Aging gracefully

By Karen Weintraub, Globe Correspondent  |  October 31, 2010

When it comes to aging well, most of us already know what we need to do: Exercise, eat right, get a good night’s sleep. Don’t smoke or drink heavily.

Just as important, doctors say, don’t wait to start taking care of yourself. Diseases that strike in the 70s and 80s often start to develop decades earlier. Too many bacon cheeseburgers, weekends on the couch, and evenings in smoky bars can add up. The good news is the same regimen that helps your heart also benefits your brain, mood, metabolism, and even skin. Aging gracefully isn’t rocket science. It just requires energy, stamina, and motivation.

Aging is much kinder to the fit body, doctors say. Exercise not only reduces the risk of heart disease, but also of stroke and dementia.

Beginning at 40, everyone should exercise at least three to four days a week, for at least 45 minutes at a time, said Massachusetts General Hospital cardiologist Malissa J. Wood. Any exercise that gets your heart rate up, including brisk walking, is helpful, she said.

“Regular physical exercise can take years off the behavior of the heart muscle,’’ Wood said, “and make it much more like the heart of a younger person.’’

Aerobic exercise also increases blood flow to the brain, said Dr. Marie Pasinski, a staff neurologist at Mass. General. Starve the brain of oxygen and nutrients with clogged blood vessels, and the risk of dementia, stroke, and heart disease soars, said Pasinski. Left untreated, such high blood pressure can shrink the brain.

People should check with doctors before beginning exercise programs, but even those who don’t start until their 70s can see benefits. “If you’re not fit now,’’ Wood said, “it’s a great time to become fit.’’

Nutritionists are nearly unanimous that a Mediterranean diet of fruits, vegetables, and fat from olive oil rather than butter is best.

Treating yourself to steak or fries once a week is OK, said Dr. Suzanne E. Salamon, associate chief for clinical geriatrics at Beth Israel Deaconess Medical Center, but eat them only in moderation.

Far better for you: blueberries, salmon, nuts, and other sources of Omega 3 fatty acids and antioxidants, which, among other benefits, delay wrinkles. “Diet and exercise is probably one of the best forms of cosmetic care that’s out there,’’ said Wood, the cardiologist.

Omega 3s, which are found in fish, particularly fatty fish like salmon and tuna, are “basically the building blocks of the brain,’’ said Pasinski, the neurologist. For strong bones, doctors said, women should consume 1,000 mg of calcium and 1,000 international units of vitamin D daily. Lowfat milk and yogurt are great sources of both. Fish is also high in vitamin D.

If you can’t stand fish or milk products, take nutritional supplements, doctors said. But it’s better to get vitamins and nutrients from food. “To me,’’ Pasinski said, “it always just makes sense to eat a healthy, well-balanced diet.’’

Wood tells her aging patients to reduce stress, even if it means changing jobs to escape a degrading boss, or telling an adult child it’s time to grow up.

“Stress hormones cause blood pressure and heart rate to go up, and cause you to deposit fat in bad parts of the body,’’ Wood said. Stress also pushes people to make unhealthy choices, such as smoking, drinking, laying around the house, and not managing prescriptions.

Change the things you can control, Wood advises, and it will help you feel better about the ones you can’t. And, she added, “If you have better physical health you’re more resilient to the things you can’t change.’’

Sleep is when the brain repairs itself. Sleep deprivation has been linked to problems from obesity to depression to dementia. “Whenever I see someone coming to me about memory problems,’’ said Pasinski, “I ask them about sleep.’’

Though it may become harder to sleep for long periods as people get older, taking afternoon naps can help make up for a short night’s sleep, said Salamon, the geriatrician.

Instead of medications, she recommends a cup of chamomile tea to help with sleep — but not too close to bedtime, to avoid late-night trips to the bathroom.

Increasingly, studies find that all these factors are interrelated. You don’t have to follow one routine for your heart and another for your brain. The same stuff works on both.

Dr. Wei Zheng, director of Vanderbilt Epidemiology Center at Vanderbilt University, recently published a study showing that middle-aged Chinese women who had four or five healthy lifestyle factors — normal weight, low belly fat, regular exercise, limited exposure to secondhand cigarette smoke, and high consumption of fruits and vegetables — had a 43 percent lower risk of death than women with none of those factors.

“Each single factor, if you look at it by itself, contributes somewhat,’’ said Zheng. “But when you combine them, you see a pretty dramatic effect.’’