The Paradox of Modern Health Management
I've been witnessing a troubling phenomenon in clinical practice lately. Too many people readily open their wallets for supplement ads promising "brain health benefits" or "effortless joint health improvement with just your money," yet they refuse medically proven treatments for chronic diseases.
If we compare humans to cars, the failure rate of parts increases as we age. Medically, we measure this through a "frailty index" - as this index rises, both overall physical function and cognitive abilities decline together, eventually leading us down the path toward death.
Unique Health Patterns Among Koreans
Koreans exhibit two distinctive health management patterns. First, they're reluctant to take chronic disease medications like blood pressure, diabetes, and cholesterol drugs that could prevent future heart attacks or strokes. Second, they're surprisingly tolerant of supplements and symptom-relief medications.
Take back pain as an example. For fundamental solutions, you need systematic core exercises, improved daily posture, and overall lifestyle changes. But most people prefer massages, physical therapy, or painkillers to address immediate discomfort rather than putting in the effort for long-term solutions.
The problem with this approach is that trying to control individual symptoms with medications leads to an endless accumulation of pills. As pain relievers, sleep aids, and bladder medications pile up, cognitive function can actually decline, muscle mass decreases, and overall stamina drops.
Problems with Healthcare Utilization Patterns
In reality, Korea's per-capita outpatient visits are nearly three times the OECD average. We also take significantly more medications compared to developed countries, and this phenomenon worsens with age. There are far too many people engaging in "doctor shopping," visiting various specialists for symptomatic treatment.
We need to approach medications, diseases, and aging from a continuous perspective. Some aspects can be improved through personal effort, while others must be accepted as inevitable. However, many people try to reject or push away these natural processes.
The Psychological Trap of Supplement Marketing
This psychology is exactly what's exploited by supplements claiming to "help with aging," ads promising "joint health improvement with just money and no effort," and stem cell treatments or anti-aging procedures that lack sufficient evidence.
From medical economics and behavioral economics perspectives studying human psychology, people tend to:
- Want solutions without effort
- Prefer anecdotal information (stories like "someone got better taking this" over large-scale statistics)
- Fall for fake expert credibility
- Believe expensive treatments are more effective (placebo effect)
Research on placebo effects shows that even when people know they're taking fake medicine, if they're told it's expensive, the effects tend to be stronger. Add word-of-mouth testimonials saying "it's good," and people become even more susceptible.
Three Real Ways to Improve Brain Health
There are three main things individuals can do to improve brain function:ㅗㄷ
1. Habits that slow physical aging - Maintaining healthy lifestyle practices
2. Chronic disease management - Aggressive treatment of blood pressure, diabetes, high cholesterol, etc.
3. Increasing cognitive reserve - Like a brain savings account, requiring three types of activities:
- Physical activity (exercise)
- Cognitive activity (mental stimulation)
- Social activity (interpersonal interaction)
All three absolutely cannot be achieved "without effort."
Preventing Sarcopenia and the Importance of Exercise
Currently, the only proven method to prevent sarcopenia and improve muscle function is resistance training. To create synergy between brain health and muscle health, exercise must be approached strategically.
Exercise fundamentally consists of four components:
- Aerobic exercise
- Resistance training
- Stretching
- Balance training
It's crucial to create a portfolio of these four elements and maintain it throughout life.
Korean Exercise Habits and Their Problems
Unfortunately, among 163 major countries, Korea ranks 5th from the bottom in regular exercise participation. While Koreans aren't completely inactive, most people only walk.
However, walking only increases metabolic activity about 3 times compared to sitting. Fast walking or power walking can be aerobic exercise, but the walking most people do has limited exercise benefits.
Real exercise should be moderate-intensity aerobic activity or higher. This includes activities that cause sweating or slight breathlessness: brisk walking, uphill walking, jogging, swimming, etc.
Age-Specific Exercise Strategies
What's particularly lacking among Korea's middle-aged and older adults is resistance training, stretching, and balance exercises. Only about 18% of Seoul citizens practice resistance training.
As we age, joints become stiffer, range of motion decreases, and daily functional abilities decline, making stretching, balance exercises, and resistance training essential.
For resistance training specifically, since everyone has different developed and weak areas, following YouTube videos alone or exercising independently tends to overuse already overdeveloped parts while neglecting weak areas. It's crucial to consult with exercise professionals to learn appropriate exercises for your individual needs.
Age-Related Limitations in Exercise Learning
After the early 70s, joints become stiffer and cognitive function tends to decline somewhat. Since frontal lobe function actually starts declining from the 40s, the ability to learn new exercises decreases.
For those over 75, rehabilitation approaches - having someone directly assist with continuous exercise - are possible, but teaching exercise for independent practice becomes extremely difficult. Therefore, it's important to receive professional education on all four exercise components and make them habitual by age 60, or at the latest, early 70s.
Specific Exercise Methods and Effects
Walking alone won't get you to 100 years of walking. While not walking at all might quickly lead to bed rest, achieving the goal of walking until 100 requires practicing all four exercise components.
I recommend maintaining this exercise portfolio as a daily habit until the day you pass away. Practicing this way, you'll naturally feel gradual improvements in physical function.
Resistance training doesn't mean lifting heavy weights. Basically, full-body resistance exercises using your own body weight are fundamental.
Exercises Particularly Important for Women
For women, there's an exercise that becomes almost mandatory from menopause: the bridge exercise (lying down and lifting the hips). This exercise:
- Develops pelvic floor muscles
- Provides core exercise benefits
- Stimulates overall core and glutes
- Improves walking posture
- Can prevent constipation and urinary problems
Recommended Exercises
My personal favorite exercises include planks, pull-ups, lunges, and squats. Squats have particularly interesting characteristics. If you do squats with proper form from a young age, the muscles around your knees strengthen, making knee-intensive activities like climbing stairs less likely to cause knee injuries.
The Importance of Prevention
These days, you can see many people wearing knee braces while hiking. Unfortunately, if you don't strengthen the muscles around your knees and neglect maintenance, then age with increasingly poor posture that stresses the knees while walking, knee cartilage can deteriorate quickly.
When knee muscles are weak and knee cartilage becomes problematic, even strengthening knee muscles through squats can become burdensome for the knees. Once diseases develop, orthopedic or rehabilitation medicine doctors will say, "Sorry, but you need to be careful with resistance training now. You shouldn't go down stairs and you shouldn't do squats."
There's a difference between preventive exercise and exercise possible after disease develops. To prevent various musculoskeletal diseases and maintain a relatively pain-free musculoskeletal system throughout life, it's important to continuously make multifaceted exercise a habit.
Research-Proven Exercise Effects
Research conducted in Pyeongchang showed that exercising twice weekly for one hour over six months, incorporating all four exercise components, can improve physical function by approximately 10-15 years.
Even those in their late 70s and early 80s, if they have the will to practice and follow well-structured exercise programs, can experience significant physical function improvements. While the research environment provided subsidized exercise, the reality is that community facilities and programs for consistently learning such exercises are still lacking.
Practical Advice
It's also good to inquire about programs you can participate in through health centers or national programs like "National Fitness 100."
I often advise using supplement money to learn exercise instead. While personal training is most effective, it's expensive. However, many patients I meet in clinic spend hundreds of dollars monthly on supplements. Saving even some of that money for customized personal training would be beneficial.
When educating about exercise in clinic, I've been fortunate to experience patients in their late 80s and early 90s who, at least temporarily, escaped bedridden states through exercise. Therefore, don't think "it's too late" - before frailty fully sets in, exercise can improve physical function, prevent cognitive decline, and create various positive cycles.
Changing Perceptions of Death and Aging
Koreans seem to have insufficient experience with what aging well looks like. First, there's significant taboo and rejection regarding death. When I explain in clinic that a patient's condition is ultimately deteriorating toward death, many people express resentment.
Second, there's considerable resistance to aging itself. Patients in nursing hospitals or care facilities are truly dying from old age, but unfortunately in Korea, when patients pass away, families sometimes sue the attending physician.
There's a prevalent view that all human diseases should be treated through medical methods. However, at the end of disease lies frailty, and after frailty comes care and death. In geriatric medicine, receiving long-term care grade 1 and going to nursing facilities is evaluated as practically equivalent to death.
Japan's Concept of "Pro-Aging"
Researching and experiencing both Japan and Korea, I find that Japan often discusses "pro-aging" rather than "anti-aging." They think deeply about how to make the final 30 years - from 70 to 100 - a time of self-completion, fulfilling enjoyment, and personal enrichment. In this regard, Korea is still quite backward.
The Secret of Super Agers
Aging is like a deficit account - it's a portfolio that must be built gradually and consistently from youth. How you eat, what you think, and how you create your physical activity portfolio matters.
"Super agers" - those in their 80s who are healthier with better physical and cognitive function than 30-year-olds - often don't view old age as a separate life stage but think about it with genuinely positive attitudes.
Along with these mindsets, creating a portfolio of aerobic exercise, resistance training, balance exercises, and stretching, plus efforts to continuously strengthen cognitive function for enjoyment in old age - lifelong learning, maintaining an active lifestyle, and various activities for continuous self-development - are extremely important.
In Conclusion
Don't be deceived by flashy supplement marketing ads. For truly healthy aging, we must practice proven methods. Actively managing chronic diseases, making systematic exercise including all four components a lifelong habit, and accepting aging with a positive mindset are the real secrets to healthy longevity.
Rather than the sweet temptation that money alone can buy health without effort, consistently practicing scientifically validated methods, even if somewhat challenging, is ultimately the only path to creating the healthy centenarian era we desire.
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