TIME Aging

Long-Life Secrets From An (Almost) 115 Year Old Woman

Joseph C. Lin—TIME

Bacon and lingerie are among Susannah Mushatt Jones's favorite things

What’s the secret to living to be almost 115?

“I don’t have a secret,” says Susannah Mushatt Jones, 114, her head tied in a yellow scarf for warmth, and her body wrapped in a pink and green blanket. Then she adds: “Believe in the Lord.”

It’s a few weeks before her 115th birthday, on July 6, and Jones is spending time with family in her Brooklyn, New York, living room. Jones is the second-oldest American, according to the roster of supercentenarians validated by the Gerontology Research Group, and her niece, Lois Judge, 74, is trying to remind her of that fact. (Update: On July 4, the Gerontology Research Group confirmed that Gertrude Weaver is the oldest American at 116 years old, now making Jones the third-oldest American.)

“I’ll be 115? I ain’t gonna be 115,” says Jones. “Nope.” Frankly, her family can’t believe it either, though Jones is doing remarkably well. She never drank or smoked, and to this day she sleeps like a champion—upwards of 10 hours a night. And while it’s impossible to isolate one thing that can explain any supercentenarian’s longevity, Jones seems to have made some interesting choices along the way.

For starters, she loves bacon. Every morning she eats four strips of it, followed by scrambled eggs and grits. “Sometimes, she’ll take the last strip, fold it in a napkin, put it in her pocket and save it for later,” says her niece Selbra Mushatt, 70. She also seems to be a minimalist when it comes to interfering with her health. The only medication she takes is a multivitamin and a pill for her blood pressure. Blind from glaucoma since she was 100, Jones refused cataract surgery, and her nieces say Jones has never had a colonoscopy or a mammogram. Lavilla Watson, 82, another one of her nieces, said a doctor recommended a pacemaker, but she refused. She sees a primary care physician every three to four months.

Jones’s Backstory

The third oldest of 11 siblings, Jones was born and raised in Lowndes County, Alabama, about an hour southwest of Montgomery. In 1922, she completed high school, and the graduation roster recognizes her for studying “Negro Music in France.” She always wanted to be a teacher and was accepted to the Tuskegee Institute’s teacher training program, but could not afford to go.

A year later, she moved to New York City and worked as a child care professional for wealthy families. She was married briefly to a man named Henry Jones and didn’t have children, so she has always called the kids she cared for “her children.” Photos of them all grown up with their own kids are propped up on a coffee table next to her in the living room.

She used her salary to help send her nieces to college and fund a college scholarship program that she established for African-American students called The Calhoun Club. She was generous with her family, but when it came to splurging on herself, Jones’s weakness was, of all things, high-end lace lingerie. “She would save her money and then go to Bloomingdale’s,’” says her niece Selbra Mushatt. “One time, when she had to get an EKG, the doctors and nurses were surprised to see her wearing that lingerie, and she said, ‘Oh sure, you can never get too old to wear fancy stuff.’”

After retiring in 1965, she lived with her niece Lavilla Watson, who remembers coming home to find Jones cracking up at I Love Lucy while cradling Watson’s newborn son in a rocking chair.

Life at 115

The world’s oldest person, 116-year-old Misao Okawa of Osaka, Japan, says the answer to a long life is eating sushi, while the oldest American, 115-year-old Jeralean Talley of Michigan, says it’s pigs’ feet. Some studies argue that long life has to do with being a conscientious, giving and most importantly, happy person. Other research says that strong personal connections play a big role, which may in part explain Jones’s long life.

She was active in her neighborhood for nearly 30 years, serving on its tenant patrol team, and these days, her nieces visit almost daily. Sunday evenings, they all gather together for a BBQ feast.

Becoming a supercentenarian likely has to do with genes, says Thomas Perls, a professor of medicine and the director of the New England Centenarian Study at Boston Medical Center, the largest study of centenarians and their families worldwide. “You have to have some relatively rare combinations of a whole bunch of genes, probably hundreds, that will help people age more slowly or protect people from age-related diseases [dementia, heart disease, stroke, diabetes, cancer],” he says. “The super-centenarians, they not only delay disability toward the very end of their lives but also diseases. In fact, they’re often functionally independent and disease-free, except for some things you can’t get away with like cataracts and osteoarthritis.”

He estimates the prevalence of centenarians in the U.S. population is about 1 per 5,000, 1 per 5 million for super-centenarians, and thus 1 per about 100 million for people over 114. And most are female. “Why women do this better than men is really unclear in terms of what genetic advantages they have versus men,” he says, “but one possibility is that many of the genetic variants of interest that may be slowing aging and decreasing the risk for age-related disease could be on the X chromosome. And women have two of those, men just have one.”

A life that lasts 115 years is, by all measures, an extraordinary thing. But the gift of time comes with the very human fear of loss, compounded perhaps by the extra years. Reflecting on the significance of her aunt’s upcoming birthday in a phone conversation, her niece Lavilla Watson says, “I’m very emotional about it. It makes me sad. Now that she’s going to be 115, they don’t live that long after that, you know?”

Then again, this birthday also feels like a thrill. “Listen,” says Judge. “Who knows anyone who is 115? That’s excitement in itself.”

TIME sleep

Less Sleep Pushes Your Brain to Age Faster

Researchers find connection between sleep deprivation and a marker of aging brains

We know that sleep is important for a host of body functions, from weight control to brain activities, but the latest study hints that it may also keep aging processes in check.

Scientists at the Duke-NUS Graduate School Singapore report in the journal Sleep that among a group of 66 elderly Chinese volunteers, those who reported sleeping less each night on average showed swelling of a brain region indicating faster cognitive decline.

The participants had MRI brain scans every two years, and answered questions about their sleep habits as well. Other studies have suggested that adults need about seven hours of sleep a night to maintain proper brain function; future research will investigate how sleep helps to preserve cognitive functions and hold off more rapid aging.

TIME Aging

The Vast Majority of Baby Boomers Are Overweight or Obese

Though aging baby boomers are smoking and drinking less, a new U.S. Census Bureau report shows the vast majority of baby boomers are overweight or obese, which may cause diabetes and arthritis, among other conditions

Aging baby boomers are smoking and drinking less, but overweight and obesity are on the rise, according to a new report from the U.S. Census Bureau. That’s especially concerning when you consider the many other diseases and disabilities—including arthritis, type-2 diabetes, heart disease and hindered mobility—that can come with excess body weight.

The percentage of overweight and obese Americans 65 and older has grown: 72% of older men and 67% of older women are now overweight or obese. Baby boomers started reaching age 65 in 2011, and the report, which was funded by the National Institutes of Health, also shows many of these older Americans are not financially prepared to pay for long-term care in nursing homes. That’s concerning, since America’s aging population, which is now around 40 million, is estimated to double by 2050.

What’s the best way to handle overweight and obesity in people 65-plus?

“There are not many studies of weight loss among the elderly. It’s a rich and fertile area,” says Dr. Adam Bernstein, research director at the Cleveland Clinic’s Wellness Institute. “The prescription would not be the same for a middle-aged person or youth.” Bernstein, who was not involved in the report, says it is possible for older men and women to lose weight, though doctors are likely to immediately focus on the consequences of excess body fat, like high blood pressure and erratic blood sugar. “If the clinician makes the determination a person is overweight and no other comorbid conditions, then what seems appropriate is a diet and exercise plan,” he says.

Past research published in the journal JAMA Internal Medicine has shown the baby boomer generation has its share of pervasive health problems, including high rates of cholesterol and hypertension. The authors concluded that there’s a need for policies that encourage prevention efforts and healthy-behavior promotion among boomers.

This new report adds urgency to the call for better health among boomers. Indeed, the costs of not taking action could be severe.

The new Census Bureau report shows that the average cost of a private room in a nursing home in 2010 was $83,585 a year—and less than one fifth of older men and women have the finances to live in a home for more than three years. Medicaid covers long-term care for qualified, low-income seniors, but as the number of people in that group grows, the costs will hurt.

“Most of the long-term care provided to older people today comes from unpaid family members and friends,” Richard Suzman, director of National Institute on Aging’s division of behavioral and social research, said in a statement. “Baby boomers had far fewer children than their parents. Combined with higher divorce rates and disrupted family structures, this will result in fewer family members to provide long-term care in the future.”

The findings highlight the need to make healthy changes early. And if we want to cut long-term healthcare costs in the future, Americans need to get healthier.

 

TIME movies

Susan Sarandon Wore Prosthetic Cankles for Tammy, and They Were Liberating

Susan Sarandon in Tammy
Susan Sarandon in 'Tammy' Michael Tackett / Warner Bros.

Playing a grandmother has its advantages, the actress tells TIME

Susan Sarandon knows that it can be risky for an actress to mess with her appearance. “If you’re a woman and you gain weight for a part and you look really terrible, the business is more concerned about hiring you than when a guy does it,” she tells TIME. “I mean, people do sometimes have a lack of imagination and just think, ‘Oh wow, she’s really changed.’”

But when Melissa McCarthy and Ben Falcone asked her to play McCarthy’s grandmother, Pearl, in their new road-trip comedy, Tammy (out July 2), Sarandon’s concern wasn’t that it was dangerous to go gray as a grandmother — even if, in reality, McCarthy is less than 25 years younger than she is. Sarandon did the math and decided the role was age-appropriate: if Pearl had her daughter as a teen mom, and her daughter was a teen mom too, the character of Tammy could easily be 30 — “I mean, [McCarthy]’s not playing 40; she looks about 4,” Sarandon jokes — and Pearl could still be younger than Sarandon, who’s about to be a grandmother in real life.

Sarandon’s bigger concern was whether how exaggerated the grandma-ness would be. If Pearl were all about facial hair, little glasses and a funny voice, she says, she worried the extras would distract viewers from the personhood of the character. When it became clear that McCarthy and Falcone had in mind to keep the character realistic, despite the crazy situations she gets into, Sarandon signed on. And the Pearl costume ended up relatively minimal, relying heavily on three sets of prosthetic “cankles,” for different degrees of the swollen ankles that figure into the movie’s plot; minimized eyebrows and eyelashes; peppercorns in her shoes for when the character’s feet were supposed to be hurting; and a grandma-approved wardrobe.

“If you put on a pair of baggy, high-waisted, under-your-breasts, elasticized jeans, it does change your outlook,” Sarandon says. “But she could be 70, and I’m almost 68. Pearl has just led a very aging, hard life and doesn’t have the advantage of my makeup and hair people.”

It’s not news that aging in the real world and aging in Hollywood are different, though both can be tough. For Sarandon, playing the former wasn’t all bad, as it meant that she didn’t have to waste any energy worrying about her appearance while she did her job. “It’s very liberating, actually, to not ever be looking at what you look like,” she says. “You hope that whenever you’re working your makeup and hair people are catching things and you don’t have to pay attention, but certainly I’m aware. I can’t help after all these years to be aware, if you’re being badly lit from above or if the camera is at your knee, but in this instance that helped everything.”

In the real world and in movies alike, Sarandon thinks it’s important to show people who are old enough to be grandparents doing more than sitting around at home. “You can’t suddenly just decide, Oh God, I’m old, because then you certainly are old. And age — I don’t want to say age is a number because that’s a really silly expression,” Sarandon says. “There are so many women who are my age and older who are so vital and engaged and creative and still working. That’s why all these young kids are having problems in the workplace, because people are not retiring.”

And that means showing those people who have a lack of imagination that playing a gray-haired grandmother doesn’t mean an actress is looking for “old lady” parts — and it certainly doesn’t mean wearing grandma pants forever. “I’m very aware,” Sarandon says, “that I’m glamming it up for the premiere.”

 

TIME Aging

14 Ways to Live a Longer, Healthier Life

These tips will reverse your aging

The answer is more complicated than counting the number of candles you blew out on your last birthday cake. Your daily habits can either add or subtract years from your life—like how much you exercise, or how stressed you allow yourself to be. Read on for 14 things you can start doing today to live a longer, healthier life.

Drop some pounds

Being obese increases the risk of diabetes, cancer and heart disease, possibly shaving up to 12 years off your life, per an analysis in the journal Obesity. But being too thin can hike your risk of osteoporosis and poor immune function. So aim to stay at a weight that’s healthy for you.

Cap your drinks

Regularly exceeding one drink a day or three in one sitting can damage organs, weaken the immune system and increase the risk of some cancers.

Ease your stress

Chronic stress makes us feel old—and actually ages us: In a 2012 study, Austrian researchers found that work-related tension harms DNA in our cells, speeding up the shortening of telomeres—which protect the ends of our chromosomes and which may indicate our life expectancy. Of course, it’s impossible to completely obliterate stress. “What’s important is how you manage it,” says Thomas Perls, MD, associate professor at Boston University school of Medicine. Practice yoga, pray, meditate, relax in the shower or do whatever else chills you out.

Health.com:Best and Worst Ways to Cope With Stress

Keep learning

Having more education lengthens your life span, according to a study in the journal Health Affairs, for a number of reasons. Extra schooling may help you become better informed about how to live a healthy life. And educated folks, as a group, have a higher income, which means greater access to good health care and insurance.

Connect

More and more research points to the value of having friends, and not just on Facebook. An Oxford University study found that being married makes you less likely to die of heart disease, which researchers suggest may be due to partners encouraging the other to seek early medical treatment. Same goes for friendships: Australian research showed that people with the most buddies lived 22 percent longer than those with the smallest circle. “Having positive, meaningful, intimate relationships is critical to most people’s well-being,” says Linda Fried, MD, dean of Columbia University’s Mailman School of Public Health.

Extend a hand

Volunteering is linked to a lower risk of death, a University of Michigan study suggests. But you don’t have to log hours at a soup kitchen: Simply helping friends and family—say, by tutoring your niece or assisting your neighbor with her groceries—lowers blood pressure, according to researchers at the University of Tennessee and Johns Hopkins University.

Health.com: 14 Reasons You’re Always Tired

Work out often

Exercising regularly—ideally at least three days of cardio and two days of strength training a week—may help slow the aging process, Canadian doctors reported. “Being physically active is like keeping the car engine tuned,” Dr. Fried says. “Even if there’s decline with age, it’s less severe.” You were never an athlete? Don’t worry: Starting to work out now can reduce your likelihood of becoming ill going forward, a 2014 study suggests.

Reconsider your protein

A diet rich in processed meat—including hot dogs, sausage, cured bacon and cured deli meats—has been linked to a higher risk of heart disease, diabetes and colon cancer. Limit your intake as much as possible.

Give up smoking

Lighting up increases your risk of not only lung cancer but also heart disease and cancer of almost every other organ. “Just one cigarette a day can take 15 years off your life,” Dr. Perls says. Though you won’t instantly revert to pre-smoking health, kicking butts will cut your added cardiovascular risk in half after a year and to that of a nonsmoker after 15.

Health.com:15 Ways Smoking Ruins Your Looks

Enjoy your joe

Good news for java lovers: Research indicates that drinking it regularly may protect against diabetes, cirrhosis and liver cancer. And Harvard research suggests that drinking 3 1/2 cups a day may lower risk of heart disease.

Sleep better

For evidence that you can—and should—make slumber a priority, look no further than a 2013 study from the University of Surrey in England, which compared a group who got less than six hours of sleep a night with a group who got 8 1/2 hours. After just one week, snoozing less had altered the expression of 711 genes, including ones involved in metabolism, inflammation and immunity, which may raise the risk of conditions from heart disease to obesity.

Have more sex

The feel-good rush you get from it helps you fight stress and depression, jolt the immune system and lower blood pressure.

Health.com:15 Everyday Habits to Boost Your Libido

Go Mediterranean

In a 2013 Annals of Internal Medicine study, women who followed a Mediterranean-style diet were 40 percent more likely to live past 70 without major chronic illness than those with less healthy diets. Eat lots of veggies, fruit, fish and whole grains, and avoid simple carbs, such as pasta and sugar (“age accelerators,” Dr. Perls calls them).

Know your history

Have one or more relatives who lived into their 90s? You may be genetically blessed. But that doesn’t mean you should quit the gym and live on doughnuts. “Before you get to extreme ages, healthy lifestyle is more critical than genes,” Dr. Perls says. So thank your ancestors, but stick to vegetables and cardio as life insurance.

This article originally appeared on Health.com.

TIME Aging

Older Mothers Tend To Live Longer, Study Finds

hands on pregnant stomach
Alex Mares—Asia Images RM/MantonGetty Images

A new study found that women who have kids after age 33 are twice as likely to live to 95 or older than those who stopped having babies earlier

Waiting a few years to start your family may give you some unexpected benefits, according to a new study.

Women who are able to give birth after the age of 33 tend to live longer than those who stopped having children before age 30, according to a study from the Boston University School of Medicine.

“Of course this does not mean women should wait to have children at older ages in order to improve their own chances of living longer,” the study’s co-author Thomas Perls, a professor of medicine at BU, said. “The age at last childbirth can be a rate of aging indicator. The natural ability to have a child at an older age likely indicates that a woman’s reproductive system is aging slowly, and therefore so is the rest of her body.”

The study, published in the journal Menopause, did not prove causation but it did find that women gave birth after age 33 had twice the odds of living to 95 years or older than those who had their last child by age 29.

Researchers said the link exists because gene variations that enable women to have babies by natural means at a later age may also be tied to living longer lives. “If a woman has those variants, she is able to reproduce and bear children for a longer period of time, increasing her chances of passing down those genes to the next generation,” Perls said.

Previous studies have turned up similar results to this one. An earlier study from the New England Centenarian Study found that women who had children after the age of 40 were four times more likely to live to 100 than women who had their last child at a younger age.

More research is still needed, according to Perls. The information found in this study shows the importance of research about genetic influences and reproductive fitness, because these trends can affect susceptibility to age-related disease.

MONEY Health Care

The State of Senior Health Depends on Your State

Dollars and cents
Finnbarr Webster / Alamy

Reports on senior health reveal a north-south divide. Many worst-ranking states rejected Medicaid expansion.

What are the best and worst places to stay healthy as you age? For answers, take out a map and follow the Mississippi River from north to south. The healthiest people over 65 are in Minnesota, the sickest in Mississippi.

That’s among the findings of the America’s Health Rankings Senior Report released in May by the United Health Foundation. The report ranks the 50 states by assessing data covering individual behavior, the environment and communities where seniors live, local health policy and clinical care.

Minnesota took top honors for the second year in a row, ranking high for everything from the rate of annual dental visits, volunteerism, high percentage of quality nursing-home beds and low percentage of food insecurity. This year’s runners-up are Hawaii, New Hampshire, Vermont and Massachusetts. (See how your state fared here.).

The researchers base their rankings on 34 measures of health. But here’s one you won’t find in the report: state compliance with the Affordable Care Act (ACA). While the health reform law isn’t mainly about seniors, it has one important feature that can boost the health of lower-income older people: the expansion of Medicaid.

The ACA aims to expand health insurance coverage for low-income Americans through broadened Medicaid eligibility, with the federal government picking up 100% of the tab for the first three years (2014-2016) and no less than 90% after that. But when the U.S. Supreme Court affirmed the ACA’s legality in 2012, it made the Medicaid expansion optional, and 21 states have rejected the expansion for ideological or fiscal reasons.

And guess what: Most of the states with the worst senior health report cards also rejected the Medicaid expansion.

Nearly all Americans over age 65 are covered by Medicare. But the Medicaid expansion also is a key lever for improving senior health because it extends coverage to older people who haven’t yet become eligible for Medicare. That means otherwise uninsured low-income seniors are able to get medical care in the years leading up to age 65—and they are healthier when they arrive at Medicare’s doorstep.

Two studies from non-partisan reports verify this. The U.S. Government Accountability Office reported late last year that seniors who had continuous health insurance coverage in the six years before enrolling in Medicare used fewer and less costly medical services during their first six years in the program; in their first year of Medicare enrollment, they had 35% lower average total spending.

The GAO study confirmed the findings of a 2009 study report by two researchers at the Harvard Medical School. That study looked at individuals who were continuously or intermittently uninsured between age 51 and 64; these patients cost Medicare an additional $1,000 per person due mainly to complications from cardiovascular disease, diabetes and delayed surgeries for arthritis.

Fifty-two percent of Medicaid-rejecting states ranked in the study’s bottom third for senior health, including two very large states, Texas and Florida. Many of these states also can be found in a list of states with the highest rates of poverty among people over 65.

What emerges is a north-south divide on senior health. “Many states that haven’t expanded Medicaid are in the South, and there’s a clear link between socioeconomic status and health status,” says Tricia Neuman, senior vice-president at the Henry J Kaiser Family Foundation and director of the foundation’s Medicare policy program. “Insurance may not be the only answer, but it certainly is helpful.”

The United Health Foundation—a non-profit funded by the insurer UnitedHealth Groupdidn’t consider insurance coverage in its study, but it did consider poverty. Minnesota’s rate was 5.4%—well below the 9.3% national rate. Mississippi ranked dead last, with a 13.5% poverty rate.

In states that rejected the Medicaid expansion, we are witnessing a victory of politics over compassion and morality. Jonathan Gruber, an economics professor at the Massachusetts Institute of Technology and a key architect of health reform in Massachusetts and under the ACA, summed it up in an interview with HealthInsurance.org earlier this year, saying that these states “are willing to sacrifice billions of dollars of injections into their economy in order to punish poor people. It really is just almost awesome in its evilness.”

MONEY Social Security

As Social Security Cuts Take Effect, The Most Vulnerable Are Left to Cope

Cuts to Social Security have closed offices in some of the areas where they're needed most.

Until earlier this year, there was a Social Security field office in Gadsden County, Florida, in the state’s panhandle. It’s the kind of place where seniors need to get in-person help with their benefits rather than pick up a phone or go online.

“Our poverty rate is nearly double the state average, and we trail the state averages in education,” said Brenda Holt, a county commissioner. “Most of the people here don’t have computers, let alone reliable Internet access.”

Holt testified Wednesday before the U.S. Senate Special Committee on Aging, which is investigating the impact of budget cutting at the Social Security Administration over the past five years. Sixty-four field offices and more than 500 temporary mobile offices, known as contact stations, have been closed. And the SSA is reducing or eliminating a variety of in-person services that it once provided in its offices.

The SSA also has been developing a long-range strategy for delivering services. A draft document states that it will rely on the Internet and “self-service delivery”—and provide in-person services in “very limited circumstances, such as for complex transactions and to meet the needs of vulnerable populations.”

Gadsden County meets any criteria you could pick for vulnerability. But the field office in Quincy, the county seat, was closed with just a few weeks’ notice in March, Holt said. The nearest office is 30 miles away in Tallahassee—reachable only by car or a crowded shuttle bus that runs once a day in each direction.

The Senate committee’s investigation found SSA’s process for office consolidation wanting for clear criteria, transparency and community feedback. Only after persistent objections by local officials did the SSA offer to set up a videoconferencing station in a local library that connects seniors to representatives in its Tallahassee office.

“It’s deeply frustrated and angered our community,” said Holt. “Many of our residents live in a financial environment where they make choices between medications and food to feed their families. Problems with Social Security benefits can have a catastrophic effect on families.”

The SSA’s workload is rising as baby boomers retire; the number of claims in fiscal 2013 was 27 percent higher than in 2007. Yet the agency has 11,000 fewer workers than it did three years ago, and hiring freezes have led to uneven staffing in offices.

The SSA has received less than its budget request in 14 of the last 16 years. In fiscal 2012, it operated with 88% of the amount requested ($11.4 billion). The budget was restored somewhat in fiscal 2014 to $11.7 billion. And President Barack Obama’s 2015 budget request is $12 billion.

But service still suffers. The National Council of Social Security Management Associations reports that field office wait time is 30% longer than in 2012, and wait times and busy rates on the agency’s toll-free 800 number have doubled.

The SSA’s plan to save $70 million a year by replacing annual paper benefit statements with electronic access also has been a misstep, at least in the short run. Paper statements were suspended in 2011, but just 6 percent of all workers have signed up for online access, in some cases because of a lack of computer access or literacy but also because of sign-up difficulties related to the website’s complex anti-fraud systems.

In April the agency backtracked, announcing it will resume mailings of paper statements this September at five-year intervals to workers who have not signed up to view their statements online. (You can create an online account here.)

Wednesday’s hearing shed much-needed light on the customer service squeeze at SSA, though it would have been good to hear legislators acknowledge that Congress had no business cutting the SSA budget in the first place. The agency is funded by the same dedicated stream (payroll taxes) that funds benefits, and its administrative costs are low, 1.4% of all outlays. The SSA is funded by Americans’ tax dollars and exists to provide customer service to all Americans.

Nancy Berryhill, the SSA’s deputy commissioner for operations, did her best at the hearing to defend the agency’s efforts to cope. “It’s my job to balance service across nation—these are difficult times.”

Still, she conceded that there’s room for improvement. “We need to get more input from the community,” she said, speaking about the events in Gadsden County. “Adding the video service made a difference after the fact, but we need to be more thoughtful in the future.”

TIME Aging

7 Medical Tests Every Man Needs

Medical patient and doctor
Lee Edwards—Getty Images/Caiaimage

Admit it, guys: You don’t even like going to the doctor when there’s something wrong, let alone for preventative check-ups. But being proactive about your health—by getting recommended screenings for serious conditions and diseases—could mean you’ll spend less time at the doctor’s office down the road.

Depending on age, family history, and lifestyle factors, people need different tests at different times in their lives. Here’s a good overview for all men to keep in mind.

Diabetes

You may never need a screening for diabetes if you maintain a healthy weight and have no other risk factors for the disease (such as high cholesterol or high blood pressure). But for most men over 45—especially overweight men—a fasting plasma glucose test, or an A1C test, is a good idea, says Kevin Polsley, MD, assistant professor of internal medicine at Loyola University Health System in Chicago.

The U.S. Department of Health and Human Services also recommends diabetes screenings for overweight adults younger than 45 who have a family history of the disease, or who are of African American, Asian American, Latino, Native American, or Pacific Islander descent.

Fasting plasma glucose and A1C are both blood tests that should be done in your doctor’s office. The A1C test does not require fasting beforehand, but if your doctor wants to test you using fasting plasma glucose, you will be asked not to eat or drink anything but water for eight hours beforehand.

Health.com: Could You Have Type 2? 10 Diabetes Symptoms

Sexually Transmitted Infections

Even if you’ve been in a monogamous relationship for years, it’s not a bad idea to get tested if you haven’t already done so. Many common sexually transmitted infections can go undiagnosed for years. For example, people can go as long as 10 years without showing symptoms of HIV. The U.S. Preventive Services Task Force recommends that everyone ages 15 to 65 be screened for HIV at least once. This is especially important, Dr. Polsley says, if you have had unprotected sex, used injected drugs, or had a blood transfusion between 1978 and 1985.

In addition, the Centers for Disease Control and Prevention recommends a one-time hepatitis C screening for all adults born between 1945 and 1965, regardless of risk factors. “Believe it or not, there’s a lot of hepatitis C cases out there in which people either don’t have symptoms yet or don’t know what’s causing their symptoms,” says Dr. Polsley. “Screening for STIs is something I offer as routine at just about every physical, regardless of a patient’s age or health history.”

Health.com: Best and Worst Foods for Sex

Body Mass Index

You don’t need to make an appointment to figure out your body mass index, a measure of body fat based on your height and weight. Regardless of whether you calculate this stat yourself or your physician does the math for you, it’s important to be aware of this number, says Dr. Polsley.

A BMI between 18.5 and 24.9 is considered normal weight. Although this calculation isn’t perfect—and can sometimes label healthy people as overweight or vice versa—most doctors agree that it’s still an important component of assessing overall health. “It can be a very good opportunity to discuss diet and exercise, and to show our patients how important these things are,” Dr. Polsley says.

Health.com: 11 Reasons Why You’re Not Losing Belly Fat

Cholesterol

The American Heart Association recommends men have their cholesterol levels tested every four to six years once they turn 20. “Men have an overall higher risk for cardiovascular disease than women, and high cholesterol is often a big part of that,” Dr. Polsley says. But your doctor may want to screen you earlier (and more often) if you have heart disease risk factors such as diabetes, tobacco use, or high blood pressure.

Cholesterol is measured by a blood test, and your doctor may ask you not to eat for 9 to 12 hours beforehand. Generally, a cholesterol test will measure your levels of total cholesterol, HDL (good) cholesterol, LDL (bad) cholesterol, and triglycerides. Depending on your results, your doctor may make dietary recommendations or prescribe a cholesterol-lowering medication like a statin.

Blood pressure

Like high cholesterol, high blood pressure is often a symptomless condition—but luckily, the test for hypertension is quick and painless, involving a rubber cuff that squeezes the arm and measures the flow of blood through a large artery in the bicep. “You should have your blood pressure checked pretty much every time you see your doctor,” says Dr. Polsley, starting at age 18.

Don’t get to the doc often? Have it checked at least every two years, or yearly if your numbers were previously considered borderline (a top “systolic” number above 120 or bottom “diastolic” number higher than 80).

You can check your blood pressure at health fairs, in pharmacies, or at home with a monitoring device. If your systolic pressure cracks 130 or your diastolic goes over 85, your doctor may recommend lifestyle modifications—like exercising more and eating less salt—or they might prescribe medication.

Health.com: 31 Fat-Burning Recipes

Colonoscopy

Most men should be screened for colon cancer beginning at age 50, but those with a family history of the disease may benefit from earlier testing. Men and women alike tend to dread this test—in which a small camera is inserted into the anus and explores the large intestine for polyps or other signs of cancer—but Dr. Polsley says it’s not as bad as it sounds.

“The preparation for the test is actually the worst part,” he says: You’ll need to empty your bowls completely before the exam, which may involve not eating solid foods for one to three days, drinking lots of clear liquids, or taking laxatives. “The actual colonoscopy shouldn’t be too uncomfortable, because you’re sedated through the whole thing.”

But here’s the bright side: If your doctor doesn’t find anything suspicious, you won’t need another colonoscopy for up to 10 years.

Prostate exam

Screening for prostate cancer is more controversial than for other cancers, says Dr. Polsley, and some studies have shown that these tests can be expensive and unnecessary, and may do more harm than good. But he suggests that all men over 50 at least talk with their doctors about the pros and cons of these tests—usually either a digital rectal exam (in which the doctor inserts a gloved finger, or digit, into the rectum to feel for lumps and abnormalities) and a PSA test, which measures a protein called prostate-specific antigen in the blood.

Prostate cancer screenings can and do save lives, but they may also result in false-positive or false-negative results. And because many cases of prostate cancer progress very slowly, some men (especially older men) don’t benefit from aggressive treatment. Whether you decide to get screened for prostate cancer should be a decision you make with your doctor, says Dr. Polsley. In the meantime, it’s important to know the symptoms of an enlarged prostate—like having to urinate frequently or having trouble urinating—which could also signal cancer.

This article originally appeared on Health.com.

TIME Aging

10 Ways to Live to 100

Women exercising and laughing
Sam Edwards—Getty Images/Caiaimage

No one really wants to think about aging, but let’s face it: the habits you practice now can play a role in how long you’ll live, and how much life you’ll have in your years.

The world’s oldest man, Polish immigrant Alexander Imich, passed away on Sunday in New York City at the age of 111. That’s way longer than the average American male life expectancy of 76, according to the Centers for Disease Control and Prevention.

Health.com: 13 Everyday Habits That Age You

While Imich told The New York Times that he chalked up his longevity to good genes, there are healthy habits you can pick up to help you live a longer, happier life. Here are some ideas:

Find a hobby
Doing something you find truly fulfilling will give you a sense of accomplishment, and can help reduce stress.

Floss!
Flossing does more than clean your teeth: Getting all that inflammation-causing bacteria off your gums can reduce your risk of heart disease and stroke.

Health.com: 14 Reasons Why You’re Always Tired

Plan a vacay
Taking a break from work can lower your risk of heart disease and add 1 to 2 years to your life.

Rest up
Your body repairs cells during sleep, so skimping on it doesn’t do your body any favors. Plus, adequate sleep also affects your quality of life. Aim for 7 to 8 hours of shut-eye per night.

Get busy
Having sex releases the feel-good hormone oxytocin, another stress reliever. Plus, a study from the University of Quebec found that women burn 3 calories per minute of sex while men burn 4.

Health.com: 7 Foods for Better Sex

Be social
People with stronger friendships were 50% more likely to live longer than those with weaker connections, a 2010 analysis found. That makes the impact of friendlessness comparable to that of smoking (more on that below).

Eat right
You need to fuel your body with healthy foods to live a long life. Limit your intake of foods high in fat, salt, and added sugar (which can increase your risk of heart disease, obesity, and other chronic diseases) and look for superfoods rich in vitamins, minerals, fiber, and protein.

Health.com: Best Superfoods for Weight Loss

Hit the gym
Not only is exercise good for the heart, but working out can trigger the release of endorphins, pain-relieving chemicals known to boost your mood. Shoot for at least 150 minutes of moderate exercise a week, per the CDC.

Beat stress
A study published in the Journal of Clinical Endocrinology & Metabolism found that high levels of the stress hormone cortisol are associated with an increased risk of dying from cardiovascular disease. That’s even more reason to take up calming activities, like meditation and yoga.

Stop smoking and limit drinking
Imich, a former smoker, swore off both cigarettes and alcohol and you should follow his lead-at lease when it comes to the cigs. Smoking causes one out of 5 deaths in the U.S. each year, according to the CDC. Moderate alcohol consumption is good for you, but experts recommend that women have no more than one drink per day (or up to 7 per week); for men it’s 1 to 2 drinks per day, or a max of 14 per week.

This article originally appeared on Health.com.

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