social life. There's a loneliness epidemic going on in the developed world, certainly in the United States, and this impacts our health as well. So citing all of these factors that are going to lead us to a longer health span is backed up by data, and there's a lot of good data that such things as eating enough protein and doing resistance training, for example, reduces the risk of frailty or falls, uh et cetera.

And this is uh so for a long list of disorders that are on the list that I just read, as well as other disorders such as arthritis and knee pain and eye disease that many of us will experience in our later years.

This is Doctor Talks. Real talk from real doctors on the issues that matter to you most. Hi, it's great to see you. I'm often asked, what is the definition of lifespan and health span?

And why would you want to study these two things? That's what we're going to talk about today. And the rest of our series will be focusing on ways to improve our health span through lifestyle medicine, basically.

So the average lifespan of an American woman. And I'm sorry for those of you who are not in the U. S., but these are the data that I have the most uh experience with.

The lifespan of the average American woman in the U. S. is in around 81 years of age. But the health span is somewhat less than 10 years less than that.

So most people will be in pretty good shape until they're in their early to mid sixties. So lifespan is how long we're alive. Health span is how long we're having a reasonable quality of life.

And there's obviously a huge difference there. So what is going on in those years between health span and lifespan? Well, what we've been able to do with modern medicine is to uh control a lot of diseases and uh prevent mortality from many diseases.

So oftentimes nowadays, if you have a heart attack, you won't die from it, but you often will be severely limited in what you're able to do. So the years with no good health span, but still alive are often characterized by people with limited mobility, multiple medications, limited exercise tolerance, symptoms like shortness of breath or chronic pain.

And so this is something that none of us wants to experience. And that's the whole point of this series of talks. So what are the medical problems that ah can cause us to have a limited health span in spite of a longer lifespan?

Well, it turns out that More than half of American women, that is, have uh high blood pressure, for example, once they are in menopause. And again, the data here are highly variable from one report to another based on exactly what age limits they are looking at and exactly what definition of blood pressure.

But that's just a rough estimate of how many people have high blood pressure. Similar numbers for high cholesterol are noted in the UK, but in the US they seem to be less.

I'm not sure why that is. Fewer people are characterized as having high cholesterol or lipidemia, hyperlipidemia. What about diabetes and pre-diabetes?

Well, again, the numbers depend on exactly what study you're looking at, but this turns out to be an enormous problem. And it's estimated that fewer than 10 % of people in the US over age 60 are metabolically healthy.

In other words, all the check marks that we've been talking about, blood pressure, diabetes testing, cholesterol, activity levels, and so on, obesity, are all baked into a formula.

And fewer than 10 % of the people are getting good check marks in every single box. And I'm one of those people. I have several things going on in my own health span and lifespan, which have caused me to record conferences.

So why should we care about that? Well, obviously quality of life is important and also the cost and the resources that are being utilized. There's enormous use of resources, especially in the last year of life for many of us.

And there's some concern that these resources won't be available in the future, especially as the uh number of employed younger people who are contributing to the Medicare funding diminishes.

that's uh besides what it feels like to have a limited lifespan ah or a limited house span rather, that is the financial reason to be concerned about it.

So let's start with a couple of the items that are deemed important by the American Heart Association because cardiovascular disease is still the main cause of loss of life in the United States for both men and women.

So the American Heart Association has come up with what they deem life's essential aid. And I'm gonna be reading these off so I don't miss any of them.

Blood pressure management. And the current definition of good blood pressure is below 120 over 80. So that definition has changed in recent years. uh Controlling cholesterol, and again, the definitions are going to vary in different settings.

Having good sleep is important, and we're going to have sessions on sleep in the near future. Eating healthy food. And again, there's an endless supply of dietary advice floating out there in the news media and on social media.

And we're going to call on some experts to try to guide us through that. Avoidance of smoking. We've known for many, many years about the concerns of smoking for lung cancer and heart disease.

And it turns out for many other disorders as well. reasonable activity level, and this is where many of us fall down. We're going again to be talking quite a lot about what constitutes healthy activity and why does it matter.

uh Avoidance of diabetes. So if your testing indicates that you have diabetes, that you be on treatment for that disorder. And minimizing alcohol. And again, for women, Most reports would suggest that one drink per day is the maximum.

And many advocates for sobriety are quoting literature that says that there's no healthy level of alcohol intake for anybody at any age. So we're going to be talking more about this.

Besides the American Heart Association Essential Aid, A couple other items that we might put on this list that may make it onto their list one of these years are caring for our teeth, good dental care.

And there's data about what tooth decay and gum disease can offer as far as risk for different diseases. Social life, there's a loneliness epidemic going on in the developed world, certainly in the United States.

and this impacts our health as well. So citing all of these factors that are going to lead us to a longer health span is backed up by data. And there's a lot of good data that such things as eating enough protein and doing uh resistance training, for example, reduces the risk of frailty or falls, oh et cetera.

And this is so for a long list of disorders that are on the list that I just read, as well as other disorders such as arthritis and knee pain and eye disease that many of us will experience in our later years.

So ah it's not just that it's a pretty picture to have all these good behaviors and good life qualities going on, but It's how you get to be healthy into your later years, as healthy as you can be.

And the other thing about this list is that, quote Stacey Sims, women are not small men. And much of the medical literature historically has not included women as a separate group.

Some of them actively excluded women for a number of years for several different reasons, pregnancy uh and risk to the newborn being one of them. But what we currently have is a situation where women are being treated as though they were small men oh in many instances.

So the guidelines for how much of a given medication to use or what's the proper cutoff for a certain blood level of such as the lipids or the blood pressure levels have been established historically with men.

So that has been correcting itself mostly since 1993 when a law was passed to improve the access of women into the medical clinical research system. But then there are also diseases that are much higher risk for women.

dementia being one of them. Osteoporosis is another one, bone health, which we will talk about. Obviously, breast disorders are not confined to women, but they are hugely more prevalent in women than they are in men.

And there's a few other disorders like this. So these need to be particularly focused on in our series of talks. So it's great to have you on board. I hope you find this interesting.

and you get some important life strategies from these talks. Thanks so much. Thank you for tuning into Dr. Talks. We hope today's episode has enlightened and inspired you on your path to optimal health.

Each day is a new opportunity to make choices, but empower your wellbeing. For more insights and strategies, subscribe to our podcast and visit our website, www. DrTalks.com.

Stay connected. Stay healthy and join us next time on Doctor Talks, real talks from real doctors on the issues that matter to you most.

Women’s Healthspan Voices with Dr. Pat McShane

Patricia McShane, MD

Comments