Slow down, that used to be the mantra for middle age. The dread half-century reached, fiftysomethings were expected to take up less challenging physical activities – if they were physical at all. A gentle stroll around the golf course, perhaps, rewarded with a gin and tonic at the 19th hole; or membership of the local bowling club, blazered crown green rather than 10-pin.
Physical decline as the body aged was inevitable, something to be grumbled about, accepted and dealt with. That fundamental law has not changed, but the way we manage ageing has. Getting older need not mean getting weaker, at least not until the end is truly nigh.
“Do not go gentle into that good night,” advises Dylan Thomas. “Old age should burn and rave at close of day;/ Rage, rage against the dying of the light.” Thomas raged over a pint pot, but the rage in this case is high-intensity training, bursts of challenging – yes, painful – exercise interspersed with periods of lesser exertion and rest. We should all be doing this in our later years, except for those whose health makes such exertion dangerous.
It is not ageing that causes a decline in fitness; rather, that a decline in fitness causes ageing. This is the simple thesis of Play On: How to Get Better with Age by the American journalist and sports fan Jeff Bercovici.
Bercovici, a sometime amateur soccer player, seeks to dispel conventional wisdom about longevity: that life is essentially a dispiriting linear process in which the human machine gradually winds down, clogging here and rusting there before falling into decrepitude. Instead, he argues, we can not only extend our lives by occasionally punishing our bodies but extend our “peak years” of fitness into the autumn and winter of existence. Functionality, rather than a long lifespan, is what matters.
To do this, he examines the lives of sportsmen and women whose fitness regime has allowed them to keep performing at the top level into their 30s. Like Roger Federer, 36, the Swiss tennis player who many would say is the greatest exponent of his sport in history, and Serena Williams, his female opposite number, also 36. Beneficiaries of the latest findings in sports science and medicine, these athletes lead the way on a journey that we can all follow, at whatever level of performance.
The buzz technique that has gained favour is high-intensity interval training (HIIT) in which bursts of intense activity – such as sprinting and cycling – are interspersed with periods of lower-intensity exercise. You know you are at high intensity when muscles burn and you get out of breath. In other words, it hurts.
“Ageing science supports that we should do high intensity every week, getting your heart rate up to at least 80% of its maximum,” says Bercovici. “Even 10 or 20 minutes a week will produce results – that means getting up to the point where it feels unpleasant. It should be a feeling that you can’t keep this up much longer.
“High intensity activates different pathways in your body, with benefits at the cellular level. Together with gentler exercise, it improves overall fitness. The trick is getting the balance: say, 20% high to 80% low.”
Strength training is also important, building muscle and helping to prevent later-life injuries. There is also a neurological benefit from this type of exercise. Instinct tells us that playing bridge and doing the crossword are good for the brain, but workouts also improve cognitive function, although the process is poorly understood.
Sitting back with a cup of tea is not an option if you want to stave off the relentless process that is getting old. Many symptoms of ageing are linked to decreased hormone levels, particularly testosterone. The less testosterone you have, the harder it is to retain and build skeletal muscle (all the muscle that is not part of your circulatory system or digestive tract). Skeletal muscle burns a lot of calories. As you lose skeletal muscle, your metabolism slows, meaning any calories you consume are more likely to end up as fat. And fat secretes the hormone oestrogen and proteins that promote chronic inflammation and insulin resistance.
As the writer Bill Gifford puts it in Spring Chicken, a 2015 tour of anti-ageing science, “Ageing makes us fat, and then our fat makes us age.” It gets worse. After 45, osteoarthritis – painful inflammation of the bones at the joints – becomes much more common. This happens as the cartilage that acts as a shock absorber in those joints, particularly in the knees, wears down and the cells that help it regrow get worse at their job, again for reasons not totally understood.
The shocks that cushion the vertebrae of your spine take a beating, too. By the age of 50, more people than not have at least one bulging intervertebral disk, even if they don’t experience any symptoms. As you exit your 40s, your risk of a herniated disk shrinks. Great – except that it is because the disks themselves are shrinking, which not only predisposes you to new types of pain but explains why you will get a little shorter with each passing decade.
Your nervous system is changing, too. Reaction times are at their best around age 24 and become slower from then on. This has to do with the reduced speed at which nerve signals travel. As the protective casings of protein around peripheral nerves degrade, they cannot conduct impulses as efficiently. This is one reason that the simple act of balancing requires more conscious effort in the elderly.
But here’s the good news: most of these major changes can be attenuated, delayed or reversed through frequent and vigorous exercise. Bercovici says it won’t keep your hair dark or stop you needing glasses, but the most pernicious symptoms of ageing – cognitive impairment, muscle wasting, bone thinning, cardiovascular damage – just don’t happen in the same way in people who work out often.
Take Tour de France cyclists: they enjoy an eight-year boost to their lifespans over we couch potatoes. Athletes in endurance sports or sports that demand a mix of endurance and power, such as football or basketball, fare better than pure power athletes, such as weight lifters.
Elite sports performers continue to succeed well past the peak age for their sport, not because they train more but because they train more efficiently. They use periodisation – interweaving intense training with rest – to avoid fatigue and injury. This is something laymen can learn from.
Players in their 30s are now common in first-class tennis, most notably Federer. With 20 grand slam titles to his credit, he is the most fluent and elegant of players, with feet as light as a dancer’s. But nowadays, he doesn’t overdo it. “Federer doesn’t drive himself to the wall,” says Bercovici. “Older athletes like him are no longer striving to be the biggest, strongest or fastest, but the smartest, in using their training to maximum effect. The biggest feature of many modern sportsmen now is how much sleep they get. In America, rest in the middle of a sports season was totally alien 20 years ago, but now it is accepted.”
So pummelling yourself to death for hours on end in the gym need not be the answer. Relatively brief periods of high-intensity interval training, which make allowances for busy work and family lives, can help keep us young, or at least higher functioning older people.
Even Federer is a spring chicken compared with athletes performing well into their forties. British runner Jo Pavey is a home-grown example of increasing longevity in sport. The Devon-based athlete will be just shy of her 45th birthday in August, yet age has not dulled her love of competition. Veteran of five Olympic Games, with two children to care for, she is nevertheless preparing for the 10,000m in that month’s European Athletics Championships in Berlin. In 2014, she won gold in the same event, when she was about to turn 41, becoming the oldest European champion in history. Pavey knows how to pace herself on and off the track, missing this year’s Commonwealth Games in Australia to ensure freshness in the summer. If anyone beats the linear model for ageing, it is her.
“There’s always a next thing to aim for, and something to look forward to,” she says. “The thing is that you get some years when you feel older but when things are going wrong you can be 26 and feel old! You get years when you feel old and others when you feel young again.”
Other female athletes have maintained elite performance into their 40s, such as 42-year-old Uzbek gymnast Oksana Chusovitina, who hopes to compete in her eighth Olympics in 2020. And American road cyclist Kristin Armstrong, 44, who came home with a gold from the time trial in the 2016 Olympics in Rio de Janeiro, her third in that event.
And when age takes its toll, there is always the option of medical science. For example, we are only a decade away from being able to 3D-print replacement cartilage – something Andy Murray could do with. Cartilage is particularly affected by age – about a quarter of all adults over 55 show signs of knee osteoarthritis, the inflammation that occurs when cartilage breaks down.
Nirav Pandya, an orthopaedic surgeon at the University of California at San Francisco, says: “In the young kid you have such good healing potential. But take that person who may have had a couple of injuries in their knee when they played college sports, and now they’re 35 or 40 and it’s just bothering them. The answer before was, ‘Just stop.’ Now, it may be, ‘Let’s grow some cartilage in this area. Let’s see if we can get your body back to when you were 20 through some of the cell and molecular stuff we are doing.’”
In Silicon Valley, where longevity is an obsession, the technological solution is appealing. Tech billionaires are using their wealth to put some distance between themselves and the Grim Reaper. Sergey Brin and Larry Page, the cofounders of Google, have launched a company called Calico (California Life Company) with the mission to “harness advanced technologies to increase our understanding of the biology that controls lifespan”.
But death always enjoys the upper hand. Research suggests 120 is the absolute upper limit for the durability of the human frame, no matter what we do in the gym. Cell mutation over time is what does us in. Judith Campisi, a professor of biogerontology at the Buck Institute in the US, explains that the more biologically complex an organism, the harder it is to extend its life. We can keep roundworms alive for 10 times their normal lifespan. But humans? No.
“Maybe evolution is trying to tell us something,” she says. Most of us need not worry about life at 120, or even 90. Our sedentary lifestyle helps ensure that many of us will depart this earth well before. Public Health England (PHE) says some six million people between 40 and 60 in England are endangering their health by not taking so much as a brisk walk for 10 minutes once a month. But there is always the chance to change. One of the benefits of being a couch potato in youth and early middle-age is the lack of stress damage accrued by serious athletes that can leave some of them old before their time.
“By walking just 10 continuous minutes at a brisk pace every day, an individual can reduce their risk of early death by 15%,” says Professor Muir Gray, adviser to PHE. “They can also prevent or delay the onset of disability and further reduce their risk of serious health conditions, such as diabetes, heart disease, dementia and some cancers.” Emma Stevenson, professor of sport and exercise at Newcastle University’s Institute for Ageing, says it is all about functionality – living well, not just longer. “Age is not a reason not to be doing things,” she says. “That way, we age more quickly. We may be living longer but without good nutrition and exercise we lose functionality – like simply being able to get out of a chair – and that is not good quality of life.”
How to get fit for life
1. Ramp up exercise gradually, preparing your body for the demands you wish to place on it. Walking is a great way to start. Just 10 continuous minutes at a brisk pace every day can reduce the risk of early death by 15%.
2. Aim for 10 or 20 minutes a week of high-intensity exercise – getting your heart rate up to at least 80% of its maximum. This means getting to the point where it feels unpleasant (sweating, raised heart rate, out of breath) and that you can’t keep it up for long.
3. High-intensity interval exercise should be followed by unloading activities, such as stretching and massage. Time-pressured people are tempted to extend exercise during a visit to the gym and skip stretching. Bad idea.
4. Keep to a 20:80 ratio for high:low intensity exercise. Also aim for some strength training (push-ups, squats, resistance bands) to build muscle and help to prevent later-life injuries, like those to the hip.
5. Avoid fads and eat a generally healthy diet, with plenty of vegetables and whole grains. Protein builds muscle and creatine powder in a glass of milk helps build and maintain muscle. Bone broth is good.