From obesity to loneliness, how can the middle-aged secure an extra 30 years of health? – Telegraph.co.uk

One of the most inspirational people Ive encountered in recent years is an American woman who is, I believe, the oldest stewardess in the world. Aged 84, Bette Nash has been flying for more than six decades: these days she serves customers on the American Airlines shuttle between Boston and Washington DC. She seemed surprised when I asked her for her secret. When I think about it now, she said slowly, I think my goal in life is to keep moving.

Without knowing it, Bette turned out to have been following three of the tenets of the old-age lifestyle gurus: keep active, retain your sense of curiosity and connect with people. She doesnt go to the gym, and she admits to eating chocolate, but its clear that the thrill of the job has never paled. She reminisced about the time she flew with Jackie Kennedy, wife of the former US President, in 1965. In those days, she said, the stewardesses wore white gloves and handwrote the tickets. The technology has changed since then, she says, but the people are the same. I thrive on people.

Is Bette Nash old? I dont feel like Im an old person she told me. My sister has Parkinsons and dementia and I look at her and think shes old, but shes younger than I am.

Bette is one of a new group of people, in their 70s and 80s, who are healthy and active and have much to offer, and living in what I call Extra Time an extended middle age. In Illinois, researchers have found that septugenarians who are still exercising after taking up running in the 1970s are now biologically 30 years younger than their chronological age aerobic activity being a miracle cure, according to the Academy of Medical Royal Colleges, due to its protective qualities against stroke, heart disease, some cancers and even dementia.

We are now seeing stark and growing differences between different groups in terms of both lifespan the number of years we can expect to live and healthspan, the number of years lived in good health. A shocking new report published last week by Sir Michael Marmot, director of the UCL Institute of Health Equity, finds that this gap is getting bigger. Life expectancy has stalled in England for the first time in 100 years, and gone into reverse for poorer women in deprived areas, including some of the red wall constituencies in the North East which voted for Boris Johnson.

A girl born in one of these deprived areas in 2017 will live on average three months less than one born in 2012; in that same time period, by contrast, a boy born in one of the richest areas is set to live on average three months longer. There is now a gap of almost 12 years in the healthspan of the richest and poorest.

The UK is not alone. Growth in life expectancy has slowed in many rich countries since 2011, as the dramatic improvements achieved by smoking cessation started to fade. But out of 16 OECD countries, the UK, the US and Iceland perform worst. Between 2011 and 2017, Estonia saw an annual improvement in life expectancy three times better than Britains.

What is going on? The Marmot review places most of the blame on government austerity. Sir Michael has previously demonstrated that people who work insecure jobs, who dont have control over their lives, have high levels of cortisol, the stress hormone associated with coronary heart disease, and his new report points to factors including poor housing, low incomes, zero hours contracts, cuts to Sure Start centres and air pollution. Yet the country-spanning nature of this issue seems to show there are more factors at play. Such as:

The report makes little mention of obesity, although it is associated with many of the chronic diseases which hit the poorest hardest: including type-2 diabetes and heart disease. The authors believe that obesity is a consequence of poverty and its certainly true that deprivation makes cheap junk food, cigarettes and alcohol harder to resist. But thats no reason to lie supine in front of the junk food merchants. The life chances of the poorest children would be improved if the government extended the sugar tax on fizzy drinks, which has led to a 28 per cent reduction in the average sugar content of those products, and banned junk food marketing. More schools could adopt the daily mile, invented by a Scottish headteacher to improve her pupils health with a fun daily walk or jog for a mile a day, which requires no special kit. Some GPs are already doing social prescribing: trying to tackle underlying psychological issues rather than just handing out a pill, and refer people to dance classes, should be expanded.

Does loneliness play a role? We know that people age better like Bette Nash when they have strong social connections. Yet two weeks ago, a chilling report by the Office for National Statistics suggested that social capital is declining dramatically. Communities are fracturing; neighbours have fewer positive interactions with each other; people are joining fewer clubs and societies and spending more time online, which does not bring the same level of interaction.

We urgently need to build new support networks not least because we are running out of children. This year, the number of people over 65 in the world has outstripped the number under five. This changing ratio of old to young means we cannot always rely on family. In Denmark and Germany many older people live in co-housing developments, with people who share a common philosophy. More of these in Britain could augment brilliant schemes like HomeShare, which enable older people to rent out a spare room to a student. In Germany, grandparents are even adopting single parent families who are not blood relatives. We need more of these intergenerational schemes.

Having a sense of purpose is also strongly correlated with better health. In Japanese culture, the concept of ikigai, or reason for being, plays an important role in Silver Centres, organisations which find part-time work for elderly people. I have seen 90-year olds using their calligraphy skills to write official certificates for companies, cleaning parks and packing goods for local businesses. The chance to be useful and have a gossip is a lifeline. In England we are good at putting on coffee mornings, but perhaps we need coffee mornings with a purpose.

There could be no starker indication of the north/south divide than the growing gaps in health and life expectancy. If the government is serious about levelling up, it must go beyond infrastructure to tackle health inequalities. Bette Nash, and those like her, show that the 21st century offers huge opportunities to live longer, better; indeed professor James Nazroo, at the University of Manchester, has found that it is only when they turn 80 that the richest third of Britons begins to experience the kinds of limitations i.e. in walking that people in the poorest third have been suffering from around 70. Many of the rich and well educated, then, are already making the most of Extra Time. But unless we spread that opportunity to everyone, our society will be the poorer for it.

Camilla Cavendish is the author of Extra Time: Ten Lessons for Living Longer Better, published by HarperCollins. You can buya copy for 9.99 at Telegraph Books.

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From obesity to loneliness, how can the middle-aged secure an extra 30 years of health? - Telegraph.co.uk