April 02, 2009


The Hourglass Solution: A Boomer’s Guide to the Rest of Your Life. By Jeff Johnson, Ph.D., and Paula Forman, Ph.D. Da Capo. $25.

Healing through Exercise: Scientifically-Proven Ways to Prevent and Overcome Illness and Lengthen Your Life. By Jörg Blech. Da Capo. $26.

     Just plunk down your 51 bucks (plus tax where charged), follow the prescriptions in these books, and you’ll have a longer, healthier, more fulfilled and fulfilling life. Believe!

     Or don’t. Like self-help books from time immemorial, these two take a good idea and turn it into the be-all and end-all idea for future health, wealth and success. That may be a flaw inherent in the whole self-help-book field – does anyone want to buy a book that says “here’s something you can do that may kind of help your life if you do lots of other things, too”? But one would hope that psychologist Jeff Johnson and sociology professor Paula Forman would not fall victim to overstatement. Maybe the fact that both have also been involved in the advertising business has something to do with it. What they are advertising, and advising, in The Hourglass Solution is that baby boomers think of life as being shaped like an hourglass, with constraints in the “neck” still holding them captive as they age. That is, earlier-in-life decisions about career, lifestyle, relationships, money and more will continue to constrict life unless boomers understand that there is a bottom part of the hourglass that broadens out considerably past the narrow neck – and boomers can and should take advantage of that expanded part. This is one of those clever metaphors that it is best not to examine too closely, since it invites a “sands of time” attitude toward life and a feeling that, after one escapes constriction, one plunges rapidly to the bottom, to death. That’s not what Johnson and Forman mean, of course. What they suggest – using a variety of comments by baby boomers, plus sections in which the two authors speak in alternating paragraphs – is that midlife-and-afterwards is a time for looking at things differently and acting in ways that were not previously possible. For example, one married couple divorced amicably so that she could pursue her dream of living in a bigger city and he could stay in the small town where they had lived for decades, but do a different sort of work. Other people talk about keeping their brains active by trying new things or re-trying old ones: “I got back on roller skates after thirty years – I counted that as new.” And then there is the matter of money: “Our financial obligations may be a product of decisions that no longer work as well as they did when the obligations were undertaken,” so “the issue for boomers in midlife is to evaluate the pattern of their own spending and determine the degree to which their money is enabling choice – or if their consumer choices are actually decreasing their options.” Choice is what The Hourglass Solution is ultimately all about, and the book abounds with comments such as, “Once it was done, there wasn’t a single regret.” But this is where Johnson and Forman show themselves more enamored of the advertising world than of psychology and sociology. For a great many people, if not most, there will be regrets over giving up elements of life that have been central to them for decades; there will be periods of uncertainty over the value of new choices and new decisions; there will be financial, psychological and sociological consequences of making big changes at or after midlife – and not all those consequences will be pleasant. The Hourglass Solution is not the solution at all, but a solution that will work for some people, in some circumstances, some of the time. It is good to know that plenty of choices remain to people as they age, and good to know that some people have made big changes in life and now seem happier than before. But nothing in this book is a panacea for aging, ennui, uncertainty or facing the inevitability of getting older.

     Unless, of course, you combine the Johnson-Forman approach with science writer Jörg Blech’s assertion that exercise is the one thing you need – not only to prevent illness, but also to get well if you do become acutely sick or develop such chronic conditions as diabetes, asthma, osteoarthritis, depression or ADHD. Blech takes the now nearly universal recommendation to stop living a sedentary life in order to stay healthy and reduce the chance of sickness a big step further, recommending exercise as a primary treatment when disease does strike. Exercise helps restructure and strengthen heart muscles! It can help diabetics avoid, or at least postpone, insulin use! It keeps people with cancer alive longer! It even leads the body to produce more stem cells! But – and the “but” is largely missing in Healing through Exercise – exercise is at its most helpful under carefully controlled, managed and monitored clinical conditions, and Blech’s statements about its benefits are generally based on clinical trials, most of them involving a small number of people for a limited period of time. Books that attempt to extrapolate from such trials may certainly be well-meaning, as this one is, but they may also be quite misleading. For example, one recent clinical trial – not mentioned in Blech’s book – found that supplements of B vitamins (folate, B6 and B12) reduced the incidence of age-related macular degeneration, the leading cause of vision impairment in older adults in the United States. Great! Just take some B vitamins and protect your eyes! But…although this was a seven-year trial, it involved only carefully screened women over age 40, and participants took the B vitamins at doses ranging from several dozen to several hundred times the recommended daily dietary allowance. The researchers themselves said they need many years to find out what minimum dose produces desirable effects – and whether long-term use of super-high doses produces negative ones. The point is that one-size-fits-all prescriptions are inherently flawed, even when what is prescribed is something as straightforward as exercise. Yes, Blech reports a study showing exercise-induced stem-cell rebuilding in severely out-of-shape men; but even he call the program “torturous” and explains that, “five days per week, the patients had to walk six times until they felt pain.” How likely is it that people will engage in this sort of program on their own? What less-intense level will provide equal or almost-equal benefits while improving compliance? Blech does not say, because he cannot – no one knows. Similarly, Blech correctly points out that “only a few patients who suffer from depression become healthy again by taking drugs,” largely because “up to 60 percent of patients are believed to stop following their prescriptions after three weeks.” Then Blech explains how 156 depressed elderly patients did better when undergoing 16 weeks of carefully monitored exercise sessions lasting 30 minutes each, three times per week. Most improvement occurred after the 16 weeks, because “many of the participants liked exercising so much that they continued to be active even after the official end of the study.” Wonderful…but how will depressed people – for whom motivation to do anything positive is a very serious concern – motivate themselves, outside a clinical setting, to constant, regular exercise; and what happens to people who decide they do not like it, either during an initial period or later? Again, Blech does not, cannot, address these issues. What we are left with in Healing through Exercise is a great deal less than the subtitle promises. Exercise can prevent some diseases and mitigate the effects of others; it may improve both physical and mental health in some people under some circumstances. And it is certainly an easier and cheaper approach to bodily health than medication – for people sufficiently motivated to cause themselves short-term discomfort (possibly a lot of it) in return for long-term gain (possibly not much of it). Once again, there is a very good idea here, with some scientific backing for its effectiveness; but once again, nothing in this book is a panacea, no matter how much Blech would like it to be.

No comments:

Post a Comment