Back in the 19th century, the physician and writer Oliver Wendell Holmes Sr. wrote the cheerful poem “The Deacon’s Masterpiece or The Wonderful One-Hoss Shay.” The poem tells of a deacon who wanted to build a perfect shay, a popular two-wheeled carriage drawn by a horse, one that would last 100 years. He did so, using the finest materials and craftsmanship.
And indeed his shay did endure a full century and then–literally to the day–it fell apart, virtually all at once. There was no single problem at the end of the shay’s 100 years; it just sort of dissolved into itself.
“Have you heard of the wonderful one-hoss shay,
That was built in such a logical way
It ran a hundred years to a day,
And then of a sudden it — ah, but stay,
I’ll tell you what happened without delay…”
Ideally, each of us has the potential to start life a lot like the deacon’s masterpiece shay, functioning smoothly with just a few glitches along life’s road, rolling on with the years in good health until finally, in our 80s, 90s, or 100s, our bodies give out. To have lived a life like this–being born, maturing to adulthood, growing old, and then without a multiplicity of chronic illnesses dying at an advanced age–is more prosaically called “the rectangularization of a lifespan.” To see what’s meant by that, look at the graph below.
- The light blue line shows people in the 19th century, developing chronic illnesses in their 40s with many people dying off by their 60s and 70s.
- The red line, late 20th century, shows that things are better. We’ve reduced childhood deaths, are postponing the development of chronic illnesses (heart and lung problems, diabetes, cancer), and living longer.
- The dotted line completing the rectangle shows how we might “rectangularize” our survival curve. And then, after many years of good health (like the one-hoss shay) life is over. On some distant day, tucked into a warm bed and surrounded by an assortment of concerned faces that vaguely resemble our own, we’ll die.
Famous people who rectangularized their lives: comedian George Burns, working until he reached 100 and dying a few weeks later; playwright George Bernard Shaw (94); composer Irving Berlin (101); and, with luck, some of your relatives.
Preventing late-life chronic illness is the best way to rectangularize our survival curve, and everyone reading this knows the basic rules: maintain a healthful weight, eat a real-food diet, avoid tobacco, keep active. And now, as reported in last week’s Archives of Internal Medicine, comes a key factor in preventing late-life chronic illness, a state of being called “mid-life fitness.”
This Archives report is quite an accomplishment of data collection
Starting in 1970 and ending in 2009, the Cooper Center for Longitudinal Study at the Cooper Institute in Dallas tracked a total of 18,670 people, monitoring their level of fitness (defined by physical activity, treadmill abilities, etc) and their development of chronic illnesses. They were able to follow this group closely because all ultimately entered Medicare and thus the researchers could determine exactly who had developed what based on claims, physician records, and patient self-reporting.
The illnesses they looked for were heart disease, stroke, chronic lung disease, and diabetes–the four life-shortening illnesses most preventable by lifestyle changes.
And the results were what everyone would hope for. Being fit in your 40s places you at a dramatic advantage as you age. Your likelihood of developing one of the big-four chronic illnesses is less than half that of the rest of the population. In this study, the fit rectangularized their survival curve and either were still alive and doing very nicely (“thriving of the fittest”) or had lived nice long lives and one day just died.
Your best bet for thriving is to start now. The money you’re hoarding for that new flat screen TV? Use it instead to purchase nutritious foods, join a health club, buy an elliptical, or hire a personal trainer and you, the masterpiece one-hoss shay, can continue to…
Be well,
David Edelberg, MD