insights

Life expectancy in the US has dropped for the third year in a row, according to the CDC’s National Center for Health Statistics.¹ A baby born in 2018 is expected to live 78.6 years, which places the US behind many other developed nations and lower than the Organization for Economic Co-operation and Development life expectancy of 80.3.² As Lenny Bernstein notes in The Washington Post, the last three years represent the longest consecutive decline in the American lifespan at birth since the period between 1915 and 1918, which included World War I and the Spanish Flu pandemic, events that killed millions worldwide.³

“Tragically, this troubling trend is largely driven by deaths from drug overdose and suicide,” said CDC Director Robert R. Redfield, MD, in a public statement.⁴ “Life expectancy gives us a snapshot of the Nation’s overall health and these sobering statistics are a wakeup call that we are losing too many Americans, too early and too often, to conditions that are preventable.”

Decreasing quality of life and life expectancy may continue as the younger generation matures; however, Functional Medicine clinicians can help reverse this trend by promoting whole-body health and wellness for patients. As the population becomes increasingly ill, clinicians need strategies and patient education to help with lifestyle changes. With the right tools, clinicians can empower patients to make the sustainable changes they need.

In the following video, IFM educator Terry Wahls, MD, talks about how the principles of Functional Medicine can be applied in any practice to reduce the reliance on medications and disease-modifying therapies.

Physical Activity

Some researchers have described “successful aging” as “adding life to years not years to life.”² However, there is no consensus definition of the term.⁵ A wide array of research on nutrition and exercise over the last few years has pointed to the possibility of extending healthy lifespan and preventing chronic disease. A 2018 study suggests that older adults who exercise above current recommended levels have a reduced risk of developing chronic disease compared with those who do not exercise.⁶ The data showed that adults who did more than 5,000 metabolic equivalent minutes (MET minutes) each week saw the greatest reduction in the risk of chronic disease. High levels of physical activity—well above the current recommended minimum level of 1,000 MET minutes/week—increased the likelihood of aging successfully 10 years later.⁶

Even gentle physical activity may have health benefits. In 2019, a meta-analysis and systematic review examined the effect of Tai Chi Chuan (TCC)—sequences of very slow, controlled movements—on negative emotions in non-clinical populations.⁷ This mind-body practice significantly improved negative emotions in both young and older adults, finding that TCC is a worthy complementary non-pharmacological resource for depression and anxiety.⁷

Learn more about Functional Medicine

Nutrition

Advancements in the understanding of diet and aging include research on the relationship between genetics and nutrition, as well as the influence of the gut microbiome on mood and anxiety symptoms.³ Nutrition is considered the cornerstone for the prevention of age-related diseases.⁸ A 2014 randomized trial of the Mediterranean diet, published in the New England Journal of Medicine, suggests that for people with a high cardiovascular risk, the Mediterranean diet supplemented with extra virgin olive oil or nuts reduced the incidence of major cardiovascular events.⁹

Dietary patterns that support health include the Mediterranean diet, the Dietary Approaches to Stop Hypertension (DASH) diet, the 2015 Dietary Guidelines for Americans, and the Healthy Eating Plate.⁷ These approaches have benefits that include prevention of cardiovascular disease, cancer, type 2 diabetes mellitus, and obesity, and are supported by strong evidence that promotes a primary focus on unprocessed foods, fruits and vegetables, plant-based fats and proteins, legumes, whole grains, and nuts.¹⁰

The connection between diet and mental health is significant as well. An interesting, three-year longitudinal prospective study in 2017 found that girls with emotional symptoms during early adolescence had a high adherence to a pattern rich in sweet and fat foods and low adherence to the Mediterranean diet.¹¹ They also engaged in low levels of physical activity.¹¹

Conclusion

“Your biggest tool [as a clinician] is diet and lifestyle, and providing meaning—helping people realize that they have control,” said Dr. Terry Wahls.

IFM provides clinicians with tools to help their patients adopt heathy lifestyle practices, such as eating more high-quality foods that are rich in phytonutrients, to address the underlying causes of age-related dysfunction and support general health and wellness. Learn more about tools and strategies to help patients achieve sustainable lifestyle change and improve their well-being through IFM’s new course Lifestyle: The Foundations of Functional Medicine.

Evidence-based lifestyle modifications for health

Lifestyle alternatives to anti-depressants

Diet, nutrition, and lifestyle journal helps patients track daily choices

References

1. National Vital Statistics System. Quarterly provisional estimates for selected indicators of mortality, 2017–quarter 4, 2018. Centers for Disease Control and Prevention. Published June 11, 2019. Accessed August 18, 2019. https://www.cdc.gov/nchs/nvss/vsrr/mortality.htm
2. Woolf SH, Aron L. Failing health of the United States. BMJ. 2018;360:k496. doi:10.1136/bmj.k496
3. Bernstein L. U.S. life expectancy declines again, a dismal trend not seen since World War I. The Washington Post. Published November 29, 2018. Accessed August 28, 2019. https://www.washingtonpost.com/national/health-science/us-life-expectancy-declines-again-a-dismal-trend-not-seen-since-world-war-i/2018/11/28/ae58bc8c-f28c-11e8-bc79-68604ed88993_story.html
4. Redfield RR. CDC director’s media statement on U.S. life expectancy. Centers for Disease Control and Prevention. Published November 29, 2018. Accessed August 28, 2019. https://www.cdc.gov/media/releases/2018/s1129-US-life-expectancy.html
5. Denham MJ. Lord Amulree (1900-83): the indefatigable advocate of older persons. J Med Biogr. 2006;14(4):236-242. doi:10.1177/096777200601400412
6. Harmell AL, Jeste D, Depp C. Strategies for successful aging: a research update. Curr Psychiatry Rep. 2014;16(10):476. doi:10.1007/s11920-014-0476-6
7. Zhang S, Zou L, Chen LZ, et al. The effect of Tai Chi Chuan on negative emotions in non-clinical populations: a meta-analysis and systematic review. Int J Environ Res Public Health. 2019;16(17):E3033. doi:10.3390/ijerph16173033
8. Gopinath B, Kifley A, Flood VM, Mitchell P. Physical activity as a determinant of successful aging over ten years. Sci Rep. 2018;8(1):10522. doi:10.1038/s41598-018-28526-3
9. Konstantinidou V, Daimiel L, Ordovás JM. Personalized nutrition and cardiovascular disease prevention: from Framingham to PREDIMED. Adv Nutr. 2014;5(3):368S-371S. doi:10.3945/an.113.005686
10. Estruch R, Ros E, Salas-Salvadó J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. . N Engl J Med. 2018;378(25):e34. doi:10.1056/NEJMoa1800389
11.  Locke A, Schneiderhan J, Zick SM. Diets for health: goals and guidelines. AM Fam Physician. 2018;97(11):721-728.
12. Aparicio E, Canals J, Voltas N, Valenzano A, Arija V. Emotional symptoms and dietary patterns in early adolescence: a school-based follow-up study. J Nutr Educ Behav. 2017;49(5):405-414.e1. doi:10.1016/j.jneb.2017.01.015