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Killing Ourselves to Live Longer

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The pressure most of us feel to remain fit, slim, and in control of one’s body does not end with old age — in fact, it only grows more insistent. Friends, family members, and doctors start nagging the aging person to join a gym, “eat healthy,” or, at the very least, go for daily walks. You may have imagined a reclining chair or a hammock awaiting you after decades of stress and, in the case of manual laborers, physical exertion. But no, your future more likely holds a treadmill and a lat pull, at least if you can afford to access these devices. One of the bossier self-help books for seniors commands:

Exercise six days a week for the rest of your life. Sorry, but that’s it. No negotiations. No give. No excuses. Six days, serious exercise, until you die.

The reason for this draconian regime is that “once you pass the age of 50, exercise is no longer optional. You have to exercise or get old.” You may have retired from paid work, but you have a new job: going to the gym. “Think of it as a great job, which it is.”

People over 55 are now the fastest-growing demographic for gym membership. A few gyms, like the Silver Sneakers chain, deliberately target the elderly, in some cases even to the point of discouraging those who are younger — on the theory that older folks don’t want to be intimidated by meatballs or spandexed sylphs. If the mere presence of white-haired gym-goers isn’t enough to repel the young, some gyms don’t offer free weights, partly because the sound of falling weights is supposedly annoying to older people and partly because older people, who are more likely to use exercise machines, may see them as a reproach. In the mixed-age gym I go to, membership tilts toward the over-50 crowd, where “exercise is no longer optional.” The more dedicated may use the gym as only part of their fitness regimen; they run in the morning or bike several miles to get there. Mark, a 58-year-old white-collar worker, does a 6 a.m. workout before going to work, then another one after work. His goal? “To keep going.” The price of survival is endless toil.

For an exemplar of healthy aging, we are often referred to Jeanne Louise Calment, a Frenchwoman who died in 1997 at the age of 122 — the longest confirmed human life span. Calment never worked in her life, but it could be said she “worked out.” While he was still alive, she and her wealthy husband enjoyed tennis, swimming, fencing, hunting, and mountaineering. She took up fencing when she was 85, and even at 111, when she was in a nursing home, started the morning with gymnastics performed in her wheelchair.

Anyone looking for dietary tips will be disappointed; she liked beef, fried foods, chocolates, and pound cake. Unthinkably, by today’s standards, she smoked cigarettes and sometimes cigars, though anti­smoking advocates should be relieved to know that she suffered from a persistent cough in her final years.

This is “successful aging,” which, except for the huge investment of time it can ­require, is almost indistinguishable from not aging at all.

Anthropologist Sarah Lamb and her coauthors of a book on the subject date the concept of successful aging to the 1980s and locate it throughout the Western world, where it also goes by such names as “active aging,” “healthy aging,” “productive aging,” “vital aging,” “anti-aging,” and “aging well.” Lamb reports that “the World Health Organization dedicated World Health Day 2012 to Healthy Aging, and the European Union designated 2012 as the European Year for Active Ageing. In North America and Western Europe, centers for Healthy Aging, Active Aging, and Successful Aging abound. Popular cultural and self-help books on the topic are flourishing.”

Among the titles now available on Amazon are Successful and Healthy Aging: 101 Best Ways to Feel Younger and Live Longer; Live Long, Die Short: A Guide to Authentic Health and Successful Aging; Do Not Go Gentle: Successful Aging for Baby Boomers and All Generations; Aging Backwards: Reverse the Aging Process and Look 10 Years Younger in 30 Minutes a Day; and of course Healthy Aging for Dummies. A major theme is that aging itself is abnormal and unacceptable. As the physician coauthor of Younger Next Year wrote, under the subhead “‘Normal Aging’ Isn’t Normal”:

The more I looked at the science, the more it became clear to me that such ailments and deterioration [heart attacks, strokes, the common cancers, diabetes, most falls, fractures] are not a normal part of growing old. They are an outrage.

And who is responsible for this outrage? Well, each of us is individually responsible. All of the books in the successful-aging literature insist that a long and healthy life is within the reach of anyone who will submit to the required discipline. It’s up to you and you alone, never mind what scars — from overexertion, genetic defects, or poverty — may be left from your prior existence. Nor is there much or any concern for the material factors that influence the health of an older person, such as personal wealth or ­access to transportation and social support. Except for your fitness trainer or successful-aging guru, you’re on your own.

“My diagnosis was a real wake-up call. Life is too short and we all need to really cherish and love one another.”

Unfortunately, the gurus’ instructions are far from unanimous or easy to follow. On the dietary front, there’s no more clarity than can be found in the general dietary advice for adults. Should you go with a paleo diet or one heavy in complex carbohydrates? Should you eliminate all fats that do not originate in avocados or olives? We are widely advised to follow a “Mediterranean diet,” but does that include Greek gyros and Italian charcuterie? Or perhaps we should refrain from eating anything at all. Numerous studies have shown that caloric restriction or intermittent fasting can prolong the lives of rats and other animals, but the debate over its effectiveness in humans goes on, despite the fact that most of us would find a semi-starved life not worth living. If I can discern a general rule, it is governed by deprivation: Anything you like to eat — because it is, for example, fatty, salty, or sweet — should probably be put aside now in the interests of successful aging.

As for exercise, here too we find no precise instructions. Some sources, like Younger Next Year, quoted above, specify the rough amount of exercise, such as six days a week for about 45 minutes per session, and how it should be divided between cardiovascular work and muscle training. But overall, a disturbing vagueness prevails. Often, we are urged simply to “get active” or “get moving,” on the grounds that even the smallest motion can be life-prolonging. “And even if you can’t run a four-minute mile, keep running. If you can’t run, walk — but keep moving.”

For the sedentary, fidgeting at one’s desk can help, along with parking a block or so from one’s destination. A middle-aged woman reports that “I keep maniacally active because if there’s any down time I sit there feeling guilty I’m not doing anything.” Not doing anything is the same as aging; health and longevity must be earned through constant activity. The one thing you should not be doing is sitting around and, say, reading a book about healthy aging. There are bright sides to aging, such as declines in ambition, competitiveness, and lust. A noted feminist, the Australian-born Englishwoman Lynne Segal, found artists often doing their best work in old age, and titled her balanced and richly documented book Out of Time: The Pleasures and Perils of Aging. I can add from my own experience that aging also comes along with a refreshing refusal to strive, to take on every potential obligation and opportunity that comes my way.

But as even the most ebullient of the elderly eventually come to realize, aging is above all an accumulation of disabilities, often beginning well before Medicare eligibility or the arrival of the first Social Security check. Vision loss typically begins in one’s 40s, bringing the need for reading glasses. Menopause strikes in a woman’s early 50s, along with the hollowing out of bones. Knee and lower back pain arise in the 40s and 50s, compromising the mobility required for “successful aging.” As we older people mutter to each other in the gym, “It’s just one damn thing after another,” most of these things are too commonplace and boring even to serve as small talk. The U.S. Census Bureau reports that nearly 40 percent of people age 65 and older suffer from at least one disability, with two-thirds of them saying they have difficulty walking or climbing. Yet we soldier along, making occasional concessions to arthritic joints or torn muscles but always aware that any major cessation of effort, say for two weeks or more, could lead to catastrophic collapse. “You don’t become inactive because you age,” we’ve been told over and over. “You age because you’ve become inactive.”

No doubt immortality would be a more alluring goal if we could imagine surviving without disability. More modestly, the goal of “successful aging” is often described as a “compression of morbidity” into one’s last few years. In other words, a healthy, active life followed by a swift descent into death. But the truly sinister possibility is that for many of us, all the little measures we take to remain fit — all the deprivations and exertions — will only lead to a longer chance to live with crippling and humiliating disabilities. As a New York Times columnist observed, “The price we’re paying for extended life spans is a high rate of late-life disability.” There are no guarantees.

We all know how this ends, though for the most part we prefer not to think about it. The muscles that have been so carefully sculpted and toned stiffen when calcium from the dead body leaks into them, causing rigor mortis, and loosening only when decomposition sets in. The organs we nurtured with supplements and superfoods abandon their appointed functions. The brain we have tamed with mindfulness exercises goes awry within minutes after the heart stops beating.

If this sounds offensive, let me remind you that we inhabit an entertainment culture that is thickly ­populated with the “undead,” the “walking dead,” and other borderline creatures that resemble decaying corpses. Their mouths, always open to expose rotting teeth, are bloody gashes, their eyes are set deep in their sockets, their jowls may be beginning to melt down toward their necks — as if we needed reminders of the postmortem future of the flesh.

From the book Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer, Copyright © 2018 by Barbara Ehrenreich, published by Hachette Book Group.

This article appears in the September/October 2018 issue of The Saturday Evening Post. Subscribe to the magazine for more art, inspiring stories, fiction, humor, and features from our archives.

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