One of the most significant studies in health has just celebrated 65 years since it started, and it’s still going strong.

Over those 65 years, residents of the small town of Framingham in Massachusetts, USA, have been participating in long-term studies looking at heart disease and its causes.

By the mid-1950s, the number of middle-aged men succumbing to coronary heart disease was causing serious concern – not least when several world leaders developed it. The disease had been on the rise since the start of the 20th century and the Framingham Heart Study set out in 1958 to establish what was behind this.

The study initially recruited more than 5,000 men and women, nearly a fifth of the whole population of Framingham. The researchers collected data about each of the participants every two years using interviews, clinical examinations and laboratory tests. The data covered participants’ lifestyle and environment as well as looking at their health and genetic profiles. This helped to show the importance of not smoking, taking enough physical activity, treating high blood pressure, avoiding obesity and the importance of blood fats in preventing coronary heart disease.

By 1971 the study had recruited a second generation of participants and in 1994 it extended its recruitment to reflect the changing population resulting from an influx of South Americans. 2002 saw the recruitment of a third generation. Over time, the study was widened to include other diseases, notably type 2 diabetes and dementia.

There were similar studies going on elsewhere but none was quite so comprehensive or prolonged. The Framingham study resulted in many papers published in leading scientific journals, and the work was widely discussed in scientific societies worldwide, greatly influencing research, debate and health policy.

Indeed, the findings in this and the other studies changed the way doctors looked at illness. Previously, most doctors thought of an illness as being caused by germs. If the germs could be killed or prevented from spreading, the illness would be eliminated. The Framingham discoveries required a rethink. This resulted in the concept of ‘non-communicable disease’ to explain much of modern illness and highlighted the importance of what we as individuals could do to prevent these diseases, as well as transforming the public health agenda.

There are questions over the future of this study, and whether it will continue to bring sufficient returns on the cost now that its primary objectives have been achieved. The US government has cut substantially its share of the funding.

But the fact remains that this study generated a novel way of looking at all disease and increased phenomenally our understanding of coronary heart disease.

About the study:


“Oh, there’s no point in me stopping smoking at my age. I’ve been smoking since I was 14, so all the damage’s done.”

This is a common excuse used by older people, and many doctors have gone along with it and not pressed the point. But how valid an excuse is it?

Smoking causes a lot of deaths and illness. It has been estimated that if there’s no reduction in smoking it will result in over a billion deaths in the 21st century. The World Health Organization blames it for 12% of male deaths and 6% of female deaths worldwide.

Many studies have shown that stopping smoking reduces this risk, with the benefits increasing the longer a person remains a non-smoker. But these studies have mostly been based on middle-aged people.

Now a recent study* has looked at evidence for smokers older than 60, bringing together the data from 17 studies in seven countries. It showed that, even up to the age of 80, stopping smoking was effective in reducing deaths.

This study firmly shows that older people should be encouraged to stop smoking if they can. Many 60- and 70-year-olds are likely to live to much older ages, with plenty of time to experience the benefits of giving up.

The study also shows how important it is for us all – younger people, older people and the medical profession – to be cautious about coming to erroneous conclusions about the health of older people without the information to back them up.

*Link to study

Professor Brian Kirby, author of How to Live to 110: Your comprehensive guide to a healthy life


We often judge when someone is happy or sad by looking at their face. It’s a clue to when someone is depressed: their face often shows lines associated with worry and sadness.

Rather surprisingly, a study* has showed that getting rid of these lines cosmetically – and effectively paralysing the frowning muscles – by using botulinum toxin (often referred to by the commercial name “Botox”) seemed to make depressed people less depressed. Six weeks after an injection to remove the crease low on their forehead, their depression score improved by nearly 50%, and the score seemed to improve further with time.

So what was happening? It is usually thought that sad facial expressions are the result of depression and therefore only likely to change as the depression lifts. However, it’s known that the muscles of expression are intimately linked with processes in the brain, to the extent that changing your facial expression can affect your mood. But it comes as a startling finding that this can happen when using a cosmetic procedure.

The study was small and it could be a chance finding, or there may be another explanation. But perhaps this finding may open up new avenues of research in a common and frequently disabling disorder.

*Link to study

Professor Brian Kirby, author of How to Live to 110: your comprehensive guide to a healthy life


Dementia is one of the most greatly feared diseases of old age. Its personal and social consequences are formidable. So far, medicines have proved useful in some individuals once they have developed the condition, but none has been shown conclusively to prevent its onset.

Now, though, an American study* provides some indirect evidence that including omega-3 oils in your diet might help protect you against the disease.

Omega-3 oils are found especially in oily fish such as salmon, herring and mackerel, and to a lesser extent in other seafood, walnuts, flaxseed, canola oil and meat from grass-fed animals.

The study looked at a range of different nutrients in the diets of 1200 people aged 65 or more, and also at the amount of “amyloid-ß” in their blood. Levels of amyloid-ß are higher in some people who go on to develop dementia. The researchers argued that if its level could be lowered then those individuals would be at a lower risk of developing dementia.

This may seem a rather indirect approach, but dementia is hard to study directly. Much previous work has been based on self-reporting by the subjects; this is difficult in those without dementia and even more so in those who have the condition. Using a marker for dementia such as amyloid-ß therefore has advantages.

Out of all the nutrients the researchers looked at – which included vitamins and other types of oil – the only one associated with lower levels of amyloid-ß was omega-3 oil. The subjects who consumed the most omega-3 oil in their diet had significantly lower amounts of amyloid-ß. That suggests omega-3 oil may help prevent dementia. However, only long-term trials over many years will tell whether they are right.

This study on its own is not enough evidence to make a universal recommendation that everyone should consume omega-3 oil to prevent dementia.

But omega-3 oil is already recommended by health professionals as it is an essential nutrient needed by your body and it provides strong, proven protection against heart disease and a range of other serious conditions. If it protects you from dementia as well, that is an added bonus.

*Link to study abstract


Professor Brian Kirby, Author of How to Live to 110: Your comprehensive guide to a healthy life



Which is better for stopping you getting heart disease: increasing your fitness or controlling your weight?

Researchers in America have been looking at this question. The work was based on 3,000 subjects assessed over 27 years for fatness and fitness. As expected, this showed that having increased fatness or decreased fitness contributed to high
blood pressure, raised blood fat levels and the precursors of diabetes.

The researchers looked to see if someone could counter the harmful effects from an increase in their body fat by getting fitter. Unfortunately not. They showed that increasing your fitness level helps, but it doesn’t fully overcome the adverse effect of putting on fat.

What about the other way around? Would losing fat make up for a lower level of fitness? Again they showed it helped but did not entirely make up for it.

It looks as if there is no easy way out. To give yourself the best chance of avoiding heart disease, you need both to control your level of body fat and to maintain your level of fitness.

Although this study looked specifically at the importance of these measures for heart disease prevention, the findings should also be applicable to diabetes, blood vessel disease, high blood pressure and, quite probably, cancer prevention.

Link to the fatness vs fitness study


Professor Brian Kirby, author of How to Live to 110: Your comprehensive guide to a healthy life



Here’s another widely held prejudice about old age challenged by the evidence.

It’s commonly believed that people sleep less soundly as they grown older. But it seems that this isn’t true, at least for healthy people. This month, researchers at the University of Pennsylvania* showed it was the middle-aged who had the greatest sleep problems – with older people sleeping more soundly.

The results are based on what healthy participants – 155,857 men and women – said about themselves. There’s a need for confirmation by other types of studies, but the findings are noteworthy.

It’s good for preconceptions about fit elderly people to be challenged. One comment I hear quite often is “Who wants to live to an old age anyway?” Indeed, part of what we have tried to do in our book is address the widespread negative view of what old age is like.

If you manage to avoid the main diseases – which is what our book is all about – then your later years can be full of health and vitality.

And sound sleep!


Professor Brian Kirby, author of How to Live to 110 : Your comprehensive guide to a healthy life


*Grandner et al, Age and Sleep Disturbances Among American Men And Women: Data From the U.S. Behavioral Risk Factor Surveillance System

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