{"id":673,"date":"2018-01-15T02:13:19","date_gmt":"2018-01-15T02:13:19","guid":{"rendered":"http:\/\/joshmitteldorf.peachpuff-wolverine-566518.hostingersite.com\/?p=673"},"modified":"2018-01-15T02:13:19","modified_gmt":"2018-01-15T02:13:19","slug":"marriage-sex-and-longevity","status":"publish","type":"post","link":"https:\/\/scienceblog.com\/joshmitteldorf\/2018\/01\/15\/marriage-sex-and-longevity\/","title":{"rendered":"Marriage, Sex and Longevity"},"content":{"rendered":"

Like you, dear Readers, I tend to be focused on the biochemistry, and have to remind myself again and again that the mind and body are intertwined. \u00a0I came out last week with my core belief about biology: Mechanistic physics explains only half of what we are. \u00a0Life has its own laws which we will discover only if we admit they exist.<\/span><\/em><\/p>\n

In fact, <\/span>the<\/b><\/em> most powerful thing we can do to prolong life expectancy is to have robust connections to other humans. \u00a0The best-documented effects are for empowering relationships with community (especially cooperative action for change) and intimate relations of love. \u00a0Together, these factors contribute more to life expectancy than any diet or exercise program, or any supplements you can take. \u00a0The difference is comparable to life expectancy difference between heavy smokers and non-smokers. \u00a0(I wrote about these topics 2 years ago:<\/em> [<\/span>1. Social status and depression, activism vs powerlessness<\/span><\/a>, <\/span>2. Family<\/span><\/a>]<\/span><\/p>\n

\n

Elissa Epel is famous for having elucidated the connection between <\/span>stress and eroding telomeres<\/span><\/a>. \u00a0But she has also brought us positive messages: <\/span>Meditation<\/span><\/a> is associated with telomerase expression and longer telomeres. \u00a0<\/span>Altruism<\/span><\/a> breeds telomerase. \u00a0<\/span>Loving-kindness<\/span><\/a> is associated with longer telomeres. \u00a0In a <\/span>publication last summer<\/span><\/a>, she and co-authors documented the benefits of sex. \u00a0Women (all subjects were partnered females) who had sex at least once in the week surveyed had longer telomeres than women who did not.<\/span><\/p>\n

The result added to evidence that goes back at least 20 years. \u00a0The <\/span>Caerphilly study<\/span><\/a> showed that frequency of sex correlated with lower all-cause mortality in men. \u00a0The conclusion <\/span>extends to women<\/span><\/a>. \u00a0The tendency of medical professionals to interpret the result in terms of the biochemistry of orgasm has been tempered, as it became clear that sex with a partner, with or without orgasm, has benefits above masturbation [<\/span>ref<\/span><\/a>]. \u00a0Intimacy without sex has its health rewards, as does the strength of one\u2019s community fabric.<\/span><\/p>\n

So, in this context, the headline result from the newest study is no surprise. \u00a0The puzzle is that, even though powerful connections between social relations and health are confirmed again and again, the details keep changing, and consistency is elusive.<\/span><\/p>\n

For example, the study just cited found that subjects who reported more sexual activity had longer telomeres, but they didn\u2019t have more telomerase activity. \u00a0In fact, they had (almost statistically significant) <\/span>less<\/i><\/b> telomerase activity. \u00a0This was a short-term study. \u00a0Telomerase activity is a short-term variable, and telomere length is supposed to respond in the longer term to telomerase activity. \u00a0We should not have been surprised if an increase in telomerase had been observed, without a significant difference in telomerelength. \u00a0The opposite finding suggests a missing link in the causal chain. \u00a0(The <\/span>Discussion<\/span><\/i> text in the article is very open about this mystery.)<\/span><\/p>\n

The study included only women. \u00a0Women have been found to be more sensitive to the quality of loving attention and the depth of their connections in love, while men tend to respond to the cruder quantitative variable of sexual activity [<\/span>ref<\/span><\/a>]. \u00a0But for women in this study, telomere length was related only to the frequency of sex, and not to the quality of relationship, or to relationship satisfaction. \u00a0In fact, they found no significant association with any of the subjective questions asked concerning satisfaction with the relationship, or feelings of closeness. \u00a0Again, the investigators themselves were surprised.<\/span><\/p>\n

Paradoxical results from other studies: \u00a0Men (>57yo) who had frequent sex (more than once per week) and men who self-reported that sex was \u201cextremely satisfying\u201d had twice as many heart attacks in the ensuing five years [<\/span>ref<\/span><\/a>]. \u00a0In the same study, results for women were not strong enough to be statistically significant, but were strange enough to be puzzling. \u00a0Women (>57yo) who reported sexual relations that were highly satisfying had higher risk of cardiovascular disease, but women who reported most intense pleasure from sex had lower risk. \u201cThese findings challenge the assumption that sex brings uniform health benefits to everyone.\u201d<\/span><\/p>\n

This classic study<\/span><\/a> found that marriage offers substantial benefits in life expectancy for both men and women, but that the benfits for men are far larger. \u00a0The relative risk in mortality rate, unmarried vs married, is 1.5 for women but 3.5 for men. The large disparity has not held up in <\/span>more recent studies<\/span><\/a>.<\/span><\/p>\n

This<\/span><\/a> is the most comprehensive recent review of the relationship between social variables and all-cause mortality, but it is confusingly written (I believe the verbal interpretation of statistics is incorrect). \u00a0The message comes through loud and strong, that <\/span>social integration<\/span><\/a> accounts for a large benefit in decreased all-cause mortality, accounting for 5 to 10 years of life expectancy. \u00a0But even more than in other fields of social science, there are contradictory results and inconsistencies that thwart anyone trying to tell a neat story.<\/span><\/p>\n

 <\/p>\n

Why is social connection so important to health<\/b><\/p>\n\n\n\n
\n

\u201cTwo main types of models have been proposed to explain how social support influences physical health. In <\/span>main-effect models<\/i><\/b>, high levels of social integration are health promoting, regardless of whether one is under stress [<\/span>ref<\/span><\/a>, <\/span>ref<\/span><\/a>]. Greater integration into one\u2019s social network gives an individual identity, purpose, and control, a perceived sense of security and embeddedness, and a source of reinforcement for health-promoting behaviors or punishment for health-compromising behaviors, all of which can promote health [<\/span>ref<\/span><\/a>]. In the stress-buffering model [<\/span>ref<\/span><\/a>], the negative effects of stress occurring outside of one\u2019s social relationships (e.g., at work) are diminished by the presence of strong social support, which can mitigate stressful events directly (e.g., intervening on a friend\u2019s behalf) or through reducing stress appraisals [<\/span>ref<\/span><\/a>].\u201d \u00a0[quoted from <\/em><\/span>Robles, 2004<\/span><\/a>]<\/span><\/em><\/p><\/blockquote>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Bert Uchino<\/span><\/a> distinguishes between \u201cperceived support\u201d and \u201creceived support\u201d. \u00a0The correlation of the former with health and mortality variables is robust. \u00a0But the latter is sometimes found to be inversely correlated with health. \u00a0This seems to say that if people are helping you and you don\u2019t appreciate it, you\u2019re worse off than if you had been on your own. \u00a0If you think you\u2019re embedded in a caring and supportive community, you\u2019ll live longer. \u00a0If you\u2019re actually embedded in a caring community, but you devalue what you\u2019ve got or if you isolate yourself because you\u2019re more comfortable that way, your life expectancy is shortened. \u00a0This is a morality tale if I ever heard one.<\/span><\/p>\n

Conflictual interactions in the context of marriage (<\/span>as in Western culture generally<\/span><\/a>) contribute to higher levels of systemic inflammation [<\/span>ref<\/span><\/a>]. \u00a0But <\/span>this study<\/span><\/a> found no relationship between job stress in men and measures of chronic inflammation. \u00a0Maybe it depends on what is meant by \u201cstress\u201d. \u00a0<\/span>This study<\/span><\/a> suggests that feeling out of control (powerlessness, low status) is associated with markers of inflammation.<\/span><\/p>\n

Perspective<\/b><\/p>\n

Why do we care about this? \u00a0Many of us are fanatical about following the best evidence when designing exercise and supplement regimens for ourselves. \u00a0But is there anyone out there who is waiting for the latest correlation with telomere length before deciding whether to fall in love? \u00a0(I didn\u2019t think so.) \u00a0<\/span><\/p>\n

No, the reason we care about this subject is that it reminds us that aging is a social process almost as much as it is a biological process, even if the social correlates of longevity confound our best intuitions about how to live well.<\/span><\/p>\n

And perhaps it reminds us, indirectly, that in the \u201crationalization\u201d of our health care system, we have made a bad bargain.\u00a0\u00a0Over the course of my lifetime, medical practice in America has gone from a model of individualized care by family doctors to impersonal care by specialists. \u00a0Medical care has become more evidence-based, and there is a much better chance that the doctor who treats your condition has a deep knowledge and experience of that condition. \u00a0But what we\u2019ve lost along the way is the doctor-patient relationship\u2014both because you see a different specialist for each condition, and also because as doctors\u2019 time is squeezed to optimize profit, the time for listening and empathizing has been eliminated. \u00a0Despite the accumulation of studies showing that doctor-patient relationship has an outsized effect on prognosis, our present health care system is systemically deficient in human caring.<\/p>\n","protected":false},"excerpt":{"rendered":"

Like you, dear Readers, I tend to be focused on the biochemistry, and have to remind myself again and again that the mind and body are intertwined. \u00a0I came out last week with my core belief about biology: Mechanistic physics explains only half of what we are. \u00a0Life has its own laws which we will … Read more<\/a><\/p>\n","protected":false},"author":65,"featured_media":674,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-673","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"yoast_head":"\nMarriage, Sex and Longevity - Josh Mitteldorf<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/scienceblog.com\/joshmitteldorf\/2018\/01\/15\/marriage-sex-and-longevity\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Marriage, Sex and Longevity\" \/>\n<meta property=\"og:description\" content=\"Like you, dear Readers, I tend to be focused on the biochemistry, and have to remind myself again and again that the mind and body are intertwined. \u00a0I came out last week with my core belief about biology: Mechanistic physics explains only half of what we are. \u00a0Life has its own laws which we will ... 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The surprising fact that our bodies are genetically programmed to age and to die offers an enormous opportunity for medical intervention. It may be that therapies to slow the progress of aging need not repair or regenerate anything, but only need to interfere with an existing program of self-destruction. Mitteldorf has taught a weekly yoga class for thirty years. He is an advocate for vigorous self care, including exercise, meditation and caloric restriction. After earning a PhD in astrophysicist, Mitteldorf moved to evolutionary biology as a primary field in 1996. He has taught at Harvard, Berkeley, Bryn Mawr, LaSalle and Temple University. He is presently affiliated with MIT as a visiting scholar. In private life, Mitteldorf is an advocate for election integrity as well as public health. He is an avid amateur musician, playing piano in chamber groups, French horn in community orchestras. His two daughters are among the first children adopted from China in the mid-1980s. Much to the surprise of evolutionary biologists, genetic experiments indicate that aging has been selected as an adaptation for its own sake. This poses a conundrum: the impact of aging on individual fitness is wholly negative, so aging must be regarded as a kind of evolutionary altruism. Unlike other forms of evolutionary altruism, aging offers benefits to the community that are weak, and not well focussed on near kin of the altruist. This makes the mechanism challenging to understand and to model. more at http:\\\/\\\/mathforum.org\\\/~josh\",\"sameAs\":[\"http:\\\/\\\/AgingAdvice.org\"],\"url\":\"https:\\\/\\\/scienceblog.com\\\/joshmitteldorf\\\/author\\\/joshmitteldorf\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Marriage, Sex and Longevity - Josh Mitteldorf","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/scienceblog.com\/joshmitteldorf\/2018\/01\/15\/marriage-sex-and-longevity\/","og_locale":"en_US","og_type":"article","og_title":"Marriage, Sex and Longevity","og_description":"Like you, dear Readers, I tend to be focused on the biochemistry, and have to remind myself again and again that the mind and body are intertwined. \u00a0I came out last week with my core belief about biology: Mechanistic physics explains only half of what we are. \u00a0Life has its own laws which we will ... 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The surprising fact that our bodies are genetically programmed to age and to die offers an enormous opportunity for medical intervention. It may be that therapies to slow the progress of aging need not repair or regenerate anything, but only need to interfere with an existing program of self-destruction. Mitteldorf has taught a weekly yoga class for thirty years. He is an advocate for vigorous self care, including exercise, meditation and caloric restriction. After earning a PhD in astrophysicist, Mitteldorf moved to evolutionary biology as a primary field in 1996. He has taught at Harvard, Berkeley, Bryn Mawr, LaSalle and Temple University. He is presently affiliated with MIT as a visiting scholar. In private life, Mitteldorf is an advocate for election integrity as well as public health. He is an avid amateur musician, playing piano in chamber groups, French horn in community orchestras. His two daughters are among the first children adopted from China in the mid-1980s. Much to the surprise of evolutionary biologists, genetic experiments indicate that aging has been selected as an adaptation for its own sake. This poses a conundrum: the impact of aging on individual fitness is wholly negative, so aging must be regarded as a kind of evolutionary altruism. Unlike other forms of evolutionary altruism, aging offers benefits to the community that are weak, and not well focussed on near kin of the altruist. 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