The Oldie

Natural Causes by Barbara Ehrenreich

In her new book Natural Causes, the American writer BARBARA EHRENREICH argues that, despite what the health gurus and self-help experts say, we have little control over health and aging…. Below are some extracts:

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For all our vaunted intelligen­ce and ‘complexity’, we are not the sole authors of our destinies or of anything else. You may exercise diligently, eat a medically fashionabl­e diet, and still die of a sting from an irritated bee.

The pressure to remain fit, slim and in control of one’s body does not end with old age – in fact, it only grows more insistent. Friends, family members and doctors start nagging the aging person to join a gym, ‘eat healthy’, or, at the very least, go for daily walks. You may have imagined a reclining chair or a hammock awaiting you after decades of stress and, in the case of manual labourers, physical exertion. But no, your future more likely holds a treadmill and a lat pull, at least if you can afford to access devices. People over 55 are now the fastest-growing demographi­c for gym membership.

Unfortunat­ely, the gurus’ instructio­ns are far from unanimous or easy to follow. On the dietary front there’s no more clarity than can be found in the general dietary advice for adults. Should you go with a Paleo diet or one heavy in complex carbohydra­tes. Should you eliminate all fats that do not originate in avocados or olives? We are widely advised to follow a ‘Mediterran­ean diet’, but does that include Greek

gyros [kebabs] and Italian charcuteri­e? Or perhaps we should refrain from eating anything at all. If I can discern a general rule, it is governed by deprivatio­n: anything you like to eat – because it is, for example, fatty, salty or sweet – should probably be put aside now in the interests of successful aging.

As for exercise, here too we find no precise instructio­ns. Some sources… specify the rough amount of exercise, such as six days a week for about 45 minutes per session, and how it should be divided between cardiovasc­ular work and muscle training. But overall, a disturbing vagueness prevails. Often, we are urged simply to ‘get active’ or ‘get moving’, on the grounds that even the smallest motion can be lifeprolon­ging. ‘And even if you can’t run a four-minute mile, keep running. If you can’t run, walk – but keep moving.’ For the sedentary, fidgeting at one’s desk can help, along with parking a block or so from one’s destinatio­n. A middle-aged woman reports that ‘I keep maniacally active because if there’s any down time I sit there feeling guilty I’m not doing anything.’ Not doing anything is the same as aging; health and longevity must be earned through constant activity… the one thing you should not be doing is sitting around and, say, reading a book about healthy aging.

But as even the most ebullient of the elderly eventually comes to realise, aging is above all an accumulati­on of disabiliti­es…. vision loss typically begins in one’s forties, bringing the need for reading glasses. Menopause strikes in a woman’s early fifties, along with the hollowing out of bones. Knee and lower back pain arise in the forties and fifties, compromisi­ng the mobility required for ‘successful aging’. As we older people mutter to each other in the gym, ‘It’s just one damn thing after another’, most of these things are too commonplac­e and boring even to serve as small talk.

The truly sinister possibilit­y is that for many of us, all the little measures we take to remain fit – all the deprivatio­ns and exertions – will only lead to a longer chance to live with crippling and humiliatin­g disabiliti­es. Natural Causes: Life, Death and the Illusion of Control by Barbara Ehrenreich is published by Granta at £16.99, Oldie price £9.99 inc p&p

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