So I think exactly a year ago, we did the Paleo challenge that was basically to eat a diet that is more in line with what our human bodies have evolved to eat. So lately I’ve been thinking about the other side of that equation; exercise, and overall health. I’m pretty sure that our bodies weren’t designed to do what I do every day and sit at a desk for 8+ hours, and I’m always skeptical when I hear things like, exercising 20 minutes a day will add 10 years to your life etc.
So I got interested in thinking about life expectancy as it relates to health, and stumbled onto a cool concept called “Compression of morbidity” that I’d like to spend some time exploring today. So before we jump in and start defining this concept, we have a few terms to get our heads around that are important to understand and that I didn’t really have a firm grasp of until I started digging into this research. And I’m going to follow a paper by the guy who coined this term, James Fries, who was a Stanford professor that came up with this concept back in the 70’s.
– The average length of life we would expect for an infant born today. This includes absolutely as many deaths as possible statistically speaking so while it’s the one that is most talked about, it’s almost the least valuable for this discussion. It’s just a strict average, so has some of the problems that averages do. For instance, if there is a high infant mortality rate, that’s going to pull the average down.
– To get around some of these problems, we can start talking about life expectancies of humans that are a certain age today? So for instance, an infant born today in the US, has a life expectancy of around 78 years. But the life expectancy for someone who is 70 today, is about 15 more years, or 85. This makes sense right, because if you make it to 75, you’ve ostensibly gotten through a lot of time without having catastrophic accidents, dying from chronic disease, etc.
– So if you look at the history of life expectancy of humans, you see what we already kind of feel, that life expectancies have been going up for thousands of years. The world average in the Paleolithic era was only 33 years, and has now rocketed to 67 in 2010. But, just to emphasize why this isn’t the greatest measure of how this relates to health, in the paleolithic era, if you made it to age 15, you could expect 39 more years to 54, so that kind of cuts out some of that dramatic increase, because things have become a lot safer.
– The average longevity in a society without disease or accident. So life expectancy will always be lower than life span, but can approach it as things get safer, medicine gets better, etc.
– Fries spends a good portion of his paper providing arguments for how lifespan hasn’t really changed all that much over the years, and pretty much for humans, hovers right around 85 years. So if you don’t get a chronic disease early, and don’t get in a car accident or die in war, you’re probably going to live to about 85. I’m not going to waste a bunch of time providing his arguments, because I think that’s a pretty easy one to buy.
Maximum Life Potential
– This is the oldest age achieved by any human beings.
– Oldest verified person ever was Jeanne Calment: 122 years, 164 days
– Oldest person alive today: Besse Cooper: 115 Years, 169 days
– The important part about this, is that there really hasn’t been any huge historical change with regards to maximum life potential over the past few centuries. It’s gone up to be sure, but nowhere near the amount that life expectancy has gone up over the years.
So now that we have those terms defined, Fries begins a little to turn to policy, and how we think about age. So much of the time we think about how people are getting older, more people are living longer, etc, and that is true, but if you accept the premise that really it’s futile to try to do things to make people live longer and longer, because really our lifespan has always hovered at around 85, and our maximum potential hasn’t increased all that much either. He makes the argument that it’s pretty much a genetically determined thing for the human body to live to about 85.
So the next piece to look at, and the part that I’m really interested, is that if we only can reasonably plan to live to about 85, what do those last years look like? I’m sure we’ve all been close to someone or known someone who has had some rough years at the end of their life. In and out of hospitals, severely decreased mobility, etc. It’s a pretty painful situation for everyone involved so I think we can all agree that we would want to aggressively avoid this.
This is where Fries introduces the concept of “compression of morbidity” So let’s define morbidity: It is the presence or incidence of a disease or medical condition that causes such a burden to the sufferer that it severely decreases their quality of life.
So it goes without saying that we want that morbidity window to be as short as possible, even zero would be great if we just dropped dead in our sleep right? So there are certain indicators of morbidity that kind of kick off this ‘window of morbidity’: You can probably name them; Pneumonia, Heart Attack, Stroke, Emphysema, Cancer, etc. I would also expand the definition to things like alzheimers, traumatic structural injury like a hip breaking.
It’s depressing, but these morbidity factors are likely going to happen to us and the people we are close to. The longer we live, the greater chance of this stuff happening. So if you take the traditional view, that people are just getting older and older, and life EXPECTANCY is going to continue going up up up, it seems that we are hopelessly destined to spend more and more time in this ‘morbidity window.’
That’s where things get a little more uplifting with what we talked about earlier related to life SPAN. If you buy that no matter what, we probably shouldn’t expect to live much past 85 years old, then we can focus on compressing that morbidity window as much as possible. That is, rather than trying to have long life as a goal, our goal should be super-compressed morbidity. Where we live as long as we can with a good quality of life and then drop dead.
So Fries discussion turns to delaying those factors that indicate morbidity. If we can just delay as long as possible that first morbidity indicator, we can start compressing that morbidity window, hopefully to the point where the first catastrophic thing that happens to us will kill us right there.
So now we have something hopeful to shoot for. We know that behavior changes can affect incidence of a lot of these things. I’m not sure why this idea feels more tangible or attainable to me, but I’ve got kind of a top 5 things to do to compress your own morbidity. You’ve heard all of these before, but I think it’s a valuable exercise to look at them in the light of delaying the onset of morbidity factors as long as possible.
– Eat a healthy diet. You guys know I drink the Paleo-kool aid, but this is one of those no-brainers that has been proven over and over again to help lower the risk of heart disease, stroke, a bunch of other stuff. These are all indicators of morbidity, so instead of thinking, ‘oh, if I eat these vegetables instead of this cake, it’s going to add a couple years to my life,’ think, ‘If I eat these vegetables instead of cake, I’m going to be able to get a few days closer to 85 without having a morbidity event!”
– Cardiovascular Exercise – Again we hear this one over and over, but let’s look at it with a different lens. Remember, we are trying to compress morbidity; that period of our life where our quality of life sucks. When I get old, I want to be able to go for a walk and horse around with my grandkids. I don’t care at all about if I can run a 5K, so my ‘life’ fitness plan doesn’t really need to focus on traditional cardio where I’m trying to keep my heart rate at a certain painful level.
– Weight training – I want to be able to pick something up off the ground, stand up in the shower on my own, and get out of my chair without a struggle. So weight training will make sure that my bones and muscles know what that feels like. Want to focus on full body movements that are FUNCTIONAL, like squats, deadlifts, pullups, etc. Yeah curls can be fun to see your biceps bulge, but that kind of program where you isolate tiny little muscles, isn’t going to do much to compress your morbidity and increase your quality of life later on.
– Don’t smoke or drink too much – Again, another no-brainer because it’s super bad for you in many ways, but for some reason the reason that it’s going to delay morbidity is a more powerful reason for me than simply, “you’ll live longer if you don’t smoke.
Ultimately, I think that the way we look at longevity needs to shift a bit. We shouldn’t be trying to live longer and longer, because data shows that humans aren’t really made to live longer and longer. But we DO want to delay, as long as possible, the indicators of morbidity because that is going to ensure that the time we spend here with a poor quality of life will be minimized as much as possible.