Living Well at 93—A Long & Healthy Life

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One woman's odyssey through the Trump presidency. My focus is centered on the many issues affecting women--but what doesn't? There's a new post every week.

I have been close friends with Julia for over forty years. Despite our age difference we’ve always seemed to see things in the same light or we’ve reveled in arguing our opinions—and laughed at ourselves. Art, politics, food, movies, books: we love it all. Julia has seen me through some tough times, including my divorce, and has always had wise words to say. At 93 to my 68, she remains not just a friend but an inspiration—and the voice of my conscience when it comes to health. It’s pretty hard to argue with someone who is still physically fit, enjoys life, and looks beautiful. When she describes her diet, know that she didn’t move into it overnight. She did a lot of research and luckily she’s a great cook. She’s spent decades working out how to age well, and she’s succeeded.
Julia

My husband and I are both 93 years old.

My father was a brilliant medical doctor who went very far but would have gone much farther if his health had not held him back. He was one of my inspirations to go into nursing.

When I graduated from high school I had no idea what I wanted to be, so I went to college for one year, and then my father told me it was time to make a decision about what I was going to do, because my brother was entering college and he couldn’t afford to send both of us—as he put it—if we didn’t each have defined goals. That’s when I chose nursing at a prestigious hospital in Boston where my father had been a resident. I talked a girlfriend of mine into going with me to Boston, but her mother would not let her go farther from home than New York City, so we switched to a hospital in Manhattan that was then one of the three best in the country. After three years we graduated as RNs in September of 1945. All graduates from my hospital were given two years of college credit from Hunter College and Columbia University, and I planned on going for a BS degree, enrolling for January of 1946.

However, between graduating as an RN and enrolling in college I met my husband on a blind date, and after several following dates with him I decided to stay where I was, which was too far from the university I’d planned to attend. Instead, I worked as an RN in a local hospital, and we were married the following year; then I joined him, after World War II, when he returned to finish college in Massachusetts.

When my husband developed angina in his late fifties I started to look into diets. Back then the only thing available for angina was nitroglycerine—there was a total absence of drugs or preventative remedies. I began reading everything about heart disease I could find in the library. At that time the most accessible and respected peer-reviewed medical journals were The New England Journal of Medicine, and next best were the The Journal of the American Medical Association, followed by The Lancet.

Many years passed before anyone knew that trans fats were so dangerous, but as soon as I read about it we immediately started using organic olive oil and canola oil*. Whatever all doctors knew and recommended had not worked for my husband. If I saw anything about hydrogenation on a food label I avoided it. After six years on our absolutely-no-trans-fat diet, my husband’s HDL high-density lipoprotein (the good lipid) went from around 19 mg/dl to about a 45 mg/dl. At the same time his LDL low-density lipoprotein (the bad lipid) that collects in the form of plaque on the walls of blood vessels hovered a little over 100 mg/dl.

The first medical study I read in the early 1980’s that was very helpful was written in 1970 about the Tarahumara Native Americans of Sierra Madre Occidental Mountains in Mexico, whose HDL and LDL averages were numerically outstanding—they had no history of heart disease, diabetes or high blood pressure, and even cancer was rare. It was an agrarian culture with strong male traditions of long-distance running and hunting and a sort of football they played far into the night. Strenuous agricultural, domestic and childcare work kept the women busy. The Tarahumara diet consisted of vegetables, primarily corn and beans. They ate very little meat as it was only periodically caught, and no added salt or sugar. At times they found beehives, and honey was a rare treat—luckily rare as it is primarily sugar. Most of their fat intake was polyunsaturated. HDL averaged around 26 mg/dl and some were much lower. There were others with higher readings, though this was mostly seen in pregnant women. Their LDL averaged 89 mg/dl. I immediately started to implement a diet that was primarily vegetables, fruit, nuts and whole grains and nonfat milk.

NOVA aired a show in 1991 called Avoiding the Surgeon’s Knife that followed four patients who participated in the first year of Dr. Dean Ornish’s Lifestyle Heart Trial in 1986-87 in California. It was a clinical study of intensive lifestyle changes for reversal of coronary heart disease without the use of drugs or surgery. The study took a group of twenty-two randomized patients with moderate to severe coronary heart disease, gave each one a cardiac catheterization and placed them on very low fat, vegetarian (whole grain, fruit and vegetable) diet, only the amount of salt needed to sustain life which is so tiny that it is possible to get enough just from the food consumed, exercise, stress reduction by meditation or yoga, along with love and support from friends and relatives. At the end of the first year, both the experimental and control groups had a second cardiac catheterization. The results confirmed a dramatic reduction in arterial plaque among the experimental group. These and other positive outcomes, including a significant reduction in mortality, continued in those who stayed in the study over the following four years. A randomized controlled trial showed, for the first time, that even severe heart disease could be reversed by the Ornish Program, as demonstrated by improved cardiac function after only thirty days.

A twenty-five-year diet, exercise and lifestyle study of the population of Okinawa by an internist, a geriatrician, and an anthropologist resulted in a book published in 2002 titled The Okinawa Program. On Okinawa the men and women were lean, youthful-looking, energetic, with low stress levels and remarkably low rates of heart disease and cancer—even stomach cancer, which claimed many mainland Japanese—and they enjoyed the longest life expectancy in the world.

After WW II, McDonald’s and other Western restaurants, primarily fast junk food, became available in Okinawa. The following generations loved the unhealthy food and now suffer from obesity and all the other diseases from the West their parents had long avoided.

I think it was in 1994 that I read if you keep your LDL at 70 mg/dl you will not put on any added plaque; if you keep it under that number you may start to lose plaque, and the lower it goes from there the more plaque you’ll continue to cast off. It’s a progressive and steady improvement set in motion and sustained by the same eating habits and moderate exercise plan seen in the Lifestyle Trial which, today, has more generous choices and is easier to follow.

I have a good appetite and I’ve kept my weight about the same my adult life. I usually don’t eat excessively, but if I find I’m gaining pounds I eat less nuts and eliminate bread. If you keep weighing yourself and never weigh over one or two pounds more than you should it’s very easy to maintain. Having small bites helps—it takes you longer to eat and your appetite begins to diminish in about twenty minutes. We eat lots of vegetables and fruits and very little of the fattening stuff. I don’t count calories, I haven’t the patience for calories—I simply eyeball everything. And we exercise daily on a treadmill, all things being equal, if neither of us has had any kind of injury or infirmity. Yoga or meditation and enjoying projects we do together or with company are also good for stress.

It’s imperative to keep the salt down. There have been articles and studies backed by the salt, sugar and dairy industries written by qualified but unscrupulous scientists who were and are paid, literally, millions of dollars to lie, or at least mislead and misinform. Some of the same scientists who kept cigarettes on the market for over sixty years by saying no one could prove tobacco caused harm are among the greedy specialists now behind efforts to legitimize salt, sugar and saturated fat. One of their questionable studies was done with a cohort of people, many with terminal cancer and end-stage heart disease, who consumed so little food to begin with because of their disease that it didn’t matter how much salt there was in what they ate. A close friend of mine had a pioneering heart-valve operation in Germany performed by the doctor who invented it, a surgery then unavailable in the States and without which she would have been gone in no more than six months. After her operation she ate everything she should have avoided, and her heart disease worsened. Tragically, my friend also developed two cancers, and she became unable to swallow and her suffering was horrendous. Nevertheless, this was the type of patient they looked for to recruit for the salt study—patients who were terminally ill with severely diminished appetites and soon to die. There is no mention that these kinds of dying patients were included in the study.

Now the dairy industry is trying to fool you into believing that saturated fat in cheese is not harmful but good for you. When you see a clinical study or trial you need to take it with more than a grain of salt (no pun intended), because many are not approached with objective intentions or careful controls, or over a long enough period of time among a heterogeneous population. For example, I recently read an article by a dietitian who after seeing the misleading study on salt decided that someone with congestive heart failure could have two thousand milligrams of salt daily, which is far too much when the heart is enlarged and not pumping to its capacity. The way the article was written glosses over the full extent of what the American Heart Association said about the study, stating only that the Association disagreed with their conclusions while neglecting to say why. The article appeared to agree with the dietician, which represents to me an irresponsible dissemination of potentially damaging information.

Johns Hopkins puts out a good health letter, and Cleveland Clinic has a range of newsletters that are still pretty reliable. Berkeley Wellness out of UC Berkeley is very good; and Michael F. Jacobson, co-founder of the Center for Science in the Public Interest in Washington, DC, publishes Nutrition Action Healthletter, which has some excellent cover stories, the September 2016 “Kidney Check” and October 2016 “Colorectal Cancer” being two outstanding recent examples. Nutrition Action also has an impressive scientific advisory board, and has written describing why and how these unscrupulous scientists are lying about salt, sugar, and saturated fat. The Mayo Clinic’s online newsletters are creditable as well. There are health newsletters associated with other prestigious medical institutions that in my opinion are best to avoid, because of clinical sloppiness, errors, or questionable standards and associations; however, if you stick with the newsletters I’ve mentioned you’re off to a good running start in your health education.

My parents lived to 63 and 64; my husband’s father died in his forties. As a child his father had rheumatic fever that left him with a faulty heart valve. My husband’s mother, who went through menopause in her late thirties, developed heart problems in her early fifties and died at 65.

My reason for deciding to live this way is that I’ve seen people suffer, both in my profession and in my personal life. It’s not so easy, because most people don’t just pop off and die, they end up usually suffering terribly. Generations ago people died faster, but today we have so many medical ways to extend our lives, and it’s evolved into something that’s all most people seem to care about. The majority of doctors are only interested in keeping you alive, not in the quality of your life or what you want. However, this clinical extension of life has created a great deal of suffering, and I’m scared stiff of suffering because I’ve seen what happens and it frightens me. That’s what keeps us on my diet. Luckily, my husband is very cooperative. We may cheat three or four times a year because we’ve been doing so well for so long, but when you’re first dieting I would not recommend deviating from it for the first few years.

I’d advise people to cut out all trans fats, try to avoid saturated fats, and take in no more than fifteen hundred milligrams of salt daily. Make sure you use Diamond Crystal Kosher salt and only pour it out, don’t crush it because once you do it reverts to the same density as regular table salt. Always try to sprinkle some of the salt onto the top of your food—if you mix it in during preparation before or during cooking you will always have to use more to achieve the same flavor result. Diamond Crystal Kosher salt has half the amount of sodium by weight as any other salt, and it’s the air in-between the crystals that reduces your sodium intake.

It’s advisable to store nuts and seeds in the freezer as the oils in them can go rancid quickly. When it comes to fruits, the darker and brighter colored they are the more nutrients they have. All berries are good for you and always eat blueberries, and peaches if you can find good ones. We use frozen blueberries and eat a quarter cup of them or more every day. And no sugar is added—the only sugar in your diet should come from vegetables, and mainly from fruit, which we also eat with nuts after dinner for dessert. If you drink juice make sure it contains the pulp, because it’s the pulp (fiber) that keeps the sugar (glucose) from rushing into your bloodstream.

My husband’s and my lipids are excellent. My HDL is in the 60’s, his is in the mid 40’s; our LDLs are both usually under 70. We eat shrimp and eggs in moderation—even though they are high in cholesterol, from a nutritional and dietary standpoint it’s the trans and saturated fats that play a greater role in damaging blood vessels and stimulating inflammation.

Bacon is very popular but one of the most dangerous foods you can eat. You should not eat any meats that have been cured, salted, smoked, dried or canned because they all have nitrosamines even when they are processed with celery salt. If you don’t mind developing cancer—and there is a long list you can choose from—just keep eating nitrosamine foods.

Our regimen is strict so we have to be very creative with recipes. What I find exasperating are the cooking shows and recipes in newspapers and magazines that, with few exceptions, are very unhealthy. Some of these cooks are so ignorant or deluded they’ll proclaim a dish of theirs as being healthy based only on its raw (originally healthy) ingredients, which may have been true enough before they loaded it up with cream, butter and lots of salt—some healthy!

A couple of my recipes:

Best Yoghurt

serves 1

1 heaping cup of plain fat-free organic yoghurt

1/4 cup of frozen blueberries

1 smallish orange, peeled, sectioned and cut into pieces

1 smallish apple, peeled if not organic, and cut into bite-size pieces

5 grapes, the darker in color the healthier

Whatever other added fruit available that you want (peaches are best, watermelon is too watery)

¼ cup walnuts, almonds and cashews

2 average-size Brazil nuts

1 tablespoon sunflower seeds

1 tablespoon pumpkin seeds

2 tablespoons Kretchmer toasted wheat germ

Before starting on the fruit, roast nuts and seeds for thirty minutes in a toaster oven at 225 to 300 degrees–each oven is different. When the nuts are cool and you are ready to eat, mix everything together.

Open-Faced Chicken Sandwich

serves 2

4 large Romaine lettuce leaves

Hellmann’s Mayonnaise

2 slices of large sweet onion each about ¼ of an inch thick cut into 1” or 2” pieces and soaked in a good red or white vinegar for at least 15 minutes (to remove the sharpness)

1 medium or large tomato sliced, or cherry tomatoes halved, or roasted tomatoes

About 8 ounces organic rotisserie chicken, skin discarded, white and/or dark meat sliced

Fresh parsley for garnish (optional)

1 slice whole wheat bread toasted

1 TBSP Costco’s parmesan cheese grated. (Costco is the best tasting and has the lowest amount of salt in any parmesan. If you can’t get Costco use half a tablespoon.)

On a plate place one piece of toast wipe it with mayonnaise and arrange the pieces of onion over the toast. Wipe the onions with a little mayonnaise. Then lightly wipe a lettuce leaf with mayonnaise, fold it in half and place over the onions. Repeat with a second lettuce leaf, then cover the lettuce with 4 ounces of chicken slices. Wipe a little more mayonnaise on the chicken and cover with tomatoes. Then dust with parmesan.

NOTE:

*Never purchase or store your olive oil in plastic bottles. Migration of small molecules from plastic can diminish oil quality and food safety. Plastic materials are also porous, which permits the penetration of air, light and humidity that negatively impacts shelf life, nutritional value and flavor.

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