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Want to live to 100? That may depend on your sex

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Want to live to 100? That may depend on your sex

Do you want to live to 100? The path to becoming a healthy centenarian — as opposed to just a centenarian — is surprisingly different for those born as women and men, says social researcher and author Maddy Dychtwald. And it’s never too early to start on the journey, even when you’re young and spry. (We’re talking to you, zoomers.)

As co-founder of Age Wave, a nonprofit think tank focusing on longevity and aging, Dychtwald has been researching these topics for nearly 40 years. In her new book, “Ageless Aging: A Woman’s Guide to Increasing Healthspan, Brainspan, and Lifespan,” Dychtwald addresses the most recent aging picture for women and identifies a holistic plan for longevity. It weaves together science and medicine, psychology and spirituality, as well as financial advice in a research-based guidebook that’s brimming with actionable steps.

“There’s this ripple effect,” Dychtwald says of the lifestyle she recommends for maximizing healthspan — meaning how long you are living in good health, versus how long you are just living. “If you can impact one piece — sleep, nutrition, fitness, having a sense of purpose and connection — it begins to affect the others.” This interview has been edited for length and clarity.

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Shelf Help is a new wellness column where we interview researchers, thinkers and writers about their latest books — all with the aim of learning how to live a more complete life.

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How is longevity different for women than men?

Woman have actually won the longevity lottery. We live, on average in the United States, six years longer than men. So that’s incredibly positive. But there is a dark side to this. And that is: We women, on average, spend the last 12 to 14 years in declining health. So we are not doing a great job of matching our healthspan to our lifespan. There’s a gendered gap when it comes to healthspan. Why? I don’t know that the answer is clear, even in the minds of scientists. What we do know is that estrogen has protective properties for women. But once their estrogen levels decline, they have more health challenges than men do, as they get older. But it’s something scientists don’t fully understand yet.

If women are 51% of the population, doesn’t it stand to reason that scientists would better understand this by now?

You would think! I think the healthcare system, overall, is well-meaning. But it’s been created by men and as a result, the focus has really been more on men than women. One great example of how women can, as a community, really motivate physicians and researchers and scientists to change is the whole breast cancer issue. Women really spoke out on this and I think, as a result, we’ve seen great strides in research and survival rates and treatment methodologies.

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A headshot of a smiling woman with brown hair, wearing a red shirt

Author Maddy Dychtwald.

(Lisa Keating Photography)

You endured a health challenge, which is one of the things that led to your writing this book. Can you tell us about that?

I’m a big exerciser, it’s how I manage stress. I started getting pain in my hips, to the point where I was limping. I did PT, I got cortisone treatments, I did a variety of things to manage the pain. But it wasn’t solving the problem. Turns out I needed double hip surgery — I was 68, which is young for the condition I had. But they couldn’t see me for months — and I was in excruciating pain. I started researching and learned, from experts in my network, that I needed to get my inflammation levels down. I went on an anti-inflammation diet — I cut out gluten, sugar and dairy — and I found that within six weeks all my pain went away. I thought: “Whoa, there are all these things that we can all do — and they don’t necessarily cost any money — to live better, longer.” I started looking at other things I could do. I worked with a psychiatrist at Harvard who taught me about meditation and affirmations. I was doing precovery, essentially — preparing for my surgery in advance. And it made a difference. This book is the distillation of all that, along with the work I’ve been doing at Age Wave for 40 years.

New research around genetics versus lifestyle choices also informs the book — and your decision to direct it at women. What does the latest research tell us about how to influence our destiny?

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We used to just assume that genetics were our destiny. That whatever our genetic package is, that’s kind of the hand that we were dealt. But, in fact, according to the most recent science from Alphabet’s Calico Life Sciences and other research, up to 90% of our health and longevity are literally within our control. And I find that an incredibly empowering piece of information. It gives us almost total agency. I didn’t want to just keep that information to myself, I wanted to share it with the world. There are a lot of books out there on longevity, but there aren’t many that really focus in on women and longevity. And obviously, women and men are really different.

We used to just assume that genetics were our destiny. That whatever our genetic package is, that’s kind of the hand that we were dealt. But, in fact, according to the most recent science … up to 90% of our health and longevity are literally within our control.

— Maddy Dychtwald

During COVID, I was home more than I had been before. There were so many health issues I saw around me and I had an opportunity to really lean into my own sense of purpose. And in order to lean into it in a way that felt good to me, I wanted to [educate] women in their 40s, 50s, 60s and beyond. There are tens of millions of women just in the U.S. in that age group who are starting to feel the aches and pains of getting older, or who are coping with a chronic degenerative disease, or just dealing with the reality of menopause — and who are looking for solutions. I wanted to give women a one-stop resource to clear up the confusion, give them straightforward answers based on science as well as action steps to live better, longer.

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You talk about a “holistic recipe” for healthy aging as a woman. What are the ingredients to that — what daily activities, for example, do you incorporate to promote longevity?

There are a lot of books out there on sleep or exercise or nutrition or hormones or having a positive attitude — and by the way, our attitudes toward our own aging can actually add 7½ years to our lifespan — but it’s not just about one thing, it’s all these things working together. They don’t exist in silos.

The cover of Maddy Dychtwald's book "Ageless Aging"

Take finances — there’s a gender pay gap. I encourage all women to take charge of their finances. If you don’t have your financial house in order, chances are it will affect your stress levels, your health, your well-being. And you may not even have the financial well-being to pay for your health — and that’s a scary place to be.

If you exercise effectively, it affects your mood and your stress. That helps with sleep, which helps with cognition and so many other things, including managing your finances. It’s cyclical.

Sleep is such a key ingredient. What do you do to manage that?

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Sleep is not my superpower. But I learned there were things I could do. One was to really be mindful of my circadian rhythms; controlling our sleep-wake cycles are very important. I learned that what I did during the day was as important, if not more important, than what I did at night to go to sleep. It’s simple — anyone can do it — and it doesn’t cost a penny. Which is: When you get up first thing in the morning, watch the sun rise for 10 minutes. If it’s already up, get sun on your skin for 10 minutes. I do what I call “stacking my habits.” So at the same time, I do some breathing exercises that help me be calm and energetic simultaneously — what a great way to start my day.

One surprising piece of new research that you cite is that exercise has a bigger impact on health, and staving off brain decline later in life, for woman over men.

Yes. We already know that exercising in the morning is the best time of day to exercise, it brings optimal results, and it’s best on an empty stomach. But brand-new research, in a February 2024 study from the Smidt Heart Institute at Cedars-Sinai, says that women don’t have to exercise as hard, or as long, as men to get optimal results. They can get the same health benefits as men from exercise in less time.

For example, women can reduce their risk of death by 18% by doing 140 minutes of moderate aerobic exercise per week, while men need 300 minutes to achieve the same benefit. Women can also achieve the same survival benefit from moderate to vigorous aerobic exercise, like cycling or brisk walking, after 2½ hours per week, while men need about five hours. And when it comes to building muscle mass, strengthening exercises such as weightlifting or core exercises, women can achieve the same positive benefits after one session weekly while men need three sessions.

TAKEAWAYS

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From “Ageless Aging”

You talk about two topics that demand the medical community’s much closer attention. What are they?

Brain health — no one wants to talk about anything above the neck — and hormones. Hormones affect our cognition, sleep, joints and bones, mood. If you’re not able to sleep at night, it affects your brain health, brainspan and longevity. If your bone density is impacted, you’re more likely to fall, and that could lead to health issues.

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And Alzheimer’s disease is twice as likely to happen to women than men — people don’t want to talk about it. It’s super scary. But there are things we can do. Dr. Andrea Pfeifer, a neurosurgeon and CEO of AC Immune, a company working on a vaccine for Alzheimer’s, says probiotics are what she takes — the gut-brain connection is very real. Many physicians recommend the Mediterranean diet. I do the anti-inflammatory diet.

Another thing is limiting or stopping alcohol. And exercise — every single brain expert I spoke to said that’s the No. 1 thing to protect healthspan and brainspan. The fear of cognitive decline and Alzheimer’s for women is real, but only 4% of women have a genetic connection. And we can take steps to prevent or delay it.

Are there any positive sides of aging for women?

We gain a certain amount of wisdom and experience as we get older. According to recent studies we’ve done at Age Wave, women, as it turns out, from the age of 50 on, they seem to be gaining more confidence in themselves and their lives, whereas men seem to plateau out at around 50. This is all in general, of course. But for women, empowering.

Maggie Chiang / For The Times

Shelf Help is a new wellness column where we interview researchers, thinkers and writers about their latest books — all with the aim of learning how to live a more complete life. Want to pitch us? Email alyssa.bereznak@latimes.com.

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Opinion: Most older Americans who need hearing aids don't use them. Here's how to change that

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Opinion: Most older Americans who need hearing aids don't use them. Here's how to change that

Having depended on hearing aids for nearly three decades, I’m astounded by the lack of Medicare coverage for devices that can solve a problem afflicting tens of millions of older Americans.

Nearly two-thirds of Americans over age 70 have some degree of hearing loss, and over half of those 75 and older experience impairment serious enough to be considered disabling. But most don’t wear hearing aids.

Because the legislation that created Medicare nearly 60 years ago specifically excluded hearing aids, those who rely on the program’s traditional coverage must pay for them out of pocket. That expense is among the chief barriers to wider use of the devices.

Age-related hearing loss impedes basic communication and the relationships that depend on it. Expanded access to hearing aids could therefore do no less than enable more older Americans to establish and maintain the social connections that are essential to a meaningful life.

Hearing loss is like an invisible, muffling curtain that falls in front of anyone speaking. Asking people to repeat themselves can yield irritated and hurtful responses. And it’s hopeless to ask a soft-spoken person to speak up. Sometimes it’s easier just to nod and smile.

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Many older people I know choose to avoid social gatherings altogether because they can’t hear well. Without hearing aids, I’d stay home too.

Hearing loss can harm one’s health in other ways. For example, I’ve written about the need for a comprehensive approach to reducing cancer risk at older ages, including preventive services such as colorectal cancer screening. But these services rely on conversations between patients and their healthcare providers. An older patient’s ability to hear and understand such conversations shouldn’t be taken for granted or ignored.

The Food and Drug Administration did improve access to hearing aids by making some of them available without a prescription in 2022, but the over-the-counter devices are inadequate for serious hearing loss like mine. My private health insurance, meanwhile, started covering hearing aids a few years ago, providing up to $2,500 for them every five years. One hearing aid alone can cost that much or more, however.

Despite its limitations, my private coverage for hearing aids is better than nothing, which is what traditional Medicare provides.

Hearing loss is more common among lower-income people and those without advanced education. The toll from noisy workplaces compounds age-related hearing loss for some. One analysis found that most Americans with a serious hearing disability can’t afford the typical price of hearing aids.

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Many of the older adults who can’t come up with these significant out-of-pocket expenses spent their working years in low-wage jobs that our country depends on. Denying them treatment for their hearing loss is a lousy way to treat people who gave years of service to our society.

Although some older adults with hearing loss won’t benefit from hearing aids, Medicare coverage for the devices might encourage more beneficiaries to get their hearing tested so they can get the treatment that’s right for them. And while Medicare coverage alone won’t address the stigma some people associate with hearing aids, the availability of newer, more comfortable and less obvious technology might win over some refuseniks.

Legislation reintroduced with bipartisan support last year would finally correct this glaring gap in Medicare coverage by removing the hearing aid exclusion from the law. There’s no reason to delay action on this any longer. Are our representatives listening?

Mary C. White is an adjunct professor of environmental health at Emory University’s Rollins School of Public Health, a Public Voices fellow at AcademyHealth in partnership with the OpEd Project and a former federal epidemiologist.

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Second human case of bird flu detected in Michigan dairy worker

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Second human case of bird flu detected in Michigan dairy worker

A second human case of bird flu in a diary worker has been confirmed in Michigan, state and federal health officials announced Wednesday.

The symptoms were mild, consisting of conjunctivitis. The Texas dairy worker who contracted the virus in March also came down with pink eye.

At a press call on Wednesday, Nirav Shah, principal deputy director of the U.S. Centers for Disease Control and Prevention, said the finding was “not unexpected” and that it was a scenario “that we had been preparing for.”

He said that since the discovery of H5N1 in dairy cattle, state and federal health officials have been closely monitoring farmworkers and slaughterhouse workers and urging farmers and farmworker organizations to “be alert, not alarmed.”

Federal officials say they still believe the human health risk of bird flu is low; however, it underscores the need for people who are interacting with infected or potentially infected farm animals or birds to take precautions, including avoiding dead animals and wearing personal protective equipment (PPE) if there’s a need to be in close contact.

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Though a nasal swab from the person in Michigan tested negative for influenza, an eye swab from the patient was shipped to the CDC and tested positive for influenza A(H5N1) virus.

This is the third case of H5N1 reported in the United States. A poultry worker in Colorado was identified in 2022.

Although the symptoms in the three farmworkers in the U.S. have been mild, people elsewhere in the world have suffered more severe illness, including death. According to the World Health Organization, between Jan. 1, 2003, and March 28, 2024, there have been 888 cases of human infection from 23 countries; 463 were fatal.

In preparation for a more widespread outbreak, the CDC updated its guidance for PPE in dairies and issued a nationwide order for healthcare providers to be on the lookout for novel influenza.

On Tuesday, the CDC asked clinical laboratories and health departments to increase the number of influenza samples being analyzed “to maximize the likelihood of catching a case of H5N1 in the community,” Shah said.

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The US Department of Agriculture is also expanding its surveillance and support by providing $1500 to non-infected farms to beef up biosecurity, and $100 to producers who want to buy inline samplers to test their milk. The agency will also provide $2000 per farm to cover veterinary fees for testing, as well as shipping costs to send those tests to laboratories for analysis.

There have been no cases of H5N1 detected in California’s dairy herds.

Officials said ongoing analysis of the nation’s dairy supply suggests it is safe to consume, Despite the risk to human health being low, an official with the Administration for Strategic Preparedness and Response said it will make Tamiflu available upon request “to jurisdictions that do not have their own stockpile and are responding to pre-symptomatic persons with exposure to confirmed or suspected infected birds, cattle or other animal exposures.”

Dawn O’Connell, assistant secretary of the preparedness agency, said it started the “fill and finish” process for approximately 4.8 million doses of vaccine “that is well matched to the currently circulating strain of H5N1 through the national pre-pandemic influenza vaccine stockpile program.”

She said the decision to get started on H5N1 vaccines was not a response to any heightened concern, but since it takes several months to fill and finish vaccine doses, the agency “thought it made sense given what we were seeing.”

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Gas stoves may contribute to early deaths and childhood asthma, new Stanford study finds

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Gas stoves may contribute to early deaths and childhood asthma, new Stanford study finds

Lung-irritating pollution created by cooking with gas stoves may be contributing to tens of thousands of premature deaths and cases of childhood asthma in the United States, according to a new study published in the journal Science Advances.

For decades, scientists have known the flames from a gas stovetop produce nitrogen dioxide, a pungent gas that can inflame a person’s lungs when inhaled. But for the first time, a team of researchers from Stanford University and Oakland-based research institute PSE Healthy Energy published a nationwide estimate of the long-term health consequences associated with cooking with natural gas and propane stoves.

Researchers concluded that exposure to nitrogen dioxide emissions alone may contribute to nearly 19,000 premature deaths in the United States each year. It has also resulted in as many as 200,000 current cases of pediatric asthma compared with cooking with electric stoves, which do not produce nitrogen dioxide.

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Stanford researcher Yannai Kashtan noted higher levels of pollution were correlated with the amount of gas that was burned. But pollution also accumulated at higher levels inside smaller homes.

“If you live in a smaller house, you’re exposed to more pollution, and that can lead to income and racial disparities in exposure,” Kashtan said. “In general, folks living in neighborhoods with higher levels of outdoor pollution also tend to have higher indoor pollution. So this environmental injustice extends indoors as well.”

The American Gas Assn., a trade organization representing more than 200 local energy companies nationwide, dismissed the findings as “misleading and unsupported.”

“Despite the impressive names on this study, the data presented here clearly does not support any linkages between gas stoves and childhood asthma or adult mortality,” the association’s president and CEO, Karen Harbert said in a statement earlier this month.

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The study is the latest examining the serious health effects associated with breathing fumes from gas stoves, which release planet-warming carbon emissions and a variety of air pollutants. In recent years, the popular household appliance has become a political hot-button issue as policymakers and regulators have weighed environmental impacts against consumer choice.

Many large cities in California, including Los Angeles, have moved toward phasing out gas stoves in newly constructed residences. Earlier this month, the California Assembly advanced a bill to the Senate that would require gas stoves to come with warning labels detailing the pollution and health effects that can arise from cooking with gas.

Gas stoves emit a variety of pollutants, including asphyxiating carbon monoxide, cancer-causing formaldehyde and benzene. The flame also creates nitrogen dioxide, a precursor to smog and a pollutant that can cause difficulty breathing.

Environmental groups say consumers should be notified about these pollutants and the potential harm they can cause.

“Gas stoves create pollution in our homes, increasing the risk of childhood asthma and other respiratory problems for our families,” said Jenn Engstrom, state director for California Public Interest Research Group. “However, this risk has largely been hidden from the public. Consumers deserve the truth when it comes to the danger of cooking with gas. Warning labels will give consumers what they need to make informed decisions when they purchase appliances for their homes.”

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Kashtan and other researchers had previously discovered cooking with gas stoves presented a similar cancer risk as inhaling second-hand cigarette smoke. They also found some gas stoves leaked contaminants even when the burners were off.

The effects are especially devastating to children, whose smaller and still-developing lungs need to take more breaths than adults, Kashtan said. Older adults, especially those with cardiovascular or respiratory illness, are also more vulnerable to pollution from gas stoves.

To alleviate indoor air pollution, experts recommend using ventilation hoods and opening windows while cooking,

Starting in 2008, California required new and redeveloped homes to have ventilation that could prevent pollution from building up indoors. But during their research, measuring emissions in more than 100 households across the country, Yannai said they found many kitchens didn’t have ventilation hoods at all.

Although the health effects of breathing these pollutants are clear, researchers still wonder to what degree these conditions could be reversible. As communities take steps to mitigate their exposure or transition away, he said we could soon see the results.

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“It’s never too late to stop breathing in pollution,” he said.

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