Recap: Is friendship the key to healthy aging? | Rose Anne Kenny

0:00Hello, and welcome to Zoe Recap, where each week we find the best bits from one of our podcast episodes to help you improve your health. Today, we're exploring the impact of social interactions on our health. Last year, a study found that a third of Americans aged between 50 and 80 feel lonely. I'm sure most of us can relate to this feeling and understand how a lack of social connection can take a serious toll on our mental health. But is loneliness affecting more than just our minds? Does it also impact our physical health and how well we age? In this episode, Professor Roseanne Kenny joined me to answer these questions and discover ways that we can foster meaningful relationships.

0:42She starts by telling us about her groundbreaking study into ageing in Ireland. So it's a longitudinal study on ageing, much like the twin study at King's. And we follow the same people aged 50 and over every two years and apply the same tests to them every two years. And we do everything because we're trying to understand the tapestry of what it's like to have the experience of aging in Ireland. What does all that tapestry, all that color look like? So from a health perspective, we do subjective health, asking about, do you have this? Do you have that? Do you feel this from a health perspective?

1:23From a health perspective, we also do objective measurements. We measure blood pressure. We measure brain blood flow. We do MRI scans of brains. We measure your walking speed. We measure your bone density, et cetera. We do genetic measurements, including the clocks we were talking about, the epigenetic clocks. We do nutritional assessments, including now faeces, stools, for microbiome. I'm glad to hear that. Big believers of microbiome here. I know. Mental health measures, income and assets. And the funny thing there is when we had the discussions with the economists who were helping us with the study, we were going through the different questions because you can't ask, you can't cover everything in detail.

2:07So you have to cherry pick a bit. And they said, oh, no one's ever going to answer questions about incontinence. I said, well, they won't tell you how much money they have in the bank either. And I was right. I was right. The most difficult information to get is the economics information. The rest is no problem. We do a lot around work in retirement, Jonathan, because we're following people through their retirement period, et cetera. Marital status, household structure, family networks and friendships and social participation and how active you are both with your friends and family, but also in volunteering and other clubs and organizations.

2:45And then, of course, education. And Roseanne, I was really interested to talk about that sort of social network because I think there are various of these sort of big studies that look at people over time, as you said, sort of longitudinal studies. They tend to focus on measurable health, right? The sort of thing that a doctor can use a machine to evaluate because that I think is what science and doctors have tended to be comfortable with. And I think what's brilliant here is you were looking at all of these things to do with relationships, which really have not been seen in the same way as sort of, I think historically, probably even like proper subjects of social study.

3:24Could you tell us a bit about what you found? So social participation, friendship, social relationships is as important as all of the other measures that we've talked about so frequently, like exercise and diet and physical activity and even smoking. It has as strong a biological impact as those factors. And the reason is, we believe, it's kind of like thirst or hunger. We've evolved to need other people, just like we've evolved to need food and we've evolved to need water. We've evolved to need other people. And then when we deny ourselves that exposure, the effect is in fact as bad, as toxic as anything you can get biologically.

4:17What it does is it triggers chronic inflammation in the system. And chronic inflammation is probably the underlying biological dysfunction or abnormality that underpins all of the big diseases we know about, cancer, heart disease, strokes, etc. So loneliness triggers chronic inflammation, which is why those diseases are associated very much so with loneliness, as is dementia. I think a lot of people listening to this are going to be really shocked to hear that. I mean, I think everyone listening will probably say that they understand that being lonely is a terrible thing. And there will probably be some people listening who are experiencing that and it's really difficult.

5:02And other people who are aware that it's something that maybe they're worried about, particularly as they age. I think they'll be quite shocked to hear that there is a direct link between loneliness and their health, which I think you said was as strong as whether or not you do exercise. And I think anyone listening to this podcast has heard lots of scientists say exercise has a huge impact on your health. So that is absolutely the case. There's buckets of science behind this. Good science. I'm just going to give you one lovely example because it kind of fits with how we've evolved. And if you take my cat monkeys and you isolate a monkey and they're gregarious animals, as are we, you isolate a monkey, do a biopsy of their lymph node, which is the engine for inflammation in the body.

5:47Say our neck lymph nodes, and your listeners will know this, we get a throat infection or we're feeling down or fatigued or we can feel glands in my neck is the expression. They took a biopsy of that and found that for the isolated monkeys, that the genes which regulate inflammation were upregulated. So they were active. In other words, there was an inflammatory process going on. And the genes which fight against infection and are good for the immune system had been downregulated. So they'd been dampened down, were not as active as they should have been. And that was just within 48 hours of monkeys being isolated.

6:27And then we know in humans, all of the inflammatory markers we frequently measure are also higher in people who have poor social networks, social engagement, or who experience loneliness. So the important thing, therefore, is to put as much effort into building your friendships as you do to choosing your foods or to selecting your physical activity that you like. It's as important as that. And then in that context, you know, mix them. So eat out with people and do physical activity with people. Again, with COVID, more and more people were, you know, doing yoga on their own at home. I actually think you need to get back into group sessions now with people because you get not just the physical and biological benefit of the yoga itself, but it's the group interaction, the social interaction, the laughter, the laughter.

7:30That's terribly important. So we talked a lot about loneliness, which is a sort of, this is the bad outcome, but I'd love to talk almost about like, let's say you're just at the average level in your study. So you're presumably, you're not in the position where you don't know anyway. Is it possible in fact to improve your health by just having more engagement with friends and family? So can people listen to this and say, rather than like, oh my God, I'm really scared about being lonely. Is there a more positive take of things you could do that is actually going to both make you happier and make you live healthier for longer?

8:03Absolutely. So again, coming back to the work, people who continue to dip in and out of work or do some sort of activity relating to work and occupation are much less likely to be lonely and actually have much better health. Likewise, volunteering. So most volunteering is done by older persons or persons who are retired. Those who volunteer on a regular basis have a better quality of life, less physical illness, and less depression. And because it's a longitudinal study, we've been actually able to adjust for, well, were they like that at baseline and they're just the healthier ones who volunteer, etc.

8:39That is not the case. Volunteering independently influences your biological health. That's amazing. So it's not just that people who are healthier end up doing this. You're saying that even when you're 60, 65, 70, you could decide to do things which are going to see more engagement with more people and it's just going to increase your number of healthy years. Absolutely. And so it's an independent factor. And then coupled with that, because it's hard, I think, to dissociate these two things, is your attitude. So people who are engaged and and more socially interactive actually have a much more positive attitude towards aging.

9:24Believe it or not, you are as young as you feel. Attitude and your own perception of how you're aging independently determines your aging process. And we've looked at this and other studies have, but particularly Tilda, because from the get-go, we asked questions about how you perceive yourself aging, what your attitude is. And people who felt that they were their chronological age, more or less, around that, you know, the same number of candles on the birthday cake, actually, they aged more quickly. And again, we were able to, because of the richness of the data, we were able to adjust for any factors that might have influenced that.

10:03And how you see yourself aging independently determined the pace of your subsequent aging for 10 years hence. I love that. So basically what you're saying is because I'm convinced that actually I'm only 25, I'm actually slowing down my aging and I should stick with this illusion permanently. Yeah. I'm going to tell my wife that. So your attitude does matter. And it's much easier to have a positive attitude if you're engaged with other peers who also have a positive attitude and you're constantly networking. It's harder to have a positive attitude if you're alone, if you're isolated in your attitude because the media can sometimes be negative and you just need something to buffer that.

10:46And there's no better buffer than friends or acquaintances even and having a good laugh and being surrounded by others who are positive. That's amazing. I'd love to dig a little bit into what these social interactions mean because you talked a lot about friends. I often think quite a lot about family when I think about social interactions. And then we also had a bunch of questions around, does any of this count if it's online social connection? Do you have any answers from any of your data about those different things? Okay. So the first thing I can say is both friends and family are very, very important.

11:24It's not about, however, the quantity of your relationships, it's the quality. If a friendship or a family member or engagement with the family member is strained or unpleasant. That is not good for us. And we find that that triggers a stress process. Stress hormones, autonomic nervous system, which are our kind of stress calibrators in the body, all increase and they're bad for health. So the thing about friends is we can walk away from a toxic friendship more or less, but it's very difficult to walk away from family relationship that's toxic. So you have to really be aware of that, I think, and manage your exposure to that in a family and share it with other family members.

12:13And again, sharing does have a problem. That's the first thing with respect to family and friends. So it's about the quality. Online is really interesting. There have been loads of studies. If you step back from it, of course, online is brilliant if it engages you with people. And if you can't go out or you aren't out or you're feeling down and you get this online engagement, it can pull you up and make you feel wonderful. So it makes absolutely great sense that that's happening. I would say, however, if you're with people, put your phones away. Because being online and looking down at a technology when you should be engaging face to face with another human creature, and you have evolved together over thousands of millions of years to understand each other's body language face to face is not healthy.

13:04So put the phones away. But generally speaking, online, in moderation, and if it's used to benefit is a value. Of course, it can be toxic in terms of the messaging. There'll be people listening to this who are saying, I'd really love to have more social relationships, but I don't really know how to start. Is there anything from your studies or experience that might actually be like, what are the actionable advice that you might give to somebody saying, actually, I'd really like to do that. And I don't feel very confident about how to get there. So this is the biggest problem, but I've thought a lot about this.

13:41So first of all, things you enjoy in your life, do them with other people. We've talked about that. So go to the gym, do exercise classes, try and eat out, even if in a club fashion where there's tasting menus for people, et cetera, that sort of thing. Look into that. Secondly, creativity is really good for us and creativity with others is even better. So if you have a fancy doing a bit of art or singing in a choir, et cetera, join one. It takes, it's hard. I joined a choir recently because I thought to myself, I'm talking about this all the time and I'm doing nothing about it. okay, I'm going to join a core.

14:17And I did. And it's just such fun. And it's a lovely thing to do with other people. Volunteering. If you're really struggling, organizations are always looking for volunteers. It's a good way to get started. That's amazing. And let's say you're listening to this and thinking like, I want to be a better friend. I want to improve the health of people. But maybe you're a bit unsure how to do that. Maybe you're in a country where you feel like, oh, I don't want to sort of overstep the boundary or embarrass myself. What's your advice? So I think pick up the phone and ring somebody and say, look, you came into my mind today.

14:57I've just been thinking about you. How are you? Haven't heard from you for a very long time. And since COVID, I've decided to reach out to people that I haven't heard from. Somebody did that recently. They were reading my book and I hadn't heard from him for a long time. And he rang me the evening after he read the friendship chapter. And he said, you know what? I read your chapter and I realized how lonely I am. So we met, we had dinner and we've kept engaging, etc. He was a great friend of myself and my husband, but we lost it and now we've re-engaged. So I think reach out. People will understand, will want it themselves.

15:38That's all for this week's recap. At Zoe, we believe that when it comes to your health, Small changes can actually add up to a big improvement over time. And that's why we developed Daily30, the gut supplement that's specifically formulated to become your new daily healthy habit. You simply add a scoop to any meal once a day to support your health and increase the plant diversity in your diet. By the way, whenever we talk about Daily30 as a good source of fiber, we're required to say that it contains four grams of total fat per serving. Obviously, that's all amazing healthy fats from plants. To make Daily 30 part of a gut health routine, simply visit zoe.com slash daily 30.

16:18See you next time.