Do children age you? Telegraph readers' longevity questions answered by a doctor
Claire Steves is a professor of ageing and health at King's College, London, and a consultant geriatrician at Guy's and St Thomas's NHS Foundation Trust. She has spent decades studying the ageing process and has published more than a hundred scientific studies on this topic. We asked her your questions about how to age well and live for longer.
I recently had an ECG and my cardiologist told me that it 'looks as if you have had a mild heart attack'. I drink moderately and only with my evening meal: a glass of white beforehand and a glass of red with dinner. I swim 40 laps of a 25m pool three times a week, and have done for the last 40 years. I've been told that I need to take statins, but blood tests and a CT scan seem to show that I'm OK. Do I need to change my lifestyle?
Anonymous, 81
So, you've obviously had some changes to the health of your heart that have shown up on your ECG. Your doctor seems to think that you've had a mild myocardial infarction (heart attack), but such changes can be non-specific. When you're faced with a doctor's interpretation, it's always helpful to ask why they have that perspective and whether anything else could be going on.
Anyway, when a mild infarction is picked up, we all want to prevent another, more serious attack from happening. This is what we call secondary prevention, and here we look at both lifestyle interventions and medications that might be helpful. Presumably you will have been given aspirin to thin your blood, and possibly beta blockers to keep your heart rhythm regular and other medications to protect your heart and kidneys.
So what do you need to change about how you live your life? I'm pleased to hear that you swim so regularly, as exercise is really important for the health of your heart and your whole body. It's the best thing you can do to age well apart from avoiding smoking.
Your alcohol intake, however, is a different matter. Back at medical school 30 years ago, we thought that having a few drinks a day, as you seem to, was safe and perhaps even better for you than not drinking at all. Modern science however shows that this is not the case. For your heart but also your brain, liver, muscles and balance and risk of falls, it would be better if you could reduce your drinking further, to zero, optimally. But of course, you need to decide whether that's something that's worth it for you in your life.
If you do decide to cut out alcohol, I'd recommend having a green tea before dinner instead. It may not give you the same 'buzz' but multiple studies have shown that the drink is protective of your heart and also improves your cognition.
I go on a half-hour brisk walk with my dog twice every day, followed by flexibility and weight-lifting exercises (2.5lb on either side). I also do squats. People say that I look much younger than I am, and my resting pulse is 60. Is there anything else I can do to age well?
Chris Hutley, 91
You have a fantastic routine, not only for a person of your age. We've learnt more about the importance of resistance or strength training as you age, so I'm most pleased to hear that you're doing this regularly. Your squats are working your quadriceps, the biggest muscle in your body, and it's a very functional movement: it'll still be helping you to walk up the stairs and stand up from the sofa when you're 102, I'm sure.
It is also fantastic that you are getting out with your dog so frequently. Research shows that a 45-minute walk, three times a week, is enough to protect your brain health and cardiovascular health. You are far surpassing this. The social interaction you're likely getting with other dog walkers will have its own benefits too as loneliness ages us quickly.
What you haven't mentioned is your diet – this is the second pillar of healthy ageing after exercise. One important thing you can do for yourself here is to eat enough protein. Older people actually need slightly more than young adults do, to maintain their muscle mass. You can train all you like but if your diet isn't right then the muscle won't follow. It doesn't need to be masses: somewhere between 70-100g per day for most people, or 1.3g of protein per kilogram of body weight, is right, and quite easily consumed in a day.
Plant proteins are just as good as meat for maintaining muscle. I'd recommend that you get a mix, and that you eat a lot of colourful plants too, which contain flavonoids and phytonutrients which help you age well and protect your gut microbiome. For many people in their 90s, though, I'd recommend eggs. Eggs contain a good serving of protein, but also healthy fats which are excellent for your brain health.
Does having a baby inherently age you? I didn't sleep properly for about a year (and sleep is still up and down, even though my child is now three) and I'm wondering if that will have detrimentally impacted my health in the long term. Not to mention the fact I am constantly rushing around trying to balance it all
Anonymous, 36
We know that having a child makes women age differently than they otherwise would. Women experience more frailty in old age than men, despite living for longer, and we think that this could be in part a result of being mothers, perhaps because of lack of sleep and hormonal changes.
Interestingly, research suggests that having children ages you differently based on where you are in the world. In less affluent countries, women with children seem to do better in older age, likely because of the additional resources and support that having children brings them. In richer countries like Britain, having children seems to be an accelerator of age. However, we currently don't understand as much about the link between motherhood and ageing as I and many other experts would like. More research is needed on this topic.
My advice for you right now is not to worry about this too much. Focus on looking after yourself (and your child), protecting your sleep as much as you can. Aim to get bed at least eight hours before you need to wake up, to account for the time it takes you to drift off or spend awake in the night, and to enable seven hours of actual sleep. Don't be afraid to ask for help from others around you to help you achieve this.
Can we slow down or even reverse the effects of ageing for women's egg quality? Are there any supplements that help with this?
Catherine van Zeeland, 44
You can't 'reverse' the age of your eggs, because egg cells are formed while a woman is still in utero, actually still inside her mother. Your eggs will have remained in a remarkable state of suspension while you age, until the moment that you ovulate. Thus, contrary to what many people think, the ageing of sperm and eggs is quite different. Many women are aware of the increasing risk of chromosomal abnormalities with maternal ageing, as the eggs come out of suspended animation, but did you know that older sperm is more likely to have genetic point mutations that can lead to health issues in offspring?
Given how complex the menopause is, I think it's better to see it as a developmental stage rather than a part of the overall ageing process. Anthropologists believe that the menopause happens because it frees older women from the responsibility of giving birth to more children, meaning that there's an extra pair of hands to help with young families. It also allows older women to take on leadership roles in their communities, and share their knowledge with the new generation. Hence why many societies in our world are matriarchies. We humans are one of a very small handful of species that undergo it at all – it's just us and two or three species of whales, and possibly chimpanzees.
One caveat when it comes to ageing and fertility is that as you age, the FSH hormone in your system, which stimulates ovulation, starts to have different sugar molecules attached to it, which seems to affect the way the ovary responds. There are changes in sugars coating many molecules relating to other aspects of the ageing process too, which we think we can change through lifestyles, and thereby improve health. More research is needed to fully understand how this affects fertility, but keeping your metabolic health in check as you age – in other words, eating a healthy diet and avoiding high amounts of refined sugar – would be very wise.
Should I continue to work or retire in the next few years? I want to keep earning for a comfortable retirement, and I enjoy my work, but I want more time to see my children and grandchildren. My other passion, shared with my partner, is playing music, and further developing my abilities there. I consider myself to be in excellent health. Given my age and what's important to me, what should I do?
Martin Richards, 72
When to retire is an enormous question, and one we all ought to give careful thought to, as it can have huge consequences on our health. The state of course says that you can retire at 66, as a man, but some studies suggest that retirement leads to a drop in self-reported health and life satisfaction. We might moan about them, but our jobs are an important part of our identities, our social lives and in some cases, the amount of physical activity we get.
Fortunately, this quandary has been studied extensively in recent years, by scientists at the English Longitudinal Study of Ageing. They found recently that the best thing you can actually do for your health is to pick up a new job at retirement age, over sticking with the same one or stopping altogether. (Though it might be that there's something special about the group that take up new jobs later in life that keep them ageing well – so this isn't definitive).
Now, I'm not suggesting that you need to pick up shifts at your local pub or become a groundsman to maintain your excellent health. What's key in your time of life is to make sure your days are rich in mental, social and physical activity. You haven't said what it is that you do for work, though the fact you enjoy it suggests that it's mentally stimulating. From your longing to see more of your children and grandchildren, it sounds like you might not currently get all of the socialisation that you need.
My advice is to weigh up whether your life will be more or less 'rich,' in all the meanings of that word, without work. What you haven't mentioned here is how much exertion your job causes you. Some studies do suggest a sharp drop-off in health after retirement. Usually this is to do with a stoppage of physical activity (the transition from the walk to the office, however brief, to whole days spent on the couch). Getting enough physical activity should be a key part of your calculation.
Here is the best tip I can give: to reap the most benefits when you choose to retire, treat that like a new job in itself. Make a plan and work out how to live the rest of your life well. I'm especially pleased to hear about your love of music. Playing musical instruments is one of the best ways to keep your cognition and mental faculties sharp as you age. Please ensure that you keep this up.
I've heard that your appetite shrinks and you become less interested in food as you age. Is there anything you can do to prevent this and keep taste buds sharp, so that you can keep enjoying food?
Anonymous, 34
Older people eat less, and we need fewer calories as we age – that's certainly true. But we all know people in their 70s and 80s who love food. One study I led found that people who lose their appetite when they age have less diverse gut microbiomes. We can't be sure that there's a causal relationship, but it would seem to be the case that protecting your gut health will keep your appetite alive for decades to come. The best way to do that is by eating a healthy diet, one that's rich in polyphenols and dietary fibres – so lots of fruits, vegetables and whole grains.
A huge part of the taste and enjoyment of food is its smell. Your sense of smell also changes as you age, in relation to the cognitive changes in your brain. So the best way to sharpen your sense of smell, and therefore your taste buds, is to do all the things we usually advise to preserve neuronal function. Stay physically active, drink as little alcohol as possible, and again, maintain a varied, plant-rich diet.
Do we know why memory for names seems to disappear early with age-related cognitive decline? It is happening to me and most of my friends!
Anonymous, 72
Forgetting names is very common with age, as you say. It's only really a worry if you find that you forget the names of people who are very important to you, like your grandchildren or closer friends. More concerning is when patients I see forget the names for different things in the world – such as referring to a particular animal as a 'bird', when more specifically, it's a penguin. Both can be signs of neurodegeneration. In either case, I would urge you to get checked out for dementia.
Happily, it doesn't sound like this applies to you, and instead you're experiencing the very normal and inconvenient phenomenon of forgetting the names of acquaintances from time to time. There's no specific science to illustrate why this happens; we simply know that memory declines with age in healthy adults. My suspicion, having worked with lots of older people, is that names serve an important social function and so present more opportunities to be forgotten. You'll just as likely forget the name of a Latin plant, or the Greek island you visited 40 years ago, but you won't often be expected to recall either in conversation.
Fortunately, there are lots of little tricks and games you can try to practice your memory for names and avoid social awkwardness. Linking a name to a memorable object can be really helpful, as can writing down a name and visualising it.
How late is too late to start when it comes to slowing the ageing process, and what are the most useful things that someone my age can do?
Therese Clancy, 76
We often think of anti-ageing as being a concern for the 'not yet old' – those in midlife or younger. But your 70s are as good a time as any to focus on ageing well, and increasingly, research suggests that our brains can remain malleable into the late decades of our lives. This is great news for the health of your brain and your mental health, but certainly, there are still changes you can make to help your body age well too.
As I've told other readers, being physically active is crucial to your health in older age and staying fit will help to stave off frailty. You must take things slowly, however, and stretch well before you go on a brisk walk or lift any weights – which I'd advise you do, as it's a good way to maintain muscle mass. Stretching well in the morning, and before exercise may help reduce risk of injury.
As to vitamin supplementation, adults who are replete in their essential vitamins don't need to take supplements, but older adults often develop deficiencies (even if they eat well), and so asking your doctor to check for common vitamin deficiencies could help you replace what you need. You might consider upping the amount of plants in your diet to support your gut microbiome, as this can change as you age and improving your diet with plant fibres can help reverse this, even in later life.
Sleep changes as we age. We know that older people get less of it, but giving yourself an eight-hour window each night is good for your brain and body. Contrary to previous research, new wearable data suggest that you can't get too much of actual sleep.
My skin has become so thin that even the slightest bump can cause tears in the skin on my arms and legs. I'm asthmatic, and have been on corticosteroids since my early 40s. Is there anything I can do to stop this condition from getting worse, other than keeping my arms and legs covered?
Jane Reid, 71
Being 'thin skinned' isn't just a metaphor. As you age, your skin does become less thick and this can leave you at greater risk of tears and bruises. Being on certain drugs, like the corticosteroids you mention, can further thin out your skin. It's important that you protect your arms and legs because those tears can lead to cellulitis, a nasty bacterial infection.
It can also be helpful to avoid washing too heavily with soap. Only use as much as you need, and apply an emollient straight after you've finished in the shower, to give your skin the best chance to absorb it. Unfortunately there's little science on the best kind, but lots of people around the world swear by pure shea butter as a fantastic thing for thin skin, and other skin problems. I'd recommend this, as supermarket lotions contain lots of different petrochemicals, and we don't yet know exactly how they might affect your health. Happily, pure shea butter is available in lots of shops, and it's relatively cheap.
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