Jane Brody

Personal Health Columnist
The New York Times

Well, you know, we're dealing with a totally different population now than we did even as recently as 25 years ago. And now Americans are living into their 80's and beyond - the fastest growing segment of the population is over 65 and we even have a population explosion among centenarians - people over 100. This means that the bodies that we are taking care of have to last a lot longer than they used to. And that means that they have to be fed better and they have to be exercised better.

How do you motivate people to take care of themselves?

I think one of the most telling aspects of our society is the fact that so many people in their 40s are now watching their elderly parents develop chronic diseases that require medication, hospitalization, surgery and sometimes nursing home care. And, uh, younger people now are thinking to themselves, We don't want to go that way, if we're going to live to 80 and beyond we want it to be good, golden years not tarnished golden years.

What do people need to think about when they think about taking care of themselves?

I think the two most important aspects of self care involve what and how much people eat, and how they move their bodies. It's critically important that the calories that you consume match the calories that you use up otherwise you gain weight. And we now have a runaway problem of overweight and obesity in this country that is causing high blood pressure, diabetes, heart disease, kidney disease, stroke, all those chronic ailments that we could all live very well without.

But how do you get people to say, Yeah, I'd better do this?

Most people are not alone in this world, they have families who worry about them and that they have to worry about themselves. They have children, they have grandchildren, they have parents. And if any if those elements gets sick - especially with a chronic disease that lingers - it affects the entire family. It affects them psychologically, it affects them financially, and it affects them emotionally.

What advice do you give someone who perhaps hasn't exercised or thought about their weight?

The most wonderful thing about physical activity is that it's never too late to start. That even if you are currently 80 years old and you have a chronic illness or you have arthritis or whatever, anytime you start you will improve your health. You will not only be healthier, you will feel better, you'll have a better appetite, you'll better match your caloric intake with your caloric output. It's interesting, exercise does not increase people's appetites. It helps them match their appetite to the amount of calories they really need.

You've been writing about this for at least 25 years. How did you get so passionate about it?

Well, first I read all the medical literature as it comes out in first-run journals as well as the literature that appears in what they call the medical throwaways. And every single issue of every journal just about, has an article that says if you eat better, if you exercise more, you will be a healthier person. I mean, it was really hard to ignore.

And way back in the 1960's when I started out as a science and health writer most science writers were simply writing about patching up people after they got sick. Especially for heart disease. I mean, heart disease was epidemic in our society - it still is the leading killer of Americans, but it's killing a lot fewer American men than it used to, and that's a good thing. That has happened because men have quit smoking, they're eating less saturated fat and they're exercising more than they did in the 1960's. So we have a triad of differences that are making a tremendous health difference in men.

Unfortunately, it hasn't made the same difference in women and that is because women took up smoking with a vengeance just as men were beginning to quit. And now women are suffering the consequences of having been avid smokers for many, many years. But I think what has motivated me more than anything is the realization that I can do something about my own health - that this is something I can control and that everyone has the ability to control, to a very large extent, what happens to them. Your genes only set up a predisposition, they do not cause disease.

How can we improve education? How can we get the word out?

I think we have to start with children. We must start in preschool, kindergarten and all the elementary grades and instead of having vending machines spewing out soft drinks and candy in our schools we should have, if we have vending machines, they should be distributing low fat or skim milk and apples, otherwise eliminate the vending machines. We have a tremendous problem with what our young children are learning about how to eat and how not to exercise. We eliminate physical education programs as soon as the school budgets get tight - these are among the first things to go. And so we're raising a whole generation of children who will have worse problems, worse health habits than our current older population has.

What does the term "caregiving" mean to you?

"Caregiving" means taking care of yourself and therefore being able to take care of the people you love. And self-care really has to come first because once your own health is compromised, you really can't give your all to anybody else.

You know, it's a very interesting thing that if all Americans just got 30 minutes of physical activity a day we would save something like 70 billion dollars a year in health care. I mean, this is an extraordinarily cost-effective measure and there's nothing in the medical arsenal that can match it.

You know, the ancient Greeks came up with a saying that the goal in life should be to die young as late in life as possible. And I think that should be everyone's goal today.

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