Expert Tips for Living Longer: It’s Not All About Eating Vegetables and Exercising長(zhǎng)壽之道：吃蔬菜和勤鍛煉并非全部

貝姬·厄珀姆 譯/陳麗

Quality relationships and a sense of purpose can go a long way1 in helping you add years （and happiness） to your life.良好的人際關(guān)系和清晰的目標(biāo)感很重要，有助于延年益壽（并增加幸福感）。

The beginning of a new year is a time when many of us reassess our health habits. We try to build on what’s working and make an effort to drop a few things that seem to get in the way of our quest to become our “best self.”

But do you ever wonder if you’re focusing on the right things？ In an ideal world， we’d have unlimited amounts of time and energy to devote to every healthy food and activity that we read or hear about， but most of us have to be selective in choosing what to pursue.

As you might expect， choices like exercise， alcohol consumption， and smoking can all impact how long you live， but research also suggests that efforts we make in other ways—some of which may not seem “health”-related—can make a big difference， no matter what your age.

At any age， asking life’s big questions

Whether people are in their twenties and thirties， at midlife， or in their sixties and seventies， they should take time to reflect on life’s “big” questions， says Philip Pizzo， MD2， former dean of the Stanford School of Medicine in California， and the founding director of the Stanford Distinguished Careers Institute （DCI）.

Dr. Pizzo wrote an article published in January 2020 in the Journal of the American Medical Association （JAMA） offering a “prescription for longevity in the 21st century” that focused on the importance of life purpose， social engagement， and positive lifestyle choices. “What is my sense of purpose that defines me？ What gives me satisfaction？ How do I overcome boundaries of loneliness by reaching out and creating community？” are questions that we should consider and even discuss with our doctors， says Pizzo.

“Along with lifestyle choices like exercising， good nutrition， and not smoking， these factors make a huge difference in terms of well-being and really impact health outcomes，” he adds.

Cultivating connection with friends and family and strengthening your life purpose may require you to step out of your comfort zone even more than a Zumba class， but they offer the reward of a long and satisfying life， no sweat or spandex3 required.

Social connection： the ties that bind may help hold your health together， too

If you were going to invest now in your future best self， where would you put your time and your energy？ This is a key question Robert Waldinger， MD， asked in his TED talk entitled， “What Makes a Good Life？ Lessons from the Longest Study on Happiness，” which has amassed over 15 million views. Dr. Waldinger is a psychiatrist at Massachusetts General Hospital in Boston as well as the director of the Harvard Study of Adult Development， one of the world’s longest studies of adult life.

Researchers found that people who were the most satisfied with their relationships at age 50 were the healthiest at age 80. This is likely due to several factors， says Waldinger. “One is that we’re more connected to people， we’re more likely to take better care of ourselves. Our mood is better， we feel better， and that might lead us to engage in something good for us， like exercise or eating better or drinking less，” he says.

Sometimes it’s these connections and the feelings they engender that can help us make better decisions， says Waldinger. The positive impact of relationships is not necessarily about the “big” choices， but rather the small microscopic decisions that are moment to moment， he adds.

Having a supportive partner can help you take better care of yourself as well， says Waldinger. “They can remind you to take your medicine or to get that problem you’ve been concerned about checked out at the doctor，” he says. Your partner wants you to stay healthy and they might nudge you in that direction， says Waldinger.

Relationships need not be perfect to be valuable

It’s important to note that in relationships or life， things aren’t smooth and happy all the time; that’s not the goal and it’s not how you measure “success，” says Waldinger. “People have difficulties in relationships， but when it’s possible， try to hang in there and work out differences，” he says.

“It’s an investment worth making，” he adds. Obviously， we don’t want to encourage people to stay in abusive relationships， but the idea is to hang in there when times get difficult and not just to give up， he adds.

Life purpose： finding meaning can help you live longer

Why are we here？ Do you feel like what you do makes a difference？ Those might seem like “deep questions” that you may not often consider， but research shows they can really affect your health. A study published in May 2019 in JAMA Network Open set out to see if there’s a connection between a strong life purpose and living longer.

To assess the strength of life purpose， 6，985 participants between ages 51 and 61 were asked to respond on a scale from 1 （strongly disagree） to 6 （strongly agree） for seven different items. Questions included statements such as， “Some people wander aimlessly through life， but I am not one of them，” or “I feel as though I have more to do in life.”

“We found that people with the lowest scoring group had about a two-and-a-half-fold increased risk of death compared with people with the highest scores，” says Celeste Leigh Pearce， PhD4， MPH5， associate professor of epidemiology at the University of Michigan in Ann Arbor and coauthor of the study.

Unlike many health behaviors， life purpose can look different for everyone， says Pearce. “That’s what I like about it. Each person can identify what matters to them and then seek out opportunities to pursue their own personal goals and values，” says Pearce.

Healthy lifestyle choices： good habits can reduce your risk of many diseases

Lifestyle habits can also make a substantial difference in increasing the years and quality of your life， according to a study published in January 2020 in BMJ6. Investigators from Harvard looked at more than 110，000 women and men who were enrolled in the Nurses’ Health Study and the Health Professionals Follow-Up Study. Five key health habits were evaluated in the following ways：

A healthy diet was measured by a high score on the Alternative Healthy Eating Index. This measure was developed by experts at Harvard University’s department of nutrition， and a high score indicates a diet rich in vegetables， fruits， whole grains， nuts， and legumes with limited amounts of red or processed meat， trans fats， and sodium.

Regular exercise was defined as at least 3.5 hours a week， or 30 minutes a day， of moderate to vigorous activity.

Healthy weight range was a body mass index （BMI）7 of 18.5 to 24.9.

Smoking was self-reported， and never having smoked or having stopped smoking were preferred behaviors compared with currently smoking.

Moderate alcohol consumption was consistent with guidelines from the Centers for Disease Control and Prevention （CDC） and defined as one or fewer drinks8 per day for women and two or fewer drinks per day for men.? ? ? ? ? ? ? ■

每個(gè)新年伊始，許多人都會(huì)重新評(píng)估自己的健康習(xí)慣。我們?cè)噲D繼續(xù)保持那些行之有效的習(xí)慣，并努力改掉一些似乎妨礙我們成就“最佳自我”的習(xí)慣。

但你可曾想過(guò)，你所專(zhuān)注的習(xí)慣是否正確？理想狀態(tài)下，我們可以有無(wú)限的時(shí)間和精力來(lái)嘗試我們讀到或聽(tīng)說(shuō)過(guò)的每種健康食物和運(yùn)動(dòng)，但大多數(shù)人在決定嘗試什么時(shí)都不得不有所挑選。

正如你所預(yù)料的，諸如鍛煉、飲酒、抽煙這樣的習(xí)慣均會(huì)影響壽命，但是研究也表明，我們?cè)谄渌矫娴呐Α@些努力有些看起來(lái)或許與“健康”無(wú)關(guān)——同樣會(huì)對(duì)壽命產(chǎn)生重大影響，而且這種影響與年齡大小沒(méi)有關(guān)系。

不分老少，都要思考人生的重大問(wèn)題

人們不論正值青壯、人到中年，還是已邁入老年，都應(yīng)該花些時(shí)間來(lái)思考人生的“重大”問(wèn)題，菲利普·皮佐博士如是說(shuō)。皮佐曾經(jīng)擔(dān)任位于美國(guó)加利福尼亞州的斯坦福大學(xué)醫(yī)學(xué)院的院長(zhǎng)，是斯坦福大學(xué)杰出事業(yè)研究院的創(chuàng)始院長(zhǎng)。

皮佐博士在2020年1月出版的《美國(guó)醫(yī)學(xué)會(huì)雜志》上發(fā)表了一篇文章，提供了一份“21世紀(jì)的長(zhǎng)壽處方”，重點(diǎn)討論了人生目標(biāo)、社會(huì)交往和積極生活方式的重要性?！笆裁词俏医枰宰晕叶ㄎ坏娜松繕?biāo)？什么給我以滿足感？我如何通過(guò)與外界交往并創(chuàng)建關(guān)系群來(lái)克服孤獨(dú)感？”——皮佐博士說(shuō)，這些是我們應(yīng)該考慮甚至向醫(yī)生咨詢(xún)的問(wèn)題。

他進(jìn)一步認(rèn)為：“這些因素，就和積極鍛煉、保證營(yíng)養(yǎng)、不吸煙等生活方式的選擇一樣，對(duì)健康極為重要，并會(huì)真正影響健康狀況?！?/p>

增強(qiáng)與朋友和家人的聯(lián)系、加強(qiáng)你的人生目標(biāo)感，這些甚至可能比報(bào)名參加尊巴健身課更能迫使你走出舒適區(qū)，而它們也提供回報(bào)——給你一個(gè)更為長(zhǎng)壽也更加幸福的人生，并且還不需要流汗和購(gòu)買(mǎi)健身衣。

社會(huì)交往：盡管具有約束性但也會(huì)幫助你保持健康

假如你現(xiàn)在準(zhǔn)備投資以求未來(lái)實(shí)現(xiàn)最佳自我，你會(huì)往哪里花時(shí)間和精力？這就是羅伯特·瓦爾丁格博士在他的TED演講中提出的關(guān)鍵問(wèn)題。該演講題為《什么造就了幸福生活？來(lái)自對(duì)幸福最久研究的結(jié)論》，累計(jì)觀看人次已經(jīng)超過(guò)1500萬(wàn)。瓦爾丁格博士是位于美國(guó)波士頓的麻省總醫(yī)院的一名精神科醫(yī)生，也是哈佛大學(xué)成人發(fā)展研究項(xiàng)目的主管，該項(xiàng)目是世界上持續(xù)時(shí)間最久的成人生活研究項(xiàng)目之一。

研究者們發(fā)現(xiàn)，50歲時(shí)對(duì)自己的情感關(guān)系最滿意的人群到了80歲時(shí)最為健康。瓦爾丁格博士表示，這一現(xiàn)象可能由多個(gè)因素造成。他說(shuō)：“一個(gè)因素是，我們?cè)脚c人交往，就越會(huì)更好地照顧自己。我們的情緒更好，自我感覺(jué)更佳，而這會(huì)引導(dǎo)我們?nèi)プ瞿承?duì)我們有益的事，例如運(yùn)動(dòng)、吃得更好或減少飲酒?！?/p>

瓦爾丁格說(shuō)，有時(shí)，正是這些社會(huì)交往以及它們促生的情緒能夠幫助我們做出更佳的決定。情感關(guān)系的積極影響不一定僅限于“重大”的選擇，更多的還是一些即時(shí)做出的極小的決策，他補(bǔ)充道。

瓦爾丁格說(shuō)，擁有一位愛(ài)護(hù)你的伴侶還能幫助你更好地照顧自己?！八麄儠?huì)提醒你吃藥，提醒你就那個(gè)讓你憂心的問(wèn)題去看醫(yī)生?！彼硎?，你的伴侶會(huì)希望你保持健康，督促你朝這個(gè)方向努力。

并非只有完美的關(guān)系才有價(jià)值

瓦爾丁格表示，值得注意的一點(diǎn)是，在兩性關(guān)系或者生活中，事情并不總會(huì)一帆風(fēng)順，生活也不會(huì)永遠(yuǎn)幸福美滿——你不該將之當(dāng)作奮斗的目標(biāo)，也不該將其作為衡量“成功”的標(biāo)尺。他說(shuō)：“兩性關(guān)系中會(huì)出現(xiàn)困難，但只要有可能，請(qǐng)盡力維系，想辦法解決分歧?！?/p>

他表示：“這份投入是值得的。”顯然，我們不是鼓勵(lì)人們?cè)谠馐芘按龝r(shí)忍氣吞聲，而是建議，如果出現(xiàn)了困難，請(qǐng)堅(jiān)持一下而不是簡(jiǎn)單放棄，他補(bǔ)充道。

人生目標(biāo)：找到人生的意義能夠延年益壽

我們?yōu)槭裁椿钪?？你覺(jué)得自己的所作所為有價(jià)值嗎？這些問(wèn)題或許看似“深?yuàn)W”，平時(shí)也不會(huì)經(jīng)?？紤]，但研究表明，它們真能影響健康。2019年5月出版的《美國(guó)醫(yī)學(xué)會(huì)雜志（網(wǎng)絡(luò)開(kāi)放版）》發(fā)表了一份研究報(bào)告，該研究旨在探討堅(jiān)定的人生目標(biāo)和長(zhǎng)壽之間有無(wú)聯(lián)系。

為了評(píng)估人生目標(biāo)的力量，6985名年齡在51歲至61歲之間的受訪者被要求就7個(gè)不同項(xiàng)目在1（強(qiáng)烈不同意）至6（強(qiáng)烈同意）的評(píng)分范圍內(nèi)做出選擇。待選問(wèn)題包括如下一些陳述：“有些人毫無(wú)目標(biāo)地虛度光陰，但我不是這樣的人”“我覺(jué)得我生命中似乎還有好多事要做”。

“我們發(fā)現(xiàn)，評(píng)分最低的人群與評(píng)分最高的人群相比，死亡的風(fēng)險(xiǎn)增加了1.5倍?！痹撗芯繄?bào)告的合著者、美國(guó)密歇根大學(xué)安娜堡分校的流行病學(xué)副教授塞萊斯特·利·皮爾斯（公衛(wèi)碩士、哲學(xué)博士）說(shuō)。

皮爾斯表示，和許多健康行為不同，人生目標(biāo)因人而異。她說(shuō)：“這正是我喜歡它的地方。每個(gè)人都能夠找到對(duì)自己而言重要的目標(biāo)，并尋找機(jī)會(huì)去追求各自的人生目標(biāo)和價(jià)值?！?/p>

健康的生活方式：好習(xí)慣能降低多種疾病風(fēng)險(xiǎn)

根據(jù)2020年1月發(fā)表在《英國(guó)醫(yī)學(xué)雜志》的一份研究報(bào)告，生活方式對(duì)延長(zhǎng)壽命、提高生活品質(zhì)也具有極其重要的影響。哈佛大學(xué)的研究者們調(diào)查了超過(guò)11萬(wàn)報(bào)名參加護(hù)士健康研究和醫(yī)務(wù)人員隨訪研究計(jì)劃的女性和男性。研究評(píng)估了5個(gè)關(guān)鍵的健康習(xí)慣，詳情如下：

健康飲食在“替代性健康飲食指數(shù)”中被給予高分。這一衡量標(biāo)準(zhǔn)是由哈佛大學(xué)營(yíng)養(yǎng)系的專(zhuān)家們研發(fā)出來(lái)的，高分飲食應(yīng)富含蔬菜、水果、全谷物、堅(jiān)果和豆類(lèi)，同時(shí)限量攝入紅肉或加工肉制品、反式脂肪和鈉。

經(jīng)常鍛煉的標(biāo)準(zhǔn)是一周至少3.5小時(shí)或者每天30分鐘的中高強(qiáng)度活動(dòng)。

健康體重的范圍是身體質(zhì)量指數(shù)在18.5至24.9之間。

抽煙是自述行為，相較目前仍在抽煙，從未抽煙或已經(jīng)戒煙是更為有利健康的行為。

適度飲酒的標(biāo)準(zhǔn)與疾病控制與預(yù)防中心的指南一致：平均每天的飲酒量，女性不超過(guò)一個(gè)飲酒單位，男性不超過(guò)兩個(gè)飲酒單位。

（譯者單位：北京外國(guó)語(yǔ)大學(xué)）