How to Live Longer: Truths and Myths

March 8, 2011 — -- Drs. Howard Friedman and Leslie Martin studied 1,500 people at Stanford University to find out who lives the longest and why. Their book, "The Longevity Project: Surprising Discoveries for Health and Long Life from the Landmark Eight-Decade Study," documents the findings of this study. It discusses the character traits they found associated with long life, and addresses some of the common myths about longevity.

Read the introduction to 'The Longevity Project' below.

Introduction: The Breakthrough Studies of a Lifetime

In September 1921, a talented young schoolgirl named Patricia and her precocious classmate John were pulled out of their San Francisco classrooms by a Stanford University psychologist, Lewis Terman. Dr. Terman was looking for gifted children and had asked their teachers to pick out the brightest kids in the class. He was interested in the sources of intellectual leadership and wondered if he could identify early glimmers of high potential.

Eighty years later, both Patricia and John were still alive at ninety-one years old. They had beaten the odds and lived very long and healthy lives. What was their secret? In an effort to find out, we have spent the past twenty years following up on the people in Dr. Terman's studies and investigating why some people thrive well into old age while others fall ill and die prematurely. Along the way, we've discovered that many common health recommendations are ill-advised or simply wrong. We've replaced those with more accurate guideposts to a longer, healthier life.

The 1,500 or so bright boys and girls selected by Dr. Terman were born around 1910. Almost all of them are now gone. We have documented when and how they died, and we have studied their lives in meticulous detail. Although many died by their sixties, many others aged in good health and lived well into old age. Surprisingly, the long-lived among them did not find the secret to health in broccoli, medical tests, vitamins, or jogging. Rather, they were individuals with certain constellations of habits and patterns of living. Their personalities, career trajectories, and social lives proved highly relevant to their long-term health, often in ways we did not expect.

The usual piecemeal suggestions given to those who want to improve their health ("relax," "eat vegetables," "lose weight," "get married") are lifesaving for some but neither effective nor economical for many. In fact, standard medical advice often backfires, leaving us overweight and stressed out as we struggle to follow specific edicts. Our society spends a fortune on health care, fad diets, pharmaceuticals, and a variety of short-term remedies that help somewhat; but there is often disappointingly little effect on our long-term health and longevity.

The late comedian and actress Lucille Ball had her own secret to staying young: live honestly, eat slowly, and lie about your age.i Lucy was both right and wrong. Living honestly, our data show, really can be important, but eating slowly doesn't much matter. Lying about your age and your health does indeed represent a challenge to health researchers, but we have figured out ways to outwit the Lucys of the world and get around this common source of research bias.

In our studies we focus first on longevity—length of life. Many studies of well-being are flawed because they rely too heavily on participants' answers to queries about their health and wellness—called their "self-report." Their self-reported answers are subjective and often inaccurate. Longevity is not distorted by self-report. Although there is a field of study on the reliability of death certificates, it is pretty much the case that if your death certificate says that you died on April 26, 1989, then we can be reasonably certain of your longevity and of your state of health on that date. Lucille Ball was not a participant in Dr. Terman's studies, but, as we shall see, one of her closest associates was.

Many common beliefs about health and longevity come from a host of biased sources—with distortions that go well beyond the self-report biases. Aside from the self-interest research biases we hear so much about (in which someone has a financial stake in the findings), there are also many sources of inadvertent skew or error. If you think about it—as we do every day in our laboratory—you come to realize that we can never be quite sure about the validity of many health studies and claims.

Of course we can study individuals who stay healthy, but to whom do we compare them? If we knew that two people started out exactly the same at birth but one ate only broccoli while the other ate only fried steak, then we might have a reasonable comparison. But almost all epidemiological studies, even those making daily headlines, compare people who differ in many, many ways. Indeed they differ in ways we cannot know about. Most comparisons of vegetarians and cheeseburger addicts, or of pill-takers and the pill-averse, therefore are necessarily somewhat flawed. The researchers generally do their best to be as accurate as possible, but there are always limits in a complex study of human health. And the statistics that emerge from the studies can be interpreted in many different ways.

One of the best ways to avoid research traps and biases is to follow individuals for their whole lives and see which characteristics influence subsequent qualities, behaviors, and outcomes. What exactly causes people with similar backgrounds to diverge in terms of their health and well-being? This step-by-step procedure is exactly what we have done, and this book is the first comprehensive report of the findings.

Tracing the lives of hundreds of individuals, we have discovered new twists to common health recommendations, such as when staying single or getting divorced can be healthy for women. Our studies have uncovered a series of what we call dead-end myths—common advice that is not supported by good science and can lead to dead ends in more than one sense of the term. Throughout this book, we'll explain exactly why the following common beliefs, to name a few, are false:

--The best of men cannot suspend their fate: The good die early, and the bad die late. (Myth!) --Get married and you will live longer. (Myth!) --Take it easy and don't work so hard and you will stay healthier. (Myth!) --Thinking happy thoughts reduces stress and leads to long life. (Myth!) --Religious people live longer, so don't miss religious services. (Myth!) --If you have hobbies like gardening, walking, and cooking, you should take up more vigorous forms of exercise. (Myth!) --Worrying is very bad for your health. (Myth!) --If you believe that you are loved and cared for, then you are on the road to good health. (Myth!) --Retire as soon as you can and play more golf to stay healthy and live longer. (Myth!) --If your child is very serious, encourage him or her to be more spontaneous and have more fun. (Myth!) --Give your children a big head start in school and they will thrive for life. (Myth!) --You can live to be a hundred only if you give up all the things that make you want to live to be a hundred (as Woody Allen is said to have joked). (Myth!)

Most books about health and longevity are cookbooks -- literally or figuratively. When they aren't giving you recipes (start Week 1 with spinach sautéed in garlic and olive oil) and food lists (an apple a day), they're offering a list of ten dos and don'ts (do exercise for thirty minutes four times a week; don't let your weight rise above a certain ratio to your height).

Exercise, diet, stress, and weight are indeed relevant to health, but in ways that vary from person to person. Lists of dos and don'ts are nearly impossible for most of us to follow for days, months, and years. Thankfully, the Terman study participants showed us that struggling with lists of specific health rules is unnecessary. The Terman men and women were born decades before running shoes, designer spas, and fancy medical tests were invented, yet many lived long, healthy lives. We'll show why.

The point of describing our findings is not to lay out the factors that are likely to leave you the last one standing. Most of us, after all, would not wish to live extra years if they were years of constant decline and pain. But the fact is, those who live longer are also generally healthier throughout their lives. Most people who live to old age do so not because they have beaten cancer, heart disease, diabetes, or lung disease; rather, the long-lived have mostly avoided serious ailments altogether.

Because Dr. Terman began studying his participants when they were very young, many of the insights that emerged are helpful not only to adults looking to get on a healthier life path but also to those hoping to set their children on a good track. Many of our findings can help people rethink the potential long-term effects of their parenting decisions, as well as promote their whole family's future health, happiness, and well-being.

We found that those who are healthier tend to be happier, and those who are happier tend to be healthier—but not for the reasons you might first imagine! The lives of the Terman participants open a new window to understanding the intriguing relationship between health and happiness. Our research yielded powerful suggestions for cultivating not only a long life but also a successful, meaningful, and productive life.

The Amazing Study

When Dr. Terman began studying Patricia and John and these hundreds of other bright boys and girls in California, he collected all sorts of valuable information about the children's families, schooling, and activities. He recorded how many books were in their houses, how active they were in their playtime, and how happy their parents' marriages were. He measured their personalities—were they prudent, extroverted, cheerful? He then followed his participants as they grew up, made career choices, and had families of their own.

When he launched the study in 1921, Dr. Terman was in his mid-forties. He died in 1956, but the project continued, carried on by others. We began serious work on this study in 1990 and so often use the phrases "our study" or "our project" when talking about analyses, findings, and interpretations. But this is not in any way intended to ignore or minimize the tremendous debt we all owe to Dr. Terman, to his collaborators, and to the Terman participants and their families.

A key to success for much of our work on better understanding health and longevity was gathering the death certificates of Terman's study participants from states and counties across the United States. It turned out to be a very difficult and time-consuming task, as each state, county, or city agency has its own procedures and requirements for obtaining a vital statistic document like a death certificate. (Here's a tip: if you want to be studied by health researchers, don't die in New York City.) But we persisted and now have this invaluable resource.

Having determined how long each of the Terman participants lived (and the precise cause of death), we were able to design and conduct a series of studies that were never before possible. We used both sophisticated statistical models and a variety of examinations of personalities, social relations, and behaviors. We looked at people who shared characteristics—those with similar personalities, say, or a history of divorce -- to see whether those traits predicted their health over time. Many of our findings took us by surprise.

You may be wondering if it's fair to generalize from these Terman study participants, who lived in different times and were mostly bright, educated, and middle class. Are the lessons of their lives applicable to people today? It depends on circumstances: a migrant farm worker with little access to education or health care, or a poverty-stricken peasant infected with HIV, has other, more significant threats to his or her health. However, most readers of this book—people who are bright, educated, and interested in health and success—are usually not that different in relevant ways from the Terman participants.

Still, of utmost importance throughout our work has been the effort to confirm that findings from our studies are highly informative for a general understanding of health and longevity. We therefore have spent much time and effort evaluating whether our results are more widely applicable. The answer is yes. We have used a number of scientific techniques to confirm this point. To validate old scales and measures, we conducted comparison studies using contemporary measures from contemporary samples of young people. We have used various statistical tests and adjustments to see if any significant limits would arise from our particular samples of participants. And, before drawing any firm conclusions, we have always compared our findings to what is more broadly known from other research.

As they grew into middle age, the Terman participants were a productive, intelligent segment of twentieth-century middle-class America. They lived through depression, war, and prosperity. They were engineers, businesspeople, housewives, lawyers, administrators, writers, teachers, and all sorts of other blue- and white-collar workers. Most were not particularly notable on a national scale, although you might recognize a few names. None won a Nobel Prize, became a national political leader, or joined the superrich, although some were very prominent in their fields of endeavor. Some died young and some lived to be a hundred.

One of the accomplished individuals in our study was Jess Oppenheimer, who worked with Lucille Ball to create the I Love Lucy show. Although the information in the data archives is strictly confidential, some of the Terman participants proudly identified themselves as part of the project. Mr. Oppenheimer was one of the best known. Oppenheimer was born in San Francisco in 1913 and lived to age seventy-five. He spent most of his adult life in the entertainment business in Los Angeles. In the 1960s, after I Love Lucy, Jess worked on the comedy series Get Smart. He married, had children, and later wrote about his career. One hint of his broad-ranging intelligence was that he received a patent in the 1950s for his work on a teleprompterlike device, which Lucy used in reading commercials while looking into the camera lens.

The case of Jess Oppenheimer gives a good illustration of the general biographies of the people we have studied. They grew up in California and often remained there. The male participants gravitated toward what they saw as the interesting industries of the twentieth century—education, engineering, broadcasting, law, finance, aviation, and sales. Many were financially successful but many others were not. There were many clerks and some artists, policemen, and technicians. One became a truck driver.

The women, however, were often limited in their early careers by the societal expectations of the 1930s and 1940s. Accordingly many became housewives, teachers, librarians, or secretaries. But not Shelley Smith. Ms. Smith (Stanford Class of 1936) went to work for Life magazine, where she met and married the photographer Carl Mydans. Covering World War II in Asia, she was captured by the Japanese in Manila and spent many months in a prisoner-of-war camp. Yet she lived a long life and died in 2002 at age eighty-six, survived by her husband, a son, a daughter, four grandchildren, and even one great-grandchild.ii

Jess Oppenheimer and Shelley Smith Mydans, like most of the Terman participants, were interesting people who, when not at work, were involved with family, friends, and hobbies. Most married and stayed married, but a significant number did not. Some were extroverted and others unsociable. Some were impulsive and others prudent. Many of the Terman participants faced significant personal and social difficulties and did not make it into their seventies and eighties. Some of their life paths led to health and long life while others dramatically increased the risks of illness and premature death.

Do You Fit the Bill? Assess Yourself

Always amusing to us is the way that the most objective health scientists become personally caught up in this research. Whenever we present our scientific findings at a research conference, our fellow professionals immediately try to see if they themselves fit the profile of the long-lived. Although the ability to predict health outcomes in any individual case is limited, it is possible to recognize patterns that can lead to meaningful changes. So throughout this book we present relevant measures and risk assessments—self-quizzes, if you will. Often these include some of the same questions Dr. Terman used decades ago. These assessments also serve to provide a deeper understanding of the ideas we're discussing. For example, here is a typical question (on one of the measures):

I am persistent in the accomplishment of my work and ends.

Very true of me 5 4 3 2 1 Not true of me

In particular, we present quizzes and measures (and scoring) that you can use to assess yourself:

• Are you conscientious in a health-relevant sense? • Do you have a sociable personality? And are you a good emotional communicator? • Are you a moody worrier? • Are you a gloomy Chicken Little? • Did your early education predispose you to long life? • Are you satisfied with your life in a way that impacts your health? • How physically active are you—on a scientific measure? • If married, how happy is your marriage? • How healthy is your job (for you)? • How do you score on three key measures of social relationships, and especially on the scale most relevant to long life? • How does your level of religiosity (or lack thereof) impact your health? • How masculine or feminine are you? • Are you at risk from health-harming chronic stress?

The "Termanators"

As they grew older, the children in Dr. Terman's study recognized that they were in a special group and in a special study, although no one thought the study would last more than ten or twenty years, much less for eight decades. Giving their identity a special name, they cleverly called themselves "Terman's Termites" or, more simply, "the Termites."

We sometimes use this nickname, "Termites," when referring to the participants in Terman's project. But there are dangers: at one scientific conference, we attempted to present a technical display called "The Longevity of the Termites," but the conference attendees simply ignored us, walking right by our informative exhibit. They evidently assumed that we were entomologists studying wood-eating social insects. Now we are more careful in our terminology.

In any scientific research project, much of the drudgery of data gathering and handling falls to graduate students, who are apprenticed to more established researchers. Our particular project has attracted a number of remarkable graduate student researchers over the years, but after a while they tired of being known as students of "Dr. Friedman's longevity project developing the Terman data." Back in 2005, our graduate students decided that if the participants could be "Termites," then we researchers could be "Termanators." And so they hung a sign outside our lab door: The Termanator Lab. Because we were working at the University of California in Riverside, only about fifty miles east of Hollywood, the name seemed to fit. Despite the nonviolent nature of our work, the plot is the same—to save human lives.

Footnotes

i. Lucille Ball's secret to staying young is quoted in A. Adams, An Uncommon Scold (New York: Simon and Schuster, 1989), 17. Regarding the matter of eating fast (among the Terman participants), relevant information was recorded during a comprehensive medical exam the children underwent in 1922 in either San Francisco or Los Angeles. About half the boys and more than a third of the girls were classified as fast eaters. When we analyzed the longevity data eighty-five years later, we found absolutely no indication that eating slowly promotes longevity. ii. The New York Times obituary of Shelley Smith Mydans was published on March 9, 2002. Excerpt courtesy of Hudson Street Press, an imprint of Penguin.