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Live Better, Longer

What does science say about maintaining good health and aging well? U of M researchers offer their insights, the latest findings, and other top tips.

When it comes to healthy aging, the challenge isn’t about finding advice. It’s about finding a way to sift through the fads and dubious advice to find information based on solid scientific research.

The University of Minnesota supports extensive cutting-edge research and initiatives that can help all of us live our best lives. And the sheer volume of research conducted means that new discoveries happen every day, which benefits us all.

Here are a few of the top recommendations for staying healthy that apply not only to those in their later years, but for all of us as we plan a healthy future.

LIAM O'DONNELL

1. Stay Connected
Having strong emotional bonds is crucial to people’s health. In fact, Dutch supermarkets have now introduced slower checkout lanes for lonely seniors who might want to have a chat with a cashier. A 2023 report fromthe U.S. Surgeon General shows that the consequences of being lonely and isolated include a 29 percent increased risk for heart disease, a 32 percent increased risk for having a stroke, and a 50 percent increased risk for developing dementia.

“The important thing is to have people in your life, whether they be family or friends, who you can turn to when you are happy, sad, have good news, bad news—just to have relationships in your life that are balanced in terms of giving and receiving,” says Mary Jo Kreitzer (Ph.D. ’90), director of the U of M's Earl E. Bakken Center for Spirituality & Healing. “And so many people, I think, when they move into older age, they’re so used to having relationships where they give, give, give. And sometimes it’s different for us to be on the end of receiving, having balance in terms of our relationships.” Kreitzer recommends expanding connections beyond friends and family through group activities, including faith communities, public gathering spots, including parks and libraries, and neighborhood and community programs.

LIAM O'DONNELL

2. Have a Purpose
We all need a reason to get out of bed. According to a study by the National Institute on Aging, people who feel a sense of purpose have a 15 percent lower death rate than those who feel aimless. “Purpose is finding something that we can do that meets a need in the world,” says Mary Jo Kreitzer. Maybe that’s reading to a child on Zoom. Or maybe it’s helping an even older neighbor get their groceries. To discover more about what drives you, check out the Center for Spirituality & Healing’s online tool called Taking Charge of Your Health and Wellbeing. (www.takingcharge.csh.umn.edu)

LIAM O'DONNELL

3. Muscle Up
After age 40, we lose on average 10 percent of our muscle mass and strength every decade. That’s an issue, according to kinesiology Professor Li Li Ji, not just because our muscles help protect us from falls and other injuries, but also because they help keep our blood sugar stable and prevent obesity.

Ji’s research focuses on physiological and nutritional strategies that may enhance our antioxidant defense, which helps prevent a body’s age-related health deterioration. “People now know that walking is good for you, but I don’t think that’s enough to prevent your muscle from declining,” he says. The American College of Sports Medicine recommends at least two sessions a week of muscle strengthening exercise—weight machines, resistance bands, push-ups and sit-ups—in addition to 150 minutes per week of moderate-intensity aerobic activity. And remember to take rest days in between strength-training sessions to give your body a chance to recuperate.

LIAM O'DONNELL

4. Protect Your Brain
Perhaps no other age-related disease is as feared as dementia. Thankfully, a landmark 2020 study published in the medical journal The Lancet says that up to 40 percent of dementia cases can be prevented by adjusting your lifestyle when you are younger. First up: Stop smoking—that includes the occasional cigarette at a party—and reduce your exposure to second-hand smoke. “If there’s one thing you can do to hasten the aging process, it’s smoking,” says Joseph Gaugler, a professor who researches long-term care and aging at the School of Public Health. The U of M has been a leader in tobacco research, including studies that led to the state’s 2007 ban on indoor smoking. In 2022, research by psychiatry and behavioral sciences Professor Dorothy Hatsukami (Ph.D. ’80), influenced the Food and Drug Administration (FDA) to announce plans to make tobacco products less addictive by setting standards that lower nicotine levels in these products.

Next up, focus on other components of a healthy lifestyle, such as regular exercise and heart-healthy eating—Gaugler recommends the Mediterranean diet—to control conditions such as heart disease and diabetes, which put you at an increased risk for memory loss.

“I don’t think any of these things should be a shock or surprise,” he says. “It’s more an issue of getting ourselves able to engage in them.”

LIAM O'DONNELL

5. Eat a Balanced Diet (Plus Nuts!)
Blueberries! Beets! Dark chocolate! It seems like every month brings a new report about the best aging superfoods. According to Lyn Steffen (B.A. ’72; M.P.H. ’87), dietician and professor of epidemiology and community health, the best diet for older adults is one that encompasses all of the food groups—especially protein, which helps maintain muscle mass as we age. She recommends an online tool called My Plate (myplate.gov), which helps users customize eating plans according to their age, weight, height, sex, and physical activity levels. 

Steffen also recommends common sense strategies to lower your sugar intake, including not keeping treats in the home (save them for special occasions) and cutting out sugary beverages. In 2020, Steffen and a team of researchers that included So-Yun Yi (M.P.H. ’18) published a study that showed eating too much sugar is associated with excess adipose (fatty) tissue around the heart, which can lead to heart disease. Dietary guidelines also recommend that fewer than 10 percent of daily calories come from sugar. Yi and Steffen also did a study that showed that eating walnuts is associated with better cardiac function; Steffen recommends eating an ounce a day of any tree nut. Steffen and others have also been involved in research that indicates a potential link between the longtime use of sugar substitutes and obesity.

And similar dietary research is ongoing elsewhere at the University. For instance, one recent study published in the journal Gut Microbiome examined the impact of eating fermented vegetables on gut health. Researchers wanted to see if frequent consumption of lacto-fermented vegetables, such as kimchi or kraut, had any effect on the trillions of bacteria that make up the gut microbiome.

Studying a group of 23 individuals who consumed at least one serving of plant-based fermented foods five times a week for two years, researchers found that potentially probiotic bacteria and fungi likely from the lacto-fermented vegetables were found in the feces of some individuals. They also found that regular consumption of lacto-fermented vegetables may stimulate bacteria with the potential to produce butyrate, a compound in the gut that is widely known for its positive effects on health.

“Our findings have implications for health prevention strategies based on the healing power of healthy foods,” says Andres Gomez, assistant professor in the Department of Animal Science. “In the future, we need to test a potential positive effect of consuming lacto-fermented vegetables in subjects with specific diseases with a known microbiome connection, such as cancer, obesity or autoimmune disease, among others.”

LIAM O'DONNELL

6. Hear! Hear!
One in three people between the ages of 65 and 74 have presbycusis, otherwise known as age-related hearing loss, according to the American Academy of Audiology. That number jumps to nearly 50 percent for people over 75, according to the National Institute on Deafness and Other Communication Disorders. What’s more, hearing challenges can have a chain-reaction impact on other aspects of health, including an increased risk of dementia and an increased risk of falling. That’s why it is so important to protect your hearing from an early age, including wearing earplugs at concerts and other noisy environments. It’s also important to recognize that when you are impacted by hearing loss, it’s a major life change.

“There are ways to work with hearing loss and to continue to have an active, interesting, and engaged lifestyle, but it takes some effort,” says Peggy Nelson, professor of audiology in the Department of Speech-Language-Hearing Sciences who researches family communication and hearing loss. “As good as our modern hearing aids are, you can’t just put one on and think the problem is solved. Having hearing aids is not the same as keeping normal hearing. It’s a big change and takes a lot of effort. ... And too quickly we start to just say, ‘Well, never mind,’ after struggling to convey something or, ‘It’s too noisy, so never mind. We’ll talk about it later.’ And that’s very natural and human, but it starts to really isolate [an] older person with hearing loss and that starts to take a toll.”

In addition to setting up closed captioning on an older person’s TV and making sure their phone is set up to work with their hearing aids, family and friends can support loved ones with hearing loss by speaking directly to them and trying to remember to speak one at a time during group conversations. Also, understand the amount of effort the person with hearing loss is putting out. “Just knowing how much effort it’s really taking is a good thing to keep in mind, even when they have their hearing aids on,” says Nelson.

LIAM O'DONNELL

7. Stifle Strokes
When it comes to preventing strokes, experts offer the same healthy lifestyle advice that they do to prevent heart attacks and dementia. Don’t smoke. Maintain a healthy weight and reduce cholesterol. Exercise. Most important, monitor your blood pressure, which is the most significant predictor for stroke risk. An annual physical with your primary care physician is a good way to keep on top of all of these risk factors, says Kamakshi Lakshminarayan (Post-Doc ’04; M.S. ’11), a professor of neurology at the U of M’s Medical School who researches stroke prevention and interventions to improve the quality of stroke care. 

In a 2022 study published in JAMA Neurology, Lakshminarayan and her colleagues found that the risk of dementia increased significantly after an ischemic stroke, regardless of a person’s vascular risk factors. (Ischemic strokes occur due to blockage of blood vessels so that blood supply is cut off to an area of the brain.) She was also the principal investigator of mGlide, a U of M administered heart health study that gives people a blood pressure machine to measure blood pressure at home and share their BP with their health care providers using their smart phone. “The mobile health technology intervention really brought down the rates of uncontrolled hypertension,” she says. “When patients are engaged, it’s a game changer.”

In other recent research, Lakshminarayan and her team also found a possible association between using certain acid reflux drugs and dementia. The study involved people over 45 who had taken proton pump inhibitors for heartburn or acid reflux. That study showed individuals who had taken PPIs for more than four years had higher risk of dementia, according to findings published in the journal Neurology. (Lakshminarayan says that the research currently shows only an association between taking the drugs and dementia. It does not mean that PPIs cause dementia, and she notes that further study is needed.)

LIAM O'DONNELL

8. Care for the Caregivers
Today, an estimated 53 million people in the United States are providing unpaid care for adult friends or relatives. These people are usually spouses and adult daughters; on average, these caregivers spend 24 hours a week providing assistance. The responsibility involved can be overwhelming. 

According to School of Public Health (SPH) Professor Joseph Gaugler, 1 in 4 caregivers report that caregiving has made their own health worse. Nearly 4 in 10 caregivers say their caregiving situation is highly stressful, and 1 in 5 feel alone, in addition to feeling a high financial strain due to care provision.

The School of Public Health’s Families and Long-Term Care (LTC) Projects is currently conducting a number of studies to identify and build systems and solutions that improve the quality of life of persons with memory loss and their families across racial, ethnic, and socioeconomic contexts.

For instance, most people with Alzheimer’s disease and related dementia (ADRD) receive some or all their care from an unpaid relative or friend. In a study published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, SPH researchers conducted a review of the scientific literature and highlighted several public health actions that could benefit caregiving, including:

· Identify ADRD caregivers. Data gaps are a major challenge in understanding the public health challenges of ADRD caregiving. Using surveys, information could be gathered to help support initiatives targeted to ADRD caregivers.

· Build community. Public health agencies should work to forge connections among ADRD caregivers through efforts like the national Dementia Friendly America networking program (dfamerica.org).

· Advance health care policies. Caregivers have important roles in our health care system and more effective public policies could formally identify the role and status of caregivers. Researchers recommend a payment system that recognizes and incentivizes the work of ADRD caregivers.

Finally, if you are a caregiver in search of advice and additional resources, you may want to check out the Family Caregiver Alliance (caregiver.org).

TECHNOLOGY LENDS A HAND
In some cases, commercial technology might be able to lend a hand for concerned caregivers trying to ensure their loved ones stay safe, especially if those individuals live at a distance.

A subscription service called I Am Fine (dailycall.iamfine.com) provides daily or twice-daily automated phone calls to any number you provide. The individual called responds by pressing 1 to check in virtually. If the individual doesn’t answer, the service will call up to four times before a text or email alert is automatically sent to family or friends alerting them that the person has not checked in.

Monthly fees for the service start at $15.


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