you get cancer or you have aging of the skin. Your skin thins anyway with age, so to add a lot of sunlight on top of it, that’s where you end up with the most damage.”
Tan Damage
A tan is part of the body’s defense system. Your skin cells release pigment to help absorb UV light and prevent cellular damage from free radicals, causing it to turn brown. A tan may look attractive, but it’s another sign of cell stress. That’s why people who spend their lives getting tan in the sun or tanning salons, even if they don’t burn, get wrinkles earlier and have a higher risk of skin cancer.
The best way to take care of your skin, then, is to protect it from sun damage and nourish it from the inside. Eating a good diet full of vitamins, minerals, and antioxidants gives your body better resources to limit damage to your skin cells so they stay healthy and young-looking.
Beyond that, there’s no big secret to preventing skin aging, says dermatologist Dr. David Green of Bethesda, Maryland. “In terms of priorities, environmental injury trumps everything—all the lotions, potions, and exfoliation you can do, can’t undo the bad things we do,” he says.
Cleansing and moisturizing are basic hygiene everyone should do to keep their skin clean and moist, but that won’t prevent wrinkles, Green explains. “Most wrinkling is not the result of dry skin,” he says. “There are people who have very oily skin who have a lot of wrinkles.”
Dr. Green points out that if you take a person with any type of skin and any level of wrinkling on their face and then look at the skin on their buttocks, which generally gets no exposure to sunlight, you’ll see dramatically less wrinkling. Point taken.
“If you take a person with any type of skin and any level of wrinkling on their face and then look at the skin on their buttocks … you’ll see dramatically less wrinkling.”
For people who already have some wrinkling they’d like to deal with, dermatologists and other skin experts tend to agree that lotions with alpha-hydroxy acid, vitamin C, and other antioxidants—and even old stand-by creams like Retin-A—can help minimize the appearance of age lines. Other experts suggest trying to reduce squinting (using glasses for vision or sunglasses for outdoors), which can prevent deep wrinkles around the eyes. And sleeping on your back can keep wrinkles from getting creased into your cheeks and mouth when you sleep.
My husband, who has astonishingly youthful skin, has done none of that; he has had the same basic skin-care routine for 40 years. He washes his face with warm water and Neutrogena soap and then splashes his face with the coldest water he can get out of the tap. He moisturizes every morning with basic Olay face lotion, which he thinks he might have originally borrowed from a girlfriend in college—and he’s still using it!
However, Jim is very careful about getting too much sun. He has olive skin to begin with, and people with more pigment in their skin are less prone to sun damage because that pigment absorbs more of the ultraviolet light. But even though Jim is naturally more protected than I am, with my fair skin, he still uses sunscreen on his face, especially whenever he’s going to be out in the sun for more than 15 minutes or so.
What’s been most dramatic, though, is how little Jim’s skin has aged since he started eating so many whole grains and antioxidant-rich foods. In fact, more than just not developing any new wrinkles, his skin is smoother and brighter than it used to be. It’s obvious he’s protecting his skin from the inside out.
Teeth for All Time
Good dental hygiene is not only good for your teeth and smile, it’s also good for your health. Scientific literature is brimming with studies that link poor oral health to a host of chronic and acute diseases, including these:
The link stems from gum disease, often called periodontal disease or gingivitis. This chronic oral health condition comes from long-term exposure of the gums to plaque on the teeth. Plaque is a sticky film on the teeth made of food particles, mucus, and bacteria. If plaque isn’t effectively cleaned from the teeth by good brushing and flossing, it can turn into tartar, a harder deposit that tends to collect around the gumline. The problem is that plaque and tartar irritate the gums, which can initiate a cascade of systemic responses.
Dentist and registered dietitian Charlene B. Krejci of Case Western Reserve University recently reviewed the scientific studies that have looked specifically at the link between oral health and women’s health. Published in the journal Oral Health and Preventive Dentistry in 2012, her review explained that plaque and tartar release “toxic products” that cause the gums to get inflamed, leading to mouth ulcers, tissue deterioration, bone and tooth loss, and inflammation throughout the body.
“Plaque and tartar release ‘toxic products’ that cause the gums to get inflamed, leading to mouth ulcers, tissue deterioration, bone and tooth loss, and inflammation throughout the body.”
“An increased concentration of circulating inflammatory markers has been directly correlated with the presence of the disease,” Dr. Krejci wrote. In study after study, gum disease has been closely linked with the presence of inflammation throughout the body. Systemic inflammation is associated with a wide variety of chronic health conditions and diseases.
So it’s clear that once you get advanced gum disease, you’re doing the rest of your body no good. Scientists still haven’t pinned down the exact role of inflammation in disease, but it’s generally believed that controlling inflammation is an important part of staying healthy as you age.
Oral health studies have not necessarily been able to conclude specific cause and effect: does poor dental hygiene cause systemic disease, or is some behavioral or environmental trigger causing both? More likely, researchers believe, there’s a cycle involved, with health factors such as smoking, obesity, and low socioeconomic status leading to multiple health problems, including dental disease. People with little money often have less access to good dental care and may not have the educational programs that teach them how to take care of their teeth. When dental disease sets in, it exacerbates other conditions that may be present as a result of poor lifestyle habits.
The message is clear: don’t put off going to the dentist, at least once a year, and every 6 months is recommended. Cleaning your teeth is not just about cleaning your teeth: the effect of regular dental hygiene adds up to a healthier mouth as you age, which contributes to better health overall.
My father lived a long and healthy life until his recent death at age 89. He was a historian and an intellectual interested in every aspect of culture, from music to architecture to literature. He was not an athlete, but throughout his later years, he religiously took long walks around the neighborhood. In bad weather, he would drive to the airport just minutes from Washington to walk the distance of the terminal several times. Yet this man who didn’t smoke, wasn’t overweight, and exercised regularly could do nothing about the hearing loss that plagued him in the last 15 years of life and the vision loss that made his last 5 years frustrating and, at times, outright depressing.
When my father’s hearing began to go, it became hard for him to converse in noisy situations. Then it became difficult to follow the conversation even among his wife and daughters, although one could argue whether he wanted to, of course! Eventually, his hearing trouble made it nearly impossible for him to carry on a conversation unless the acoustic conditions were perfect. It also robbed him of the great pleasure he derived from classical music. We intervened with whatever amplification devices we could, but it didn’t do enough.
My father’s experience made me determined, personally, to do whatever I can to prevent the same kind of a sensory loss he experienced. Luckily, the best time to start such prevention tactics is midlife, although it’s never too late.
Hearing loss typically begins in your 40s, even if you don’t notice it. Much of the current scientific knowledge about age-related hearing loss focuses on cumulative exposure to noise. That’s a really important point. Some noise exposure is just unavoidable—it’s a noisy world. But if you reduce your exposure to loud noise wherever you can, you are eliminating one level of cumulative damage and protecting your hearing in the long run.
“Hearing loss typically begins in your 40s, even if you don’t notice it.”
Try, for example, turning down the volume to a level you can just comfortably hear—whether it’s the television, the radio, or through headphones. If you really like to listen to loud music, try to do it less often.
Also use hearing protection. Earplugs are a great way to deal with loud noise. Buy a pack of disposable foam plugs or reusable earplugs, and use them whenever operating loud machinery, hunting, or during any other high noise exposure. I’ve just started using earplugs when I use a hairdryer every morning (and I’ve discovered that not all earplugs are created equal, so it takes a little testing with different types and brands). According to the CDC, hair dryers have the same noise-level rating as a power lawn mower!
Hearing loss has also been linked to oxidative stress, and recent research has been focused on possible supplements that may help prevent such oxidative damage from leading to hearing loss. Unlike many other cells in the body that can be replaced when oxidative stress leads to cell death, cells involved in hearing do not regenerate. So high levels of oxidative stress can lead to irreversible hearing loss.
A great deal of research currently focuses on the potential impact certain vitamins, minerals, and antioxidants can have on preventing hearing loss. A study published in 2011 by researchers at the University of Sydney in Australia found in a 5-year study that people with the highest vitamin A levels in their blood had a 47 percent decreased risk of hearing loss, while those with high dietary intake of vitamin E had a 14 percent reduced risk of hearing loss.
Other studies have found protective effects from various nutrients, especially antioxidants, suggesting that acute free-radical damage occurs after exposure to loud noises, and antioxidants can help repair that damage. Studies have shown better recovery after loud noise exposure using high doses of antioxidants and other micronutrients, including these:
This research is still developing—some has only been done in rats and guinea pigs—so it’s hard to say yet which supplements will clearly help prevent hearing loss. But the evidence suggests that protecting your hearing is yet another reason to eat a healthy diet with plenty of fruits and vegetables, providing at least the minimum recommended intake of vitamins and minerals.
But like the advice to limit your sun exposure to best protect your skin, most hearing experts still say noise reduction will make the biggest difference in preventing hearing loss for the average person. So before you crank up the music, think of the last time you had a conversation with someone who was hard of hearing, and picture yourself in that person’s position. It may give you just enough motivation to keep the volume a little lower. Over time, that may preserve your ability to listen to music at all.
See the Future
An ophthalmologist recently told me that even though I have no vision problems (other than needing drugstore reading glasses), I should start getting annual ophthalmologic exams when I turn 50. Why? Because both my father and my maternal grandmother suffered from macular degeneration in their 80s, so my family history puts me at risk in the future. And of course, I fully intend to be living that long (I also fully expect my husband will be cranking along right with me!). So this warning hit home.
Macular degeneration is a condition in which the center of the retina, or the macula, gradually deteriorates. It is one of the most common causes of vision loss in people over age 65; about a third of adults age 75 and older have some degree of the disease.
Macular degeneration gradually caused my father to lose the ability to comfortably read the newspaper, magazines, and books. Combined with his hearing loss, it intensified his feelings of isolation, and at times it made him feel pretty low.
According to the American Health Assistance Foundation, the biggest risk factor for macular degeneration is age, but there are others:
Two large studies have evaluated the effectiveness of dietary supplements on eye health and on macular degeneration in particular.
The first Age-Related Eye Disease Study (AREDS) found that high levels of certain antioxidants, along with zinc, significantly reduced the progression of macular degeneration. The supplements tested included the antioxidant vitamins E and C along with beta-carotene. These micronutrients don’t appear to prevent the onset of macular degeneration, but they may keep it from worsening.
A follow-up study that began in 2006, called AREDS2, is testing the same supplements as the original study, but with the addition of omega-3 fatty acids and the antioxidant lutein. Results are expected in 2013.
The science suggests that both vision and hearing loss can be prevented to some degree by staying healthy and active, but especially by eating a diet high in vitamins and antioxidants. Unlike hearing loss, though, which can also be prevented to a large degree by reducing exposure to loud noise, vision loss is harder to prevent by taking any single precaution besides optimizing your general health.