CHAPTER 1

POSTPONING YOUR ENTRY INTO THE DISABILITY ZONE

Possibly the greatest misconception people have about the process of aging is that it's synonymous with illness. It's true that chronic conditions such as heart disease are more common as we move up in years. But are such conditions a natural consequence of aging? Our research at the Human Nutrition Research Center on Aging (HNRCA) provides evidence that the link between chronic disease and aging is by no means as simple and straightforward as researchers once thought.

There are two principal factors responsible for the onset and severity of most chronic degenerative conditions -- your genetic heritage, which you cannot control; and your lifestyle, which you can and should control.

The goal of our Biomarkers Program, outlined in this book, is to maintain vitality into old age. It grew out of the realization that there are specific types of exercise and eating patterns that can greatly diminish the chances that people will develop a chronic disease; or, if they're already suffering from one, could help them escape from the imprisonment of its debilitating symptoms. How? By positively altering certain key physiological functions we call "Biomarkers."

The pillars of our Biomarkers Program are three forms of exercise -- strength-building and flexibility workouts aimed at your muscles; and aerobic or endurance forms of exercise aimed at your cardiovascular system. Besides quitting smoking (if you do), we believe there's no single thing that will increase vitality at any age more than exercise. Exercise, for reasons we'll outline in this book, is the prime mover in the drive to preserve vitality.

Granted, eating the right foods in the proper amounts is important to maintain health; but good nutrition alone will not have as appreciable an impact on most of our ten Biomarkers as exercise. Combine good nutrition with regular exercise, however, and you've got an unbeatable team. We can't think of a better antidote to fast aging.

Our Biomarkers Program is designed to

* prolong vitality by retarding or even reversing the usual biological deterioration process that people past 45 often begin to experience -- such things as metabolism slowdown, glucose intolerance, and declining strength,

* postpone disability by reducing the risk for such chronic conditions as heart disease, Type II diabetes, arteriovascular disease, hypertension, and osteoporosis,

* prevent the development of a common old-age malady we call "sarcopenia."

AN AGE-OLD PROBLEM FINALLY GETS A NAME

Think for a moment about any frail elderly people you know or have known. Maybe they aren't suffering from any serious chronic illnesses such as heart disease or cancer, yet for years they've been dependent on others for care. They spend most of their day sitting, and when they bother to get out of that easy chair at all, it's a struggle. In fact, they may need assistance to accomplish just the simple feat of going from a sitting to a standing position. They walk very tentatively -- probably with the aid of a walker or cane. It's as if their muscles no longer have enough power to deal with their body weight, let alone with even the most minimal activity. While their minds may still be quite nimble and alert, their bodies are diminished. They've lost so much muscle tone, their flesh seems to droop. In layman's terms, you could say their bodies have "rusted out" like an old piece of machinery nobody uses anymore. These old people have no diagnosed disease to explain their lack of oomph and vitality, yet it's clear that they've got bodies that have long since passed their prime.

We submit to you that such people have diminished to the point where they are suffering from a disease, only it's one that's never been given a name before. We're giving it a name here in the hope that it -- like osteoporosis, arthritis, and the other degenerative conditions of old age -- will begin getting widespread public attention.

We chose the term sarcopenia because "sarco" in Greek, the language from which so much medical terminology emanates, refers to flesh, the body; "penia" means "reduction in amount or need." Hence, we're describing an overall weakening of the body caused by a change in body composition in favor of fat and at the expense of muscle.

Although relatively little attention has been focused on the high-fat/low-muscle-power condition of sarcopenia, it's an extremely common condition in the elderly. Visit any nursing home and you'll see myriad examples of sarcopenia. Indeed, it's probably the most prevalent ailment.

In all fairness, sarcopenia has been overlooked for good reason. Its deleterious contribution to other old-age diseases is complex, subtle, and in many cases still little understood. Moreover, in contrast with more dramatic chronic diseases whose cluster of painful symptoms overtake a person in a matter of months or a few years, sarcopenia is a gradual wasting away of the body over the course of decades.

As they age, potential sarcopenia victims in their middle years slip into a sedentary way of living. The more they sit around, fail to exert themselves, and are waited upon by others, the greater the amount of their body's muscle mass that is replaced by fat. This insidious weakening of body structure and gradual loss of functional capacity then becomes a good excuse for continuing the pattern of immobility.

In the best of all possible worlds, of course, we'd have a coordinated national health policy to combat sarcopenia, as we have for osteoporosis (which is sometimes called "osteopenia," i.e., too little bone). We'd have a nationwide education campaign aimed at preventing sarcopenia; and we'd segregate those already suffering from it, perhaps treating them in special sarcopenia clinics where they'd receive daily therapy to reverse their condition. Our Biomarkers Program is an example of such treatment. For a finite period in residence, the frail elderly would work toward the goal of altering their body composition in favor of muscle and at the expense of fat. Eventually, when functional capacity was restored, they'd be released -- with the understanding that they would continue active therapy at home. In short, they would continue getting well on their own time.

Unfortunately, we are not yet living in the best of all possible worlds as far as sarcopenia is concerned. Since sarcopenia, to date, isn't even recognized as a problem, most of the frail elderly suffering from it get no treatment whatsoever to reverse its debilitating consequences. Millions of old people in the United States remain in nursing homes suffering from this unheralded low-muscle-power infirmity. And, all the while, public policy-makers wring their hands worrying about how the nation will ever pay for the baby boom generation's expected decrepitude three decades hence.

It's important to understand that sarcopenia is not a necessary or normal component of aging.

THE DISABILITY ZONE AS MOTIVATOR

Sarcopenia, like such chronic conditions as cardiovascular disease, Type II (maturity-onset) diabetes, hypertension, and osteoporosis, is associated with a sedentary lifestyle, too little exertion over a long period of time. Its remedy is the converse: the type of physical activity outlined in this book -- muscle-building and aerobic exercise regimens that people undertake for the rest of their health span.

Note we used the term health span, rather than lifetime. The distinction is an important one. Your health span is that time when you're functional and able to perform everyday-life tasks for yourself. You're self-reliant and capable of independent living in a natural home environment. In other words, your "functional capacity" is good. In contrast, your functional capacity is low when you can no longer lift a full garbage can and carry it to the side of the road or even drag it there...when that one-mile walk to the nearest bus stop or climbing two flights of stairs becomes so taxing you no longer attempt it...when you notice you can't stretch up and get something from the top shelf in your closet anymore.

The notion of "functional capacity" is more qualitative than quantitative, based more on observation than on narrow scientific criteria. Although comedian George Burns, America's favorite geriatric, probably never heard the term functional capacity, he gave his comments on the subject in his epistolary book, Dear George: Advice and Answers from America's Leading Expert on Everything from A to B. One fan asks:

Dear George --

As one geriatric to another, maybe you can tell mere at what point does one graduate from elderly to old?

Another Geriatric

Dear Geri --

You'll know you're old when everything hurts, and what doesn't hurt, doesn't work; when you feel like the night after and you haven't been anywhere; when you get winded playing chess; when your favorite part of the newspaper is "25 Years Ago Today"; when you're still chasing women but can't remember why; when you stoop to tie your shoelaces and ask yourself, "What else can I do while I'm down here?"; when everybody goes to your birthday party and stands around the cake just to get warm.

(These things really happen when you get old. I know, because that's what my father keeps telling me.)

George Burns is a nonagenarian with good functional capacity despite his chronological age. He was born on January 20, 1896, and unlike many of his chronological peers whose get-up-and-go long since got up and went, he's still a contender. As of this writing, he's dispensing witty advice, similar to what you just read, both in books and on radio and TV talk shows.

In contrast with George, older people with a low functional capacity who can no longer care for themselves can be said to have entered the "Disability Zone" -- that period, usually at the end of a person's life, when he or she becomes increasingly dependent on others.

The average man-in-the-street perceives old age as a sojourn in the Disability Zone. Stop people at random on any street corner, and here's a representative sampling of what you'll hear about that dreaded Disability Zone, although no one will use the term:

"Old is when physical impairments rule your life."

Or...

"It's when you've allowed your body's weaknesses to take control of your mind and spirit."

Or...

"You know you're old when you sit and watch as other people perform the everyday rituals of life for you."

Our research shows that the states of decrepitude described in these statements can be altered through the Biomarkers Program described in this book. You could think of our Biomarkers Program as the means to slow and flatten out your descent toward the Disability Zone. As the schematic shows, making the transition to a healthier, more energetic lifestyle via our Biomarkers Program at as early an age as possible promises to add years of vitality to your life -- and postpone for decades your entry into that unfortunate Disability Zone.

Sarcopenia is one of the main ailments that forces people into the Disability Zone. Thus, we feel if sarcopenia can be avoided, a person stands a very good chance of bypassing that dreaded Disability Zone altogether. Although we have no longitudinal studies to prove it yet, we believe that middle-aged people who remain faithful adherents to an active Biomarkers lifestyle throughout their 50s, 60s, and 70s could find themselves in the fortunate position of having their health span approach their life span.

Some of you may be wondering: Can a transition to a more active lifestyle via the Biomarkers Program increase my longevity?

Based on the current research, we can state unequivocably that people who engage in mild but regular exercise have a longer life expectancy than those who are sedentary. What we don't have as yet are statistics on the life expectancy of sedentary people who begin an exercise program in their 50s or 60s. We cannot say with certainty that they will live longer than if they stayed in that rocking chair. We suspect they will, but a definitive answer must await the conclusion of longitudinal studies encompassing the sweep of a lifetime.

We can say this: If you change your lifestyle and undertake the Biomarkers Program, the quality of your remaining years will be greatly enhanced. You'll avoid that Disability Zone much longer than you would have by remaining in that easy chair.

AS MANY AGING SCHEDULES AS THERE ARE PEOPLE

Some gerontologists have likened the process of biological aging to a long, slow tide that moves upon us so gradually it may take a long time before we're aware of its presence. Certainly aging is not something that happens suddenly. It moves in on us in increments over the whole middle part of our lives. As Butch Cassidy remarks ingenuously to his sidekick, the Sundance Kid, in the film bearing their names: "Every day you get older. That's a law." What's not an immutable law, though, is the pace at which you get older. That varies enormously from one individual to the next.

The beat of your biological drummer is different from ours and the next person's. Indeed, older people are more unlike their peers than younger folk. By a long shot. Decades of studying both normal and abnormal aging -- that is, premature aging due to illness -- have convinced investigators beyond a doubt that the older people become, the less like each other they become. Some people are weak and withered and wrinkled at age 60. Others, at age 75, are energetic, eager for new adventures, and look and feel far younger than their chronological age.

This fact has certainly been brought home to us at the HNRCA, where we've recruited thousands of volunteers for research studies over the last five years. Every week we interview older people whose chronological age, appearance, and medical test results surprise us. We'd like you to meet three senior citizens, all people who volunteered for our research studies. In terms of their aging timetables, they represent different ends of the spectrum:

Frank was 66 when he came into our center for a screening interview. He was a distinguished-looking man, and his comportment indicated he knew it. Frank characterized himself as "health-conscious," but as he talked a different picture emerged.

Frank had a whole litany of minor ailments and annoyances, but he'd only gotten treatment for those visible signs of aging that showed when he looked in a mirror or that he knew other people would notice. Although he certainly understood the connection between smoking and cardiovascular disease, he felt he was somehow immune. His father had lived to a ripe old age, why shouldn't he? Frank is like a lot of people in our society. He sees health through the prism of appearance and vanity. He has little concept of what real fitness or physical well-being are all about.

In all fairness, Frank abhorred the idea of losing his youthful looks for a very practical reason. He equated the external signs of health with economic survival. Frank had spent his career in an industry where youth and attractiveness are highly prized, and aging in an ungraceful fashion could be the unspoken grounds for dismissal.

For most of his career, Frank was a salesman for several leading national magazines, making the daily rounds of advertising agencies and executive suites soliciting pages of advertising. Even though the job was high-pressure, the glamour and chance to live well on a lavish expense account appealed to him. Sometimes he found it hard to believe he was actually being paid a good salary to enjoy life.

But by age 49 Frank had grown tired of all the glad-handing and free spending and decided he wanted a different type of job. He'd always had a flair for words, so he decided to use his advertising agency contacts to get a copywriting job. A string of interviews that didn't pan out and a long look in the mirror convinced him that his age was showing more than he'd thought. He resolved to do something about it.

Frank subscribed to several health magazines and bought a battery of vitamin and mineral pills. He went on a crash diet and did muscle-toning exercises in his bedroom until he lost the beefiness in his face and girdle of body fat he'd started to develop around his middle. Even though his eyesight was poor, he decided he could no longer afford to be seen in eyeglasses, especially bifocals, a sure sign of advancing age. He started wearing contact lenses and later switched to bifocal contact lenses, even though they gave him constant trouble and he couldn't see very well. The final touch was an expensive hairpiece to cover the signs of his receding hairline.

Frank landed that copywriting job and was in that line of work when we met him. His true health and fitness were another story.

When we took a medical history, Frank admitted, with some embarrassment, that he'd had a little plastic surgery once; and he'd also tried a number of skin-care elixirs that made claims of eliminating wrinkles and firming the skin. Frank's hearing was impaired, but he'd done nothing about it because he refused to wear any ear device, no matter how small. Frank was startled when he discovered he'd already shrunk a half inch from his peak height of 6 feet. Although he weighed only 10 pounds more than he had in college and he looked relatively trim, his body had gained fat and lost considerable muscle. He now had a lean-body mass/body-fat ratio of 4:1. The body fat gain was concentrated in his belly. At 20 he'd had a 36-inch chest and 33-inch waist. Our tape measure showed he now had a 37-inch waist.

Frank's muscular strength was below average. He'd never lifted a weight in his life, nor did he see much sense in the stretching exercises his wife did in front of the television set in their bedroom every morning. He adamantly refused to join her, and the flexibility and range of motion in his joints were the worse for it.

Frank was an off-again, on-again jogger and a once-a-week tennis player. His cardiovascular endurance on a treadmill showed it. He was below the norm for his age. Likewise, his blood pressure was high for a man of his age and race.

We asked Frank to describe a typical day.

Frank explained that he and his wife live in a condominium community geared toward people aged 50 and over. The grounds are maintained beautifully by professional landscapers, and maid service is even provided for an extra fee, so he feels it's the ideal place to work at home, his current situation. Despite the fact that he's a free-lancer, he maintains 9-to-5 hours. Breakfast is three cups of black coffee and several cigarettes, which he consumes while scanning the morning newspaper. His wife is off to work by 8:30, about the time he makes it over to his computer to start his workday writing advertising copy. Work consists of reading, writing, and talking on the telephone, punctuated by occasional visits to clients' offices or a business luncheon.

His wife gets home around six, and an evening's worth of congeniality and good food commences. The couples within their circle of friends pride themselves on their culinary skills and go all out preparing meals for each other. Frank and his wife dine out four or five nights a week, either at friends' homes or in restaurants. He gets to bed around 1 or 2 A.M. but has a problem with insomnia. He never lies in bed and worries about it, though. Instead, he reads a book or settles in front of the TV set with his cigarettes and cognac to watch a late-night movie.

While awaiting further evaluation to become a participant in one of our studies, Frank suffered a stroke that left him partially paralyzed on the right side of his body. At our last contact Frank was at home, undergoing daily rehabilitative therapy.

Frank's story is one of premature disability brought on by a misconception of what constitutes good health habits. We tell it by way of contrast with an older couple we screened around the same time.

George and Elaine McGrath live in rural Vermont on a nonworking farm they bought 50 years ago when they were young parents. It was the ideal country retreat, an unpretentious, semi-rundown place where they could turn their five children loose to roam in nearby fields and woods during summers and on weekends.

Years later, when their children were grown, they questioned whether they wanted to continue being responsible for the ramshackle, nineteenth-century house and outbuildings, not to mention the ten acres of meadows that went with it. They put the property up for sale. But after two months and no takers, George admitted he missed the challenge of caring for the place and felt cooped up on weekends in their suburban ranch home in the Boston suburbs. They decided to keep "the farm," as they call it. Later, when they retired, George talked Elaine into moving there permanently, and neither of them have regretted it.

George, a former accountant, and Elaine, ex-administrator of a social services agency, have never made a conscious effort to exercise, nor did their white-collar occupations demand any strenuous activity. The upkeep of the farm was -- and still is -- the only thing that forces them to use their muscles to any great extent.

Years ago the whole family renovated several of the outbuildings. Since their retirement, the two of them, with minimal outside help, have made further major improvements to the property. They've remodeled the main house and, as recreation for their visiting grandchildren, added a patio and swimming pool. The adjoining heated whirlpool bath is for their pleasure and relaxation. It's a godsend after a hard day of labor in their quarter-acre fruit and vegetable garden or when used to ease their sore muscles after a vigorous wood-chopping session.

The couple assured us they're not lonely, nor are they alone, despite the fact that they live on the crest of a hill two miles outside the nearest town. Their housemates are six cats, a big shaggy Scottish sheepdog who seems to produce puppies on a fixed schedule, and George's loyal Irish setter. The dogs accompany them on long daily walks, sometimes to do errands in the town nestled in the valley below them. Since they're snowed in for several weeks each winter, making vehicular travel perilous, foot power is often the only way to restock the refrigerator with the bare essentials. Besides, they say they've gotten hooked on their long walks, not just as a practical necessity, but as a form of enjoyment since the rolling landscape in their vicinity is very beautiful.

Their health?

George had open-heart surgery five years ago to replace a malfunctioning cardiac valve, which had caused him to suffer fainting spells. After an uneventful recovery, George said he felt better than ever -- and greatly relieved that he no longer had to worry about fainting at unexpected times. Except for various allergies and occasional attacks of bursitis, he has no major complaints. He said it took him much longer to do things now than when he was younger, but the more leisurely pace was nice. It gave him time to savor each project.

Elaine was also in good health and spirits. Years earlier, as a frazzled working mother, her crucible had been severe, incapacitating backaches. But for the past 30 years she'd done a series of stretching and back-strengthening exercises each morning that offered relief. Now, with no time pressure and stress in her life, the backaches were gone. She had arthritis in her hands, but she found she could reduce the pain by playing technically demanding music on the piano or the organ of the local church, where she was the choir director. While Elaine had lots of facial wrinkles from the many years she'd spent relishing the sunny outdoor life, she never mentioned them, nor the fact that her posture was somewhat stooped and she'd shrunk almost two inches from her peak height of 5 feet 6 inches.

Have you guessed their ages yet?

At the time of our first meeting, George was 81 and Elaine was 77. Clearly, neither of these two vital older people was anywhere near entry into the Disability Zone. Their active lifestyle and better-than-average results on various age-adjusted Biomarker tests were proof enough of that.

Compare George and Elaine's situation with that of Frank. At 66 Frank has already entered the Disability Zone, perhaps to emerge from it, perhaps not.

DISEASE-FREE AGING IS PARTLY WITHIN YOUR CONTROL

As these examples show, people can, indeed, deflect their descent into the Disability Zone by controlling the key physical aspects of aging that are, to a great extent,within human control -- your control!

We know that the decline in our ten Biomarkers of vitality can be halted, or at least slowed down considerably, through our exercise and diet program. All ten of these Biomarkers are amenable to intervention via our program -- what we call "Biointervention." We have studies to prove they're amenable to change even if you're already 75 years old and feel overburdened with aches and pains and have long since accepted the idea that an energetic lifestyle is over for you.

No, you're never too old to exercise. To the contrary, you're too old not to exercise. That's certainly the lesson that 12 men, aged 60 to 72, learned when they participated in a landmark 12-week muscle-building study we undertook not long ago. If you've got doubts about our claims, consider the results achieved by two of our participants:

Manuel S., a retired banker, was 70 years old when he volunteered for our strength-training study. During the screening interview, he admitted rather sheepishly that the last time his three-year-old granddaughter visited, he was horrified to discover he could barely lift the little girl off the ground. A year earlier he'd been able to pick the child up and whirl her around in the air without even thinking about it. While the child had certainly gotten heavier in the interim, she hadn't grown enough to account for his drastic drop-off in strength. Upon reflection, Manny realized his body was becoming weaker. He could feel it in his arms, back, and legs.

Here's what 12 weeks of strength training did for Manny:

* When the study started, Manny could lift 25 pounds. When it ended, he was able to lift 75 pounds. Picking up his granddaughter became less of an effort once again.

* The size of his leg muscles increased by 17 percent.

* His aerobic capacity increased markedly to the point where he could chase his granddaughter around the backyard.

* Over the course of the study, while he was gaining muscle, he simultaneously lost almost 15 pounds of useless body fat.

Like all of our study participants, Manny was so proud of these startling physical achievements that he didn't want to lose what he'd gained. Seven years earlier, at age 63, he'd given up playing soccer. He loved the game but found it was too difficult to run up and down the field. Our study proved to Manny that his body could be rejuvenated. He continued to engage in regular aerobic and strength-building workouts after the program ended. Eventually, when he felt he was back in peak shape, he rejoined his soccer club. Today he claims he's playing better than he did when he was 20 years younger. He'd better be. His teammates are all 30 to 40 years his junior!

Arthur F. was 62 years old and still working when he participated in our study. For years he'd had a physically demanding job as a loading dock worker. At age 50 he was promoted to foreman, which required much less exertion. He, too, was jolted into volunteering for our study by a humiliating incident. One day he'd tried to help one of his subordinates lift a heavy crate of scrap metal, but even with help the chore overwhelmed him. Of course, his men noticed and let him know about it. The barbs were more than Art could bear. "We understand how it is, Arty...." "At your age, the only thing you should be lifting is a beer can...." "Step aside and let the younger guys do it...."

That night Art took a long private gander in a full-length mirror. What he saw wasn't pretty -- an overweight, out-of-shape, over-the-hill guy with a large belly hanging out over his belt. The way he felt wasn't wonderful, either. Among other things, he suffered from mild but chronic lower back pain.

When Art began the study, he had an abnormally high circulating insulin that indicated there could be diabetes in his future if he didn't do something fast to reverse the trend.

Here's what happened to Art after 12 weeks of strength training:

* His strength increased from being able to lift 50 pounds to lifting almost 150.

* He lowered his fasting insulin level to normal, which we ascribe to the fact that his reactivated muscles became more sensitive to the hormone insulin and, thus, started to withdraw more of it from his blood.

Art got so hooked on weight lifting that he, too, continued to do it after the study ended. As a consequence, he strengthened his lower back muscles, and to his great joy, his chronic backache disappeared. He also discovered that the more muscle he built, the more calories he seemed to expend every day even without trying. He didn't change the amount of food he ate, but he did consciously cut down on the fat in his diet. Over time he was able to lose 25 pounds and reduce his stomach circumference by 7 inches.

From Art's point of view, the best bonus of all was being able to keep up with the younger guys at the loading dock, much to their amazement and his amusement.

We feature only two of our study participants here because it would take too long to relate the stories of all 12 men. We can give you their collective results, however. After only three months of working out...

* the muscle strength of all 12 men increased two- to threefold.

* their muscle mass grew by 10 to 15 percent.

When you learn more about how the all-important Biomarker of Strength -- the first on our list -- influences the others, you'll understand the long-term health implications of these results. Suffice it to say here, if these men continue to work out and increase their muscle strength and size without increasing the amount of calories they eat daily, their exercise efforts will yield the additional benefit of replacing the amount of harmful excess fat on their bodies with muscle.

The moral in all this is simple: If you're in good enough health to hold up this book -- which weighs several pounds -- and your mind is nimble enough to absorb our message, you can still stage a physical comeback. We don't care how old you are.

ENGAGING YOUR MIND AS WELL AS YOUR BODY

How is our program different from all the other fitness-over-50 books?

This book transcends the other approaches to extending the human "health span" for this reason: Unlike those other books and videos, ours is grounded in research-based theory supporting the notion that exercise and a proper diet are good for you. Our program places heavy emphasis on what we're learning daily in our laboratories and through our clinical research studies using real older people as subjects.

To be sure, the solution to biological degeneration is still beyond our reach. No, we scientists at HNRCA have not yet cracked the mystery that has perplexed mankind since the beginning: We still don't know why it's an immutable law that every human being deteriorates over time and eventually dies. But at least we feel we've arrived at the point where we're now asking the right questions. While it's true that formulating answers to these questions involves a lot more research, much of it is already under way and ongoing.

In other words, in this book we'll not only be advising you what to do, we'll be explaining why we're asking you to do it.

In the next chapter, we'll introduce each Biomarker and show how exercise, sometimes in conjunction with a dietary change, can go a long way toward preserving health even into old age. We'll also be giving you self-diagnostic tools that will enable you to decide for yourself how far your body, regardless of your chronological age, has already proceeded along the normal aging continuum. How much of your body mass has accumulated fat at the expense of beneficial muscle tissue? What does the distribution of fat on your body say about your risk for developing certain age-associated ailments?

Part Two of the book focuses on two important self-tests. They'll enable you to find out if your aerobic capacity and muscular strength place you in the category of low fitness, average fitness, or way above the norm for a person of your age and sex.

In Part Three we put you to work. Depending on your fitness category, which you will know from taking the tests in Part Two, we ask you to follow a detailed exercise program we call a "BioAction Plan." Think of this structured program as a transition to a more exuberant lifestyle. Once you've completed our formal BioAction Plan, you'll be able to follow easier -- and less time-consuming -- exercise guidelines from then on.

We also offer a special section for those older competitive athletes, amateur though they may be, who take exercise very seriously. Drawing on the latest research, we'll erase misconceptions about training and offer information designed to improve performance. Our goal is to help readers in this very special category participate in their sport for many more satisfying years ahead, for we feel chronological age should never be held up as the barrier to athletic endeavor.

Part Four is devoted to nutrition and as much as we currently know about its role in the aging process.

TAKING THE VITALITY VOW

While our Biomarkers Program is researched-based, don't let the notion of medical research scare you. Our program is not hard to understand. Certainly you'll have no trouble comprehending its underlying concepts. Nor is its execution beyond even the most sedentary person's ability, for the program is graduated to take all levels of health and fitness into account. However, we do think you may be challenged by the constancy and commitment our program requires.

Biomarkers is not a program for the unregenerate spectator, fence sitter, benchwarmer, or couch potato. It's a program for participants. Doing the Biomarkers Program justice will require effort on your part almost every day of your life. Our exercise and diet guidelines will stand you in good stead, healthwise, for the rest of your life -- provided you follow them for the rest of your life.

One whole chapter in this book is devoted to motivation. Make sure you read it carefully. As strong-willed as you may think you are, you could find, as we have, that aching bodies and unexpected emotions have a way of impeding logic. Your head may tell you that exercise and eating right are sensible things to do, but the rest of your body may act as a saboteur. We give you the weapons to ward off such recalcitrance. We've designed our Biomarkers Program with the goal of capitalizing, as much as possible, on the more sociable, fun aspects of exercise.

In the early 1980s, in conjunction with the Massachusetts Department of Elder Affairs, we started a walking program called "Keep Moving, Fitness After Fifty." The program was built on the pyramid principle. We trained a select group of older people to be the leaders of walking clubs in their community. They, in turn, recruited participants from among friends and friends of friends. The program continues to this day with more than 7,000 registered walkers (average age: 65), and the numbers keep multiplying.

We think the program continues to gain popularity because walking, of all the aerobic sports, is such a congenial way to exercise. It's also why the aerobic component of our Biomarkers Program is centered around walking. It's fun, it puts less stress on aging joints, and it's a way to make new friends while you're improving your sense of health and well-being.

The crucial strength-building component of our program can also be done in the company of friends -- and we think it should be. In fact, we urge everyone who undertakes our Biomarkers Program to do it with at least one other person and, preferably, with an amiable, heterogeneous group of friends.

A PRESCRIPTION FOR LENGTHENING YOUR HEALTH SPAN

The message of our Biomarkers Program is a straightforward one:

You can adopt a pattern of activity and eating that maximizes your ability to age much more slowly.

Heredity isn't everything, after all. It's certainly possible for a well-maintained Volkswagen bug to last longer than an abused Mercedes, isn't it? By the same token, an active and independent old age is within the reach of any middle-aged person who is willing to get out of that easy chair.

No, it's seldom too late to inject more pep and vitality into your life, not if you're determined enough -- and have the willpower to make the effort. We'll tell you what to do, but you have to do it!

The idea you should keep in the forefront of your consciousness like a beacon is that, your health largely depends on you. You can fill your own prescription for successful aging. No matter what your age, it's not too late to turn over a new leaf and start building strength, adding to your endurance, and eating right.

Copyright © 1991 by Dr. Irwin H. Rosenburg, Dr. William J. Evans, and Jacqueline Thompson