Ask HN: What to do to be healthy when old?

64 points by jonathan-kosgei ↗ HN
What should you be doing in your twenties to be healthy when you're older?

What can someone in their fifties do to be healthy in their sixties/seventies?

Finally, is there a good book on this topic? A sort of "owner's manual" for the human body?

90 comments

[ 0.26 ms ] story [ 32.3 ms ] thread
Don't smoke, don't drink, do exercises regularly, try to keep learning and challenge your brain. Find one or more hobbies that relax you and good, honest friends who like you for who you are.
I agree with all this, except “don’t drink”. 2 drinks a week will very unlikely to lead you to you poor health in your 30s-50s, and likely well beyond that.

    The three leading causes of attributable deaths in this age group were
    tuberculosis (1-4% [95% UI 1-0–1-7] of total deaths), 
    road injuries (1-2% [0-7–1-9]),
    and self-harm (1-1% [0-6–1-5]).

I'm all ears on how zero alcohol consumption helps with tuberculosis and road injuries.
No alcohol consumption means you're at zero risk of you driving drunk and injuring yourself while on the road.
> of you driving drunk

As always people are projecting their own behaviour on others. You have more chance to die in a traffic accident as a pedestrian, just because modern cars are ridiculously safe. I've in an accident, I was in the car on passenger seat. If I was not in the car - I would post here, because at that collision speed pedestrians doesn't survive.

It absolutely doesn't matter if I drunk that day or not. Or just was on my way to drink a lot.

There are no real pedestrians where I live and I have seen many lives lost to drunk drivers from car accidents. Please don’t drink and drive.
You can die of something that isn’t a leading cause of death, and you can position yourself to be in worse health later on without dying.
Also being wealthy seems to help.
Eat a lot of veggies

Avoid overprocessed and junk food (yes, you know what is junk and what isn't)

No smoking. No harmful drugs. Low to no booze.

Exercise regularly.

Avoid social media - mental and physical health are related

how do you avoid social media if you use it for your business?
Constrain your use to your business needs. I technically am on social media but inactive (unless we count HN, not sure I do). If I'm dealing with businesses that insist on using, say, FB then I go to their FB page and that's it. I don't view other people's feeds, I rarely look at my own FB wall page.

If you're posting to drum up business, then just post to drum up business. Stay out of the personal and political stuff which is mostly just drama and noise. Interact only with reasonable responses to your own posts and note when people are just trying to stir something up or troll, ignore them.

i cannot use a facebook page as anything posted on pages requires boosting which is completely unaffordable for smaller business. in the end your content is shown to some guys in vietnam and if you try to narrow the audience facebook expands it such that the acquisition cost of a real customer becomes insanely expensive. facebook ads never worked and are a big scam.

so i need to use my personal profile to build relationships and sell. this means i get pulled into personal use of facebook which destroys my mental health.

You don't.

Either you hire someone to manage your Social Media or decide specific rules of usage. Login only at work hours, for such amount of time to do X and nothing else. Try to have a blank account, empty of anything outside of work related, for example blank Facebook account which hosts the business page/group/whatever.

i guess i can have a blank account and join groups. i am wondering if there is an unfriend all button somewhere.
There isn't. When i wanted to turn my facebook account blank i used a script.
You can have a social media capable smartphone for $100 nowadays, so just buy another phone and SIM/contract and use the thing only for work. At 17/18/19h just turn it off and leave it in office.
There is a huge amount riding on the invisible hand you have already been dealt. All you can do is to some extent improve or worsen the outcome. Some old people take credit for their survival and fitness but the dead ones who did the same don't speak.
The easiest approach is probably to avoid or reduce obviously harmful habits and behaviors that result in chronic diseases (eg: cardiovascular disease, diabetes) - Avoid smoking and hard drugs

- Avoid excessive alcohol consumption

- Avoid fast food, excessive salt and sugar, deep fried dishes

- Avoid excessive stress and worrying

Besides that, focus on the basics:

- Consistent and restful sleep

- Healthy, balanced diet

- Regular exercise

- Novel and mentally-stimulating activities, continuous learning

- Strong social connections (not just online social networks, but actual friends and family you can hang out with in-person)

If you want even more, there have been studies about 5 blue zones where inhabitants regularly reach ages of 100 or more, and 9 habits they follow: https://www.bluezones.com/2016/11/power-9/

1. Move naturally: build exercise into your daily life

2. Purpose: a reason to wake up in the morning

3. Downshift: Routines that shed stress

4. Only eat until you are 80% full. Consider occasionally fasting.

5. Plant and bean-based diet

6. Moderate (1-2 cups/day) consumption of alcohol

7. Faith

8. Close family connections

9. Social circles that support healthy behaviors

Lift weights. Just don't overdo it and injure yourself. Don't sit or stand for long periods; get up, get a drink, give your eyes a rest too.

As you age, strong legs will keep you walking longer. Run and jump; loading your bones with more than 1x your body weight is crucial for maintaining bone density and avoiding those broken hips later in life. Leg strength has even been correlated with brain health.

Source: a Zoom seminar with a doctor that I watched a while back at my company.

I highly recommend reading “Body by Science”. I more than doubled my muscle strength spending less than 20 min a week in the gym.
I am 51 and lost 80lbs over the last two years walking 3 miles everyday. I have a lot of porridge/fruit for breakfast, vegetable curry etc at lunch and dinner can be pretty much anything, including some ice-cream. I drink a lot of coke zero. I think the takeaway is routine. Walk and don't eat a lot of sugar, bread. I generally eat bread once a week in what I call my Scooby Doo sandwich.
That all sounds great, but why would you drink a lot of coke zero, surely that has a lot of crap in it? If you're that dedicated with everything else why not just drink water or tea?
some people prefer their caffeine cold? Lots of people talk about drinking tons of coffee - but when you watch them make a cup its half dairy and sugar anyway... could be the same with Tea (builders tea for example)

and it could just be their guilty pleasure - better than the "normal" coke

We learn how to roll, crawl, walk, run. No point shouting run at the crawling child. Maybe better to say well done .
Diet soda is often a way to distract from other cravings that have calories. While it isn't as good for you as water (obviously), if it's the thing that really helps someone lose 80 lbs, it's probably a big overall win for health as a substitute vice.
Coke Zero has caffeine in it, and a flavor some find pleasing.

While I can mostly get on board with the idea that it’s better to consume less processed foods and beverages, if I remember correctly there’s never been a human study that showed a causal relationship between consuming zero calorie sweeteners and negative health outcomes.

I’m on my own journey to optimize my diet, and eat less processed foods, but Diet Coke is something I’ll probably never cut out.

Move to higher altitude

Marry someone way younger

Be religious

Walk a lot

Fast sometimes or often

Be close to parents relationship wise

Use moisturizer even in 20s

Donate blood or plasma

Keep carbs very low

Always be learning something mental and something else physical

Eat organic

Reduce omega-6 (grass fed meat has less of it AND AVOID all vegetable oils)

> Eat organic

All this is gonna make you is poorer.

organic food is likely to have less of pesticide like glyphosate

https://www.youtube.com/watch?v=Aw16LPVnNco

added sources for other points as well in the comments

Conventional farming methods are responsible for increasing the average global lifespan by almost 20 years.

Organic produce is a luxury item for high-income citizens of developed countries.

Purely considering the elemental nitrogen required for supplying the global demand of calories, we currently have no viable system for eating all organic. The intensive nature of organic farming would require most city-dwellers to return to the fields, and we would still come up short by about half of the world's required calories. Please don't respond with an article about regenerative ag unless it truly addresses the process of implementation and realistic supply of calories.

This is a nuanced and complex subject. Our food system is dysfunctional and requires systemic change, but all organic farming is likely not the answer.

> Be religious

Er, seems like an outlier on this list. I doubt religion, which often suggests causes and effects originating from divinity rather than predictive behavior, will overall result in life extending decisions.

Besides, just logically it would seem to be a source of acceptance of your impending death, when perhaps continuing to fight for life may be the superior strategy.

https://time.com/5159848/do-religious-people-live-longer

added sources for other points in the comments as well

Pre-COVID data suggesting "gathering regularly in person makes you live longer" would seemingly be not as relevant now.

Additionally, I see no control for "religiousness" of the gathering, only "The simple act of congregating with a like-minded community might deserve much of the credit."

So, per your own source, "be religious" is not what would extend your life and is therefore not accurate advice.

Healthy 50 year old here.

I see a lot of good advice in the comments but the one I don’t see which has had an amazing effect is an annual (or perhaps once every 2 year, if you’re still in your 20s) physical exam with a good physician.

My physician is an accomplished runner and we geek out on things during my physicals. He goes the extra mile on stuff like blood tests as indicators and whatnot.

Aside from that I’ve traditionally been into extreme endurance sports and while I wouldn’t change a thing, except perhaps doing more when I was younger, I’m questioning whether that’s wise or sustainable (injuries and wear-and-tear) for my ongoing health at this point.

It used to take a day or two to recover, but as I get older, it’s in terms of weeks not days.

> I see a lot of good advice in the comments but the one I don’t see which has had an amazing effect is an annual (or perhaps once every 2 year, if you’re still in your 20s) physical exam with a good physician.

FWIW I asked the Australian doctor who was inspecting me, top-to-tail, in my 37th year, whether I should be doing this every year.

“Do you feel healthy?”

“Yes.”

“Then no. No need while you’re young.”

You’ll get roughly the same answer in America but I still recommend it every $x years , if possible, especially in the late 30s.
In my opinion any activity that requires flexibility, force, coordination and speed is necessary for aging well. It can be acrobatics, martial arts, dancing, yoga, many sports. It is important to find something that you enjoy it by it self. That’s why I avoid plain running or plain weight lifting, unless they are meant to support another activity. And from experience, flexibility and speed really make living in my body enjoyable.
People miss one of the most important ones. Have a healthy social life. That includes having a partner that you can grow old with. You have to learn that people aren't perfect, that includes you, and that you have to be realistic and adjust your expectations of others and you.
Ignore most of what you read on the internet on the subject, including here.
I would definitely recommend riding a bicycle. Nothing too hard, just regular aerobic exercise. It gives your mind a break too because you're focused on doing one thing. Bonus points if you can ride in nature or somewhere beautiful.
To get metaphysical, realize that time is a construct of the mind. "You" in your 50s in an entirely different person. The only connection you have with that person is the story in your head.

Then the question become "what should you be doing to be healthy now".

Make the most of today, everyday.

I don't understand this at all. Do you also think like this about the "future you" that might have to shit themself on the bus ride if you don't go to the bathroom before you leave?
I don’t think you understood what the GP said, but then you claimed as much…

That said, even with your interpretation, imagine that if you didn’t do something, somebody else would have to shit on the bus —- you’d have to be pretty selfish not to spend a bit of time to spare the other person of the embarrassment.

There are myriad other examples where you can take action now to avail yourself of a future mild inconvenience that you might not take if the inconvenience were experienced by someone else instead. And I can't imagine that you think telling me I don't understand what GP said, without offering clarification of your own, is a useful comment.
In such a scenario, I wouldn't put much thought into going to the bathroom.

I think of it as setting my future self up for success. Go to bed early, go for groceries, have some food prepared, make plans to do something.

Why set your future self up for success if your only connection to that person is a story in your head? What is supposed to change when you take this view of being disconnected with your future self?
Exactly the same things you should to be healthy when young. Get exercise, eat healthy.
My plan is not to get old.

Staying healthy is not the goal here, it's simply one of the methods to reach the actual goal, which is ensuring that you are not a burden to others when you get old. One other method is making so much money that you can pay someone to take full care of you. Those are all valid methods; so is not getting old in the first place.

Here is my list

1) Minimize stress 2) Good sleep 3) Eat home cooked meals mostly (by this i don't mean microwaving stuff). Even in my late twenties i would proudly boast that the only thing i can cook is an egg. Now i can cook for myself, stuff i enjoy eating and stuff that doesn't take too long. 4) Reduce alcohol intake to no more than 3 beers once in a while. 5) Exercise 2-3 times a week. 6) Have a healthy social life, whatever that means for you.

I've heard it described this way: In terms of physical health/conditioning/training, from 20 to 40, the question is how much can you get. From 40 to 60, the question is how long can you keep it. After 60, the question is how slowly can you lose it.

You may say, sure, I care about physical health, but why do I care about conditioning or training? Because when you're 30, conditioning is whether you can sprint or run marathons or play sports. When you're 80, it's whether you can walk without pain.

Note: By "conditioning" here, I don't mean that you have to reach 10% body fat or 20 inch biceps or elite VO2 levels or anything like that. I don't mean obsessive levels - those can cause injury and/or result in shorter life span. I mean, though, that you make some effort to work on your body's condition (strength, aerobic, or both) in a consistent, long-term way.

You already know what you need to do, you just need to do it.

In most people it involves prioritising health over other goals to some extent, e.g. if you're doing an 80 hour job, find a 40 hour one with less stress, hit the gym and cook proper meals.

1) learn break falls from Judo. I've avoided breaking limbs twice in my life because of break falls - face planting on to concrete with a 60lb backpack, and walking off the top of two stairs into space over a marble floor.

Either one of those could have been a life-changing injury and I walked away with minor bruising. Seldom has anything in my life paid off that well.

2) Figure out the dental care thing early: correct tooth care - the right electric toothbrush, the right toothpaste, structural issues like tooth grinding.

3) Sleep issues - deviated septum, sleep apnea, anything like that. Fix it young.

4) Get tested for food allergies. I was over 40 before I discovered I was gluten intolerant, and this is common for the non-celiac gluten intolerances. I wound up in hospital with a very specific skin rash, and they diagnosed me on sight. 40 years of allergy behind that. Bad news.

When you're young fundamental structural stuff can be fucked up and your body will just power through it without noticing. Catch it before you age into it.

Good luck!

Yes, the advice about the break falls from Judo or Aikido is one of the best advices possible, because getting injured due to falls is one of the major health risks for old people, as I have seen in many older relatives.

However, the break falls cannot be just learned, they must be practiced from time to time, which requires an appropriate surface, e.g. some kind of hard mattress, resembling a tatami, or even the real thing (i.e. a special mattress or tatami made for wrestling, judo or aikido, put on an elastic floor, e.g. a wooden floor).

Going to an actual dojo would be the best, if that is possible. While the practice of Aikido, as done in most places (i.e. based on cooperative training in pairs), is not something that would transform you into a killing machine or an UFC competition champion, it is a very appropriate relatively low-effort training method for old people, useful to preserve their flexibility and balance, making them much less prone to injuries.

Also the daily practice of some solo kata taken from some martial art, or of some Tàijíquán form, is something that can be done at any age with very good results for preserving the body fitness, by exercising all muscles and articulations in coordinated movements, with the advantage that no special space is required. Most such kata can be adapted to be practiced even in a small room, or outside on the ground in some yard, when no better space is available.

Eat well, work out, try and be reasonably active day to day, don't smoke, don't drink much, gets lots of sleep, drink lots of water.

That's it.

If you live in the USA, pick a good health insurance plan. Don't trade Medicare for a managed care plan if you can avoid it.

Find a good MD to be your primary care provider.

If you lose confidence in your MD, find another one. Until that happens, don't try to be smarter than your doctors (you will probably have several before too long), and do what your doctors say. Let all your doctors know that you trust them, follow their advice, and respect and rely on them.

Find a good dentist and give them the same treatment that you give your MD.

Do balancing exercises -- broken bones reduce your mobility and vitality; they are often the cause of a downward spiral in health. Don't shun using a cane, walking stick, or walker when there is any chance you might fall, but scrupulously avoid riding around on one of those damned electric carts if you are lucky enough to be able to walk, however slowly.

Have friends and enjoy life.

Exercise as much as you can; eat as little health-damaging food as you can; get 8 hours good sleep every night if you can.

says >"Don't trade Medicare for a managed care plan if you can avoid it."<

Most of my older friends have Medicare "advantage" plans which I assume are what you're speaking of by "managed care plan". They seem to prefer those plans to plain Medicare.

Why do you suggest Medicare instead of a managed care plan?

I'm not an insider to the medical care industry, but I have plenty of friends and family who have worked there, and that is what I've heard from them over many years. Certainly, there is a lot of variation in quality within every segment of that industry. Perhaps the idea I have picked up is that managed care implies managed costs which implies fewer options and opportunities to obtain better than common-denominator results. Just the process of maintaining good relationships over many years with good physicians, together with knowing that they are not operating under onerous productivity constraints, and that they care about me and will act accordingly, has helped me maintain a positive attitude, a physically active lifestyle, and willingness to persist in doing my part of the process of staying alive.