Dr. Walter Bortz, with wife Ruth Anne. Michael Jones/Bee file
I recently had an entertaining interview with Dr. Walter Bortz, the noted Stanford gerontologist and longtime Boston Marathon-level runner, about his new book, "The Roadmap to 100." Bortz, at 80, will be running in Monday's iconic race.
The Bee's story on Bortz and his book will run in Sunday's paper, but here's a sneak preview:
Judging by the title of Stanford professor of medicine Dr. Walter Bortz's new book - "The Roadmap to 100: The Breakthrough Science of Living a Long and Healthy Life" - you might presume the noted gerontologist has uncovered some miraculous anti-aging potion.
In a way, he has.
It's called exercise and diet.
Old school as that may seem, Bortz presents solid, peer-reviewed research that confirms that it's fitness - not antioxidant supplements, or gene and hormone therapy or the latest "super fruit" - that is the key to extending and improving our lives.
"Fitness is a 30-year age offset," Bortz says. "A fit person of 70 is like an unfit person of 40. And the galling thing is, it cost us $2,000 per person per year to pay for people being unfit."
An outspoken proponent of personal responsibility for one's health, and a frequent critic of medicine's disease-oriented focus, Bortz, 80, is himself a model of healthy behavior. A veteran long-distance runner, he will compete in Monday's Boston Marathon.
Q: I read a statistic from your book that shocked me: By the middle of this century, we'll have 6 million centenarians. Does that mean people are healthier or are they just holding on longer thanks to medical science?
A: Oh, I give medical science very small partition of it.
Q: Are people healthier now than before?
A: The data clearly shows old people are staying healthier longer.
Q: A good thing, right? But don't you also write in the book that we live in a "bifurcated society," where we've got the really healthy and really unhealthy, and the healthy pay for the rest?
A: I lay a lot of the blame on health illiteracy. If you're smart, you're going to live a long time. Because now we know. It's not genes and not doctors. It's how you live your life. We are a set of a wonderful ensemble of genes. All these genes are little electric switches that must be tuned. The tuning of it is exercise. When you're fit, everything tunes correctly. If you're not fit, everything goes to hell.
Q: Exercise and nutrition: Is that going to be a hard sell to someone always looking for the quick fix?
A: Sure. We, as doctors, can treat disease. We can charge you for it. We want thing as we can send you a bill for. And they can bill you for surgery and pills. But if you come into my office and I go over you and say the best thing for you is to get on a really good exercise program, you're going to stalk out because I didn't give you the easy answer.
Q: Why aren't doctors trained more to deal with health rather than disease?
A: They get paid for having you sick. They want you to bleed. I just lectured 600 doctors at Kaiser. They are all fat.
Q: So, if doctors themselves can't stay healthy ...
A: Listen, health is a control thing. You have to own it. You must ingest health and make it a part of all your decisions. I'm a student of the human potential. How long can we live? A hundred years. That's our birthright. But it can be a good 100 years. It's not lying around in some desolate nursing home.
Q: So longevity for its own sake is not a good thing?
A: Clearly, no. It's quality of life. When I wrote my first book in 1991, called 'We Live Too Short and Die Too Long,' I asserted that 100 was our birthright. That was out on a limb back. A lot of people said, this guy's blowing smoke. Now we recognize that we ought to live to be 100 if we don't (mess) it up.
Q: "Disuse Syndrome," you write, should be recognized as the real leading cause of death. You even say that newspaper obituaries should say, 'He died of disuse syndrome' rather than heart disease. Is a sedentary lifestyle really such a killer?
A: The data exists. There's an article from JAMA about 10 years ago called actual causes of death: that sitting on a couch kills you. Everything rots out before you go into the doctor and say, 'Give me a pill.'
Q: How do you combat Disuse Syndrome in people who may not be motivated?
A: It's I.O.I. I is information. People have to know it first. You have to be informed that, if you're thin and vigorous, you'll live longer. Second is opportunity. You need to live such that you have access to good food, not damned fast food. Lastly, incentive. I'm working on the government to make it worthwhile for people to be healthy rather than sick.
Q: Subsidies for having lower cholesterol levels and higher fitness levels?
A: Yes! Come in and I'll do a health exam. If you're healthy, I'll charge you 10 percent less. It's a reward.
Q: What about the ways other than exercise and nutrition? Everything from gene therapy, to dietary supplements to super fruits - is it people wanting to get the quick fix? Or is science trying to sell us product?
A: It's money. I'm at Stanford. So high tech. They all want their laboratories. They all want to find something lucrative that helps people. I was at a lecture there a year ago on angiogenesis - new blood vessels. The speaker is said, 'With these viral vectors you get the first blush of a new vessel!' I went up to him afterward and said, 'You get the whole thing from exercise.' He says, 'Yes, but there's no money in it.' It all comes down to what you can sell in Walgreens.
Q: What can be done tangibly to help change this?
A: I have a program here in Santa Clara called Fit for Learning. We're in all the schools. I lecture the kids and tell them, 'I do not want to see you at Stanford with diabetes. It shortens your life 15 years and costs $11,000 per person per years. And if you're fat at 5, 10 or 15, you're going to be fat at 50. Then you come to me and say, 'I'm sick. Take care of me.'
Q: So the key is to get them early?
A: We need kids and their parents. It's health literacy. Right now it's a staring contest. Are we going to continue to be paying the bill for the people who don't take care of themselves, the 200 million fat Americans? They are talking about a surgery for diabetes now. I think that's immortal.
Q: Immoral how?
A: To do that is to get a smoker to stop smoking by amputating his fingers. And Stanford loves it because they can charge you for it.
Q: How popular are you now at Stanford with your contrarian views?
A: I'm in the face of my dean and my medical professors. But I'm right. And they know it. They are guilty. But medicine is a whore house.
Q: Later in the book, you touch on the quality of life issue, how being engaged in life helps you live longer and how an active elderly sex life keeps you living. Is that another incentive for staying fit?
A: I wrote a paper on aging sexuality and fitness. I surveyed our lifelong fitness association group and we've much sexier.