Interview doctor and researcher David van Bodegom
Every year in the Netherlands we take 9 billion pills. Often unnecessary, says doctor and researcher David van Bodegom. If we don’t smoke, exercise more and eat healthier, we can run up the stairs well into our 70s. That never works with drugs. That is why he wrote the book Depilation.
David van Bodegom (40) is a physician and historian. He conducts research on aging at Leyden Academy on Vitality and Aging. He is also an assistant professor at the Leiden University Medical Center (LUMC). He wrote the book Growing Old in Practice (2015) together with professor of geriatric medicine Rudi Westendorp. He wrote the novel Nood breaks law (2012) about his time in Ghana. His latest book, Depilation, is now in stores.
How come we are prescribed so many pills?
“The average person over 60 is a bit overweight, has just high blood pressure or cholesterol, has trouble falling asleep or suffers from heartburn. Then you get pills for the symptoms or to prevent worse, such as a heart attack. But it is better to start living healthier. The medical journal The Lancet even calculates that we can prevent 90 to 94 percent of heart attacks.”
Why doesn’t the doctor say that?
“Doctors do give the advice to live healthier, as an alternative to pills. But that doesn’t work. People don’t know how to handle that. In my book I show you which concrete choices you have. Take, for example, high blood pressure. You can take a pill containing metoprolol every day. But you can also go for a walk, drink less alcohol, replace your table salt with potassium salt (Lo-Salt), stop eating licorice or lose a few kilos. Buy a good blood pressure monitor with a pump and measure it yourself. Then go see what works for you. A walk every day? The licorice out of the house? Every person is different. These kinds of adjustments in your life often work just as well as metoprolol, or even better, because it also reduces the risk of diabetes.”
Going to the gym, on a diet…
“No, not at all! That’s not enough for anyone. Sweating at the gym or running three times a week isn’t effective at all if you’re sitting on the couch the rest of the time. You achieve much more if you change your daily routines. Go for a half hour walk every day. Almost all dog owners meet the standard for healthy exercise. Fill your fridge with vegetables and put them in plain sight, not at the very bottom. Fill the candy tin with unroasted nuts. Work standing up.”
We are now also talking. Quite tiring. But why would you? After all, the pills work too.
“When you’re still in your 60s, you usually feel fit, even if you have a tummy and you take pills for diabetes. But if you do nothing, you will be short of breath in ten years and you will be able to walk less. I am convinced that almost everyone should be able to exercise fit until at least 75 years of age. If you start ‘de-pilling’ on time and learn a better lifestyle, you will stay fit for much longer than with medication. I give that to everyone. It’s never too late to start living a healthier life, it always helps.”
But the doctor does not prescribe those medicines for nothing, does he?
“The pills do help, but they are less effective than healthy living. Doctors often prescribe pills out of habit, a kind of ‘medical reflex’. In this way they maintain the unhealthy lifestyle. You are basically made a patient, a diabetic or someone with high blood pressure. While many people are better off adjusting their lifestyle than taking pills for osteoporosis, sleeping problems, diabetes, erectile dysfunction and many other age-related ailments.”
Does that apply to everyone? Even after a heart attack?
“No, if you’ve had a heart attack, you often can’t live without it. Then those pills help to prevent new misery. But even then you gain the most by living a healthier life in addition to the pills. For example, if you lose a few kilos if you are overweight, you reduce the risk of diabetes, heartburn and the risk of another heart attack.”
Never a bag of fries again?
“If you eat healthy all week, it’s best to get fries on Friday. The problem is that we have come to consider it normal to eat unhealthy things every day. Every day chocolate cookies with coffee or cheese butterflies with drinks. Everyone finds it difficult to resist temptation. Therefore, remove the temptations from your daily life. Put a fruit bowl in plain sight and buy a nicer new bike.”
Suppose you want to stop taking the pills against osteoporosis. How do you handle that?
“In osteoporosis you usually get bisphosphonates, calcium and vitamin D. Discuss with your doctor what you are getting the pill for. Is it because of the abnormal bone density measurement?
Or because you have already had broken bones? You can often stop taking calcium. It seems harmless – after all, calcium is also in vitamin pills – but calcium tablets give a 20 to 30 percent greater risk of a heart attack. Few people know that. While you get calcium much easier and safer from your diet. Have a cappuccino, a handful of nuts, a bowl of yogurt and a portion of vegetables – and you’ve already got your daily calcium. If you get too little calcium from your diet, you are not eating healthy enough.”
And vitamin D?
“Vitamins or minerals in a pill usually make little sense, but vitamin D is an exception. This vitamin is hardly found in food. Your skin makes it in sunlight, but the winter sun doesn’t have the right radiation, so we’re all deficient. So take it in the winter. In the summer months you just go outside for half an hour every day with your face and hands in the sun, that’s enough. If you don’t even go out for half an hour a day, something is seriously wrong. It is also good to load your bones with your body weight. So rather go walking with a backpack than cycling. The more you put stress on the bones, the stronger they become.”
And if your knees are worn out?
“Wear, age-related diseases: I have a hard time with those terms. You are not easily ‘worn out’. And with a healthy lifestyle you can often reverse wear and tear. They are often excuse words for a bad lifestyle that is not addressed. A big part of aging is actually ‘detraining’. You don’t do it anymore, so you can’t do it anymore.”
If we start living this healthy life, can we all live to be 120 years old?
“I don’t find growing very old that interesting. Let’s all turn 75 healthy first. Because now many people are already sick and limited in their 70s. You can of course decide for yourself, but if you eat fresh and Mediterranean food, stop smoking and exercise more, you can stay fit for years longer.”
