Staying in good health isn't a question of luck

Thinking about giving someone a gold watch as a present for their 50th birthday? Think again, as a gym voucher might be better for today's middle-agers. 

Living a long and healthy life is something most of us want. According to research, it's not a matter of luck or genes; instead, mid-life lifestyle habits play a crucial role. Even with a family history of dementia, one's own actions can help reduce the risk of developing a memory disorder.

"Changes in the brain that lead to dementia can start 20 to 30 years before diagnosis, which means that mid-life is a good time to slow them down," says Research Director Miia Kivipelto.

She is the leader of the CAIDE study that is shedding light on the role of mid-life lifestyle habits in the prevention of dementia. The recent FINGER study, on the other hand, shows that lifestyle improvements enhance cognitive function even in the elderly.

Brain and heart health are largely the sum of the same factors. Being overweight or having elevated levels of cholesterol, blood pressure or blood sugar in mid-life double the risk of developing dementia later in life in comparison to those who don't have any of these risk factors. A combination of the risk factors, in turn, multiplies the risk.

 "We know more and more about the role of nutrition and exercise. In Western countries, a lack of exercise is the single most important factor underlying memory disorders."

In the CAIDE study, people who exercised at least twice a week were less likely to suffer from dementia than those who exercised less frequently. The protective effects of exercise were particularly visible in overweight people. Furthermore, those who increased their exercise levels even after mid-life were less likely to develop dementia. The intake of vegetable fats, fish, vegetables, fruit and berries reduced the risk of memory disorders, whereas the intake of saturated animal fats such as butter increased the risk. In addition, the consumption of three to five cups of coffee a day showed memory-protecting effects.

The beneficial and adverse effects of alcohol are not far apart.

"We have varying observations about the dementia-protective effects of moderate alcohol use. Nordic studies show that for women, a maximum of one glass of wine per day, and two glasses for men, are beneficial.  For some, however, even that is too much," Kivipelto says.

Heavy use of alcohol is associated with dementia at least in the carriers of the ApoE4 gene, a risk factor of Alzheimer's disease. For them, other lifestyle habits also strongly contribute to the risk of developing dementia.

Furthermore, heavy alcohol use also increases the risk of stroke, whereas moderate use is considered to protect against it. However, according to the Kuopio Ischaemic Heart Disease Risk Factor study, KIHD, daily use of alcohol is not recommendable. The study observed that people who drank even small amounts of alcohol more than twice a week were at a three times higher risk of stroke than those who did not consume alcohol at all. Moreover, heavy alcohol consumption on one occasion – four units a day for women and six for men – increased the risk of both stroke and heart attack.

Poor physical condition is at least as equally important a health risk as smoking, obesity, high blood pressure and elevated serum cholesterol.

"The beneficial health effects of exercise are more extensive than those of any drug," says Professor Rainer Rauramaa, Director of Kuopio Research Institute of Exercise Medicine. 

In addition to memory disorders, exercise has beneficial effects on the risk of diabetes, cardiovascular diseases, osteoporosis and cancer, as well as on the immune defence system and survival in general.

 "In a ten-year follow-up, enhanced oxygen intake equivalent to an improvement of one kilometre per hour in running speed reduced the risk of death by 15 per cent.  This kind of improvement in physical condition can be achieved by following general exercise recommendations, which involve several endurance and strength training sessions a week." 

Without exercise, the decline in physical condition starts at the age of 35. 

"When reaching old age, one may be in such a poor condition that outside help is necessary."

According to Rauramaa, 50 is the age when it's high time to start strength training in addition to endurance training, if it hasn't been done already. Without training, muscle mass diminishes at a speed of 1-2 per cent – up to half a kilo per year. Fast muscle cells, which help maintain balance on a slippery surface, for example, are the ones to diminish the fastest.

When looking at the KIHD study participants as groups of people whose certain lifestyle habits were either good or bad, it was noted that the better a person's lifestyle habits were, the smaller the risk of death and illness due to cancer, cardiovascular diseases and other reasons. 

"The risk was lowest in people who had all the factors we were looking at in order: consumption of vegetables, exercise, non-smoking and moderate use of alcohol," says Professor of Epidemiology Tomi-Pekka Tuomainen.

However, it is a consolation that even a single good lifestyle habit has protective effects.

"It's a good start to add the intake of vegetables, fruit and berries. Looking after your health shouldn't be something that causes stress and anxiety," says Docent Sari Voutilainen.

Indeed, positive feelings count, and stress, depression and feelings of hopelessness increase the risk of dementia, among other things.

"The brain also needs new challenges and social interaction," Kivipelto adds.

Text: Ulla Kaltiala Photos: Raija Törrönen


Giving your brain something to do

Beware of getting stuck in routines. 
Learn new things, seek challenges and the company of others. 
Combine cognitive function, exercise and social interaction: learn to dance, for example. 

How much exercise is enough?

Light endurance training (walking, cycling) at least two and a half hours per week or heavier endurance training (running, skiing) for one and a quarter hours per week. In addition, muscle training (gym, aerobics) at least twice per week.

Daily vegetables

Enjoy at least 500 grams of vegetables, berries and fruit on a daily basis, that is, 5-6 portions – something in every meal. One portion is equivalent to 1.5 dl of vegetables, one piece of fruit or 1 dl of berries. 

Population-based studies

The risk and protective factors of common chronic diseases (KIHD study) and dementia (CAIDE study) are studied as part of follow-ups starting at mid-life. Dr's Extra focuses on the health benefits of exercise intervention, while the FINGER study analyses the effect of lifestyle intervention in the prevention of dementia.

Statistics on death in Finland

A 50-year-old has an average of 33 years ahead of them. 
Two-thirds of those who died in 2013 were over 75.
Causes of death: vascular diseases 38 per cent, tumours 24 per cent, dementia 15 per cent.