Excerpt: "You: Staying Young"

Drs. Oz and Roizen tell you how to protect against aging as early as your 30s.

Nov. 25, 2007 — -- Dr. Mehmet Oz, who is known to millions as Oprah's go-to guy on all things medical, has a new book aimed at keeping you younger, longer.

"You: Staying Young: The Owner's Manual for Extending Your Warranty" is the latest installment in his and Dr. Michael Roizen's "You" book series. It tackles the dreaded topic of aging and how to keep your body from turning on you.

While aging seems to just creep upon us, Oz and Roizen say it actually begins occurring early and there are things you can do you prevent it.

Read and excerpt of the book below.

To find out more about "YOU: Staying Young" on the Discovery Health channel, and more on how Dr. Oz helped Frank Ficello and Elaine Barrett turn around their lifestyles and get healthy visit www.discoveryhealth.com.


Most of us think aging happens like this: We go on our way, living happily through life, until one day we start to feel old, and the symptoms domino right before our cataract-clouded eyes. Our bones creak, our backs hurt, we space on the names of our neighbors, we hate driving at night, we can't play golf anymore, we can't hear what our spouses are saying, and our sex lives pretty much come down to brushing up against the washing machine. Soon we're eating dinner at three-thirty and our primary goal of the day is staying up long enough to catch Wheel of Fortune.

To us, that approach means you're drowning in life?not bathing in the beauty of it. We're here to challenge that perception of aging and create a new way of thinking about "antiaging medicine." The traditional focus of the medical community has been on treating chronic diseases and reversing acute illnesses associated with aging?cancer, heart disease, stroke. The assumption was clear: Since heart disease and cancer alone account for over 50 percent of all deaths, you could live maybe 50 percent longer if you could avoid the big killers. As it turns out, this isn't what would happen. As devastating as these diseases are, wiping them out as your killer increases your average life expectancy by only about nine and a half years?not the thirty to forty years that you would expect. Why? Because something else takes their place.

To add serious years to your life -- and life to your years -- you have to lower your risk for all diseases. And the only way to do that is to slow your rate of aging on the cellular level. Curing cancer or any other disease does not necessarily do anything to change the nature or speed of your bodily aging process. That's because aging and disease?although they interact with each other -- aren't the same thing. As we grow older, all of our systems slowly deteriorate, which makes us more vulnerable to disease. By slowing the aging of our cells while simultaneously preventing disease, we can enjoy not only a higher quality of life but a much longer one as well. This is where we're taking YOU.

Of course, the reason why aging is so intimidating isn't because it appears to sneak up on you like a first-rate mugger. In reality, aging is more like a savvy bank robber who's spent months casing the joint. Why the discrepancy? Because there are huge delays between the cause of the problem and the effects you actually see in your life. And that means you have to start building defenses in your thirties, forties, and fifties against attacks that may not occur until your sixties, seventies, and eighties.

Fortunately, science has finally figured out most of the spectacular biological processes that control aging. And by learning about such things as mitochondria, telomeres, sirtuin, nitric oxide, and the vagus nerve -- which you will do in this book -- you'll appreciate how to apply these remarkable discoveries to your own life. As we take you inside your own body, you'll learn about the shoelacelike chromosome that affects memory loss. You'll discover the body's cellular energy factories that play a role in damaging and preserving your arteries (and you thought it was all due to the buttered biscuits). You'll even figure out whether you're a good candidate for hormone therapy as you age and understand how your third eye controls your sleeping pattern (yes, we said third). Ultimately, by understanding the science behind your body, you'll slow your rate of aging -- to live long and strong. While science holds the keys, only you have the power to unlock your potential longevity.

After all, aging may be inevitable, but the rate of aging is certainly not.

Your Body, Your City

Perhaps the best way to explain the dynamics of aging is to take a look at another complex system that's subjected to the same forces as your body: a city. Some cities remain beautiful and elegant in their old age (think of old but elegant European cities like London), while others that may not even be so old look worn down, beat up, and in need of an urban ICU. Every city experiences the ups and downs of aging; how well the city managers and residents adapt largely determines whether the city will age gracefully or end up on the wrong side of spray paint, riots, and urban decay (see Figure Intro 1).

Now, every city has its own genetic code, just as you have yours. For a city, genes are geography -- whether it's built on a river, or whether it's located in a hot or cold climate, or whether it lies directly in a prevalent hurricane path. The city's geography can't inherently change. But the city can adapt to that environment, with earthquake-proof construction, underground tunnels for walking in wintertime, or a ferry system for commuting. The adaptation the city makes to survive and to thrive is what's crucial to its vitality. The same goes for YOU.

Just because you've been dealt a genetic hand that predisposes you to heart disease or diabetes or needing pants as large as a parachute doesn't mean that you can't mitigate the effects of those genes. One of the major things we'll teach you is that while you can't change your genes, you can change whether they are turned on or off, or how you express them. Not every aggressive detrimental gene needs to be turned on, and not all of your sleepy protective genes have to remain dormant. Just like a city, you can compensate elegantly if you understand your options. After all, Rome is called the eternal city.

While some cities can deteriorate if they're not managed well, others can be maintained and revitalized if the right resources and investments are made available. That's the way you, too, can live gracefully and passionately with a fundamentally older infrastructure. Throughout the book, you'll learn many ways to manage your personal metropolis. You'll see that your immune system is your body's police force. Your arteries are like roadways that can be clogged, blocked, or worn down by years of abuse. Your brain is like the energy grid that supplies power to the entire city; it can be knocked out here and there if you let neurological branches fall on your power lines. Your skin, in many ways, is like a city's parks and green space, contributing to the overall sense of beauty and vibrancy. Your fat? Yep, landfill.

You? Consider yourself the mayor, with the power to make all the decisions about what's best for your biological city.

Our ultimate goal isn't just to keep your biological city from naming tumbleweed as the town flower?in other words, to keep you from dying (though that sure is a biggie). Our goal is to put your body at the top of the "ten best cities to live in" list. It's to make it vibrant and hip, with lots of resources and good management of those resources. Perhaps most of all, it's to give it the ability to adjust rapidly to changing times?to reinvent itself.How will you get to know your city and all of the things that influence it. Here's how we're going to introduce it to you: Science has pointed to fourteen major processes that drive almost all of the aging we experience. Those causes of aging -- everything from wear and tear to neurotransmitter imbalances?indicate the tools you'll need to get at what you really want: to help your body live younger and stronger, and to have more energy than a Labrador puppy.

Throughout the book, you'll encounter these causes of aging in special sections titled "Major Ager"; in the chapters between, you'll discover exactly how the Major Agers affect various parts of your body and find specific, practical suggestions about how you can counteract their effects. Understanding the reasons for aging will give you insights into the action steps for extending your own warranty, which we unveil in the last chapter.

Along the way, look for these features to help you learn about your body:Major Agers: These are the major drivers of aging that most folks have never heard of, but they work behind the scenes to age our cells. (Without our cells, we don't do so well.) Understanding these Nobel Prize-winning processes will make you a lot wiser as you wade through the littered terrain of antiaging therapies. At the very least, they'll make you sound smart around the water cooler. Take a look at our crib sheet on page 17, which summarizes these Major Agers so you can see which ones can tip the youthful scale in your favor.

YOU Tests: The beginning of each chapter will start with a quick test that you can take to assess where you stand on the aging scale. These interactive moments will give you new insights into your own body?and how young it's working.

YOU Tips: At the end of each chapter, we'll list a bunch of actions and strategies to keep your body working as vibrantly at sixty as it was at thirty-five. These tips?some admittedly controversial?will provide information about simple changes you can make to alter the complexities

of your body. Whenever the science gets thin because we can't accurately extrapolate fifty years into the future, we offer the advice that we would give our families.

YOU Tools: On page 334 and throughout the book, we've created programs that you should implement in your life. They'll help you decrease stress, stop smoking, get the right lab tests, deal with anger, and so many other things. In addition, you'll get a special chapter on ways you can improve your body (and mind) with workouts that work for everyone.

The YOU Extended Warranty Plan: At the end of the book, we'll provide a fourteen-day plan for doing the little things every day that make a big difference so that you can live longer and live younger. This plan will serve as the blueprint for your future decades.

YOU: The Principles of LongevityIt turns out that one of the best predictors of aging isn't how slowly you drive in the left-hand lane or whether or not you wear plaid pants. It's your own perception of how healthy you are. So indulge us for a moment and answer this question:How healthy are you compared to other people your age?v Excellent

v Very good

v Good

v Fair

v Bad

If you selected fair or bad, you're thirty times more as likely to die in the next two years. If that's not enough to scare the Pop-Tart right out of your mouth, then we're not sure what is. But we're not in the business of trying to frighten you to make changes; we simply want you to see that you're responsible for making your own "most livable city" list. Are you happy in your body? Do you want to live there? Where do you rank your own health? Would it top anyone's list?

The answers to these questions provide the ultimate answer to how long and well you will live. Why? Because the truth is that you likely have a gut feeling about how well you're living; about how healthy you are and about your personal weak links. Your innate feelings about your body may lead to the ultimate insight?that you may not be headed in the right direction. Luckily, science is here to help. And given what science has uncovered recently (recently, as in, some of this stuff could never have been talked about ten or even five years ago), you're going to be able to make the changes.

Before we jump into the book with explanations about these wondrous biological processes?and the specific conditions and aging-related problems you can control?let's explore what, in fact, science has found. Once you understand these new principles of longevity, you'll be better equipped to shift your actions. These five principles will change the way you think about the way your body ages.

1. Aging Is Really About Trade-offs

Despite what you think, aging?in the traditional way that we think of it, with everything slowly and painfully shutting down?isn't "meant to be." It's not an effect of life. It's actually more of a side effect of a grander plan for humans.

A lot of people think that creaky joints, craggy nails, and cranky bowels are simply part of the deal. You get to live to eighty-something; then, in exchange, you're going to have your fair share of misery along the rest of the way. Horrible being old, eh? Hold on. Yes, there is a trade-off, but it's not that one. If you take a look at every biological process that happens in your body, there's an evolutionary reason why it works that way, and that reason, without fail, is to ensure the survival of the species. That is, evolution has deemed the perpetuation of your genes to be much more important than the perpetuation of your individual life. Your biological processes are designed to protect you only long enough to reproduce and to raise your young. In fact, it wasn't until the mid?twentieth century?at least in developed countries?that human beings could expect to live much beyond their reproductive years.

Those processes that make perfect sense for reproduction may not work in your favor as you get older. That's aging. The systems designed to protect you until you finish reproducing (whether you're actually reproducing is unimportant) can be maladaptive as you age. When you look at aging through the lens of the gene, rather than the lens of the individual, it all makes much more sense. These trade-offs are what we'll occasionally refer to as the YOU-nified theory of aging?the fact that aging isn't some master plan for life but, rather, an offshoot.

2. Aging Isn't About Breaking Down as Much as It Is About Repair

Stuff breaks. Cars, computers, and relationships all have their own breaking points. And to suggest that stuff will not break either through acute injury (a five-alarm fire or a torn knee ligament) or from wear and tear over time (a fifty-year-old roadway or an overused back) would be misleading. While it's obviously important to keep your biological systems from breaking down, the real secret to longevity isn't whether or not you break; it's how well you recover and repair when you do. Our bodies, in fact, weren't designed not to break down (legs as thick as redwoods may not break, but they wouldn't be very nimble). They were designed with a great efficiency and ability to repair themselves.

As with a car, you'll get a lot more mileage out of your body if you perform routine maintenance. Aging is essentially a process in which your cells lose their resilience; they lose their ability to repair damage because the things you might never have heard of (until now), like mitochondria and telomeres, aren't working the way they should. But it's within your power to boost that resilience and keep your vehicle going an extra couple hundred thousand miles.

3. Aging Happens from Both the Inside Out and the Outside In

Many of us like to think that aging is a magical process that happens deep within our bodies; that some so-called gremlins of gerontology ratchet down our cells and our systems so we grow old. You'll learn in this book that aging is not only about those cellular processes, but, more important, it's how you respond, adapt to, and deal with the stressors that affect you from the outside?things like sun and stress and slippery sidewalks. What does that mean? It means that aging is really about the rate of aging?specifically, how the outside and inside factors accelerate or decelerate your aging. Here's the big secret about aging: Your rate of aging doubles every eight years. So, if we were able to maintain a forty-year-old's rate of aging for the rest of our lives, we would live past age one hundred twenty and "die of old age." While inside out and outside in both play a role?and both influence each other?your job is to try to manage both forms, so that you slow the real culprit in growing old: the rate of aging.

4. Aging Is Not About Individual Problems but Compounded Ones

Spend any time at a deli counter, and you know that Swiss cheese has two different looks. Big holes or small holes, all in random order and patterns. A good way to think about aging is to imagine yourself looking through a dozen slices of stacked-up Swiss cheese (see Figure Intro 2, page 14). If the holes are small and the slices are thick, you can't see through the stack. Now pretend that each of these Swiss cheese slices represents a layer of protection that your body provides to prevent aging. People who are vibrant and strong may have small holes in their system?stuff that lets through a few problems, but nothing too major. Maybe they've got a little hole in their slice of heart health, and a few little holes in their slice of brain health, and a medium-sized hole in their slice of chromosome health. Nothing major lets you see through the stack.

As aging takes effect, however, those holes can get a little bigger, or the cheese can get a little thinner. When big holes from one slice perfectly align with big holes from another slice, then, in effect, you've got big problems. That's a little bit what aging is like: The small problems may not have a big effect here and there, but when they grow, and when they interact with other problems, then you've created what we like to call a (cue scary orchestra music) web of causality. That's when seemingly small health problems spiral into bigger ones?all possibly triggered by several different causes.

5. Aging Is Reversible?All You Need Is a Nudge

Most people think aging is a landslide of a process, that we're destined to use walkers and hearing aids and thick glasses no matter what. And while we're not saying that you will absolutely avoid all the bumps (big and small) along the way, we are saying that aging isn't as inevitable as a morning trip to the bathroom.

What you will learn in this book is how to nudge your systems so that they work in your favor, to create leverage points in life. And the great thing is that it's never too early or too late to start making these changes. You don't need a complete overhaul, because, frankly, your body is a pretty fine piece of machinery. What you'll ultimately do is find and fix your own personal weak links?the things that make you most vulnerable to the effects of aging. The cumulative effect of those nudges, though not major from a behavioral or even a biological perspective, can be huge when it comes to increasing the length and quality of your life.

The truth about aging is that you -- right now -- have the ability to live 35 percent longer than expected (today's life expectancy is seventy-five for men and eighty for women) with a greater quality of life and without frailty. That means it's reasonable to say that you can get to one hundred or beyond and enjoy a good quality of life along the way. While relying on the talents, skills, and knowledge of others may get you out of a medical jam, what you really want is to avoid it in the first place. Restricting calories, increasing your strength, and getting quality sleep are three of nature's best antiaging medicines. Together, these activities -- as well as the other actions we recommend -- control 70 percent of how well you age. Wouldn't you want to hold the power of your future in your hands, rather than put it in someone else's?

Just because you've made mistakes in the past doesn't mean you can't reverse them. Even if you've had burgers for breakfast or fried your brain cells with stress, you're not necessarily destined to wear husky pants and forget birthdays. No matter what kind of life you've already led, aging is reversible: You can have a do-over if you want it. If you perform a good habit for three years, the effect on your body is as if you've done it your entire life. Even better, within three months of changing a behavior, you can start to measure a difference in your life expectancy.

As we said, aging is inevitable, but the rate of aging is not. Consider this fact: Only 10 percent of people are classified as frail when they're in their seventies. By the time people reach one hundred, almost 100 percent are considered frail. What we're trying to do is make sure that percentage stays lower for longer. We want you to feel as good at the end of the race as you do at the start.

Our goal here is to ensure that you have a high quality of life until whatever time -- forgive our bluntness -- you drop dead. That's the ideal scenario, right? Nobody wants to spend their golden years on diets of Jell-O, suffering from bedsores, or not remembering the previous nine decades. You want to feel like you're thirty even when you're eighty. You want to have the wisdom of a grandparent without feeling like one. So our goal isn't to get you to 120?unless those 120 years come with quality.

After all, living longer shouldn't be about "taking longer to die," which is what so many people think it means. It should be about enjoying every moment of a longer life?and taking longer to live.

You want to live long and live well. You want to feel alive while you're living.You don't want to grow old. You want to stay young.This is the way.Now hup to it.

From YOU: STAYING YOUNG by Michael Roizen & Mehmet Oz. Copyright © 2007 by Michael F. Roizen, M.D. and Oz Works LLC. Reprinted by permission of Free Press, a Division of Simon & Schuster, Inc.