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Longtime aging expert, now 88, heeds his own advice

Walter Bortz shares what it's like to be a senior

Aging expert Walter Bortz, widely known as the "running doctor" who completed 45 marathons while advocating the correlation between exercise and longevity, can no longer run.

At 88, the retired Stanford University professor, physician and author of titles such as "Dare To Be 100," "Living Longer for Dummies" and "Roadmap to 100" is personally experiencing some of the health trials he's spent a career studying and writing about.

During a recent interview at his Portola Valley home, seated in a comfortable chair with a walker by his side, Bortz shared what it's like to be a senior.

Advanced age "used to be something I observed in other people, and now it's happening to me," Bortz said. "So instead of being objective, it's subjective."

Bortz, who until recently was an active runner, is scheduled to undergo back surgery to address spinal stenosis.

He holds out hope that the surgery might enable him to get back to the running routine he loves so much — or at least to walk comfortably. He considers the surgery as a minor disruption in his quest to stay true to one of his cardinal tips for successful aging: "Don't slow down."

He remains firmly convinced that regular, sustained vigorous exercise is key to living 100 years in good health.

"Use it or lose it," he said. "My mantra is '100 healthy years.' Our birthright, our warranty is 100 healthy years if we don't screw it up."

With his engagement and curiosity undiminished, Bortz said he continues to travel and lecture and is at work on his next book — about aging — with the tentative title of "Aging Is Negotiable."

Running — around Stanford's Angell Field, up Portola Valley's Windy Hill, and on tracks and paths throughout the world — has been one of the great passions of his life. But he admits he might have overdone it on the marathons.

"The Greeks said, 'Everything in moderation,' and I was not moderate. I think I just wore (my legs) out, just gone from too much use," said Bortz, who ran the Boston Marathon in 2010 to celebrate his 80th birthday and then again in 2013.

"I never had any distinction as a runner — I was once interviewed by PBS for coming in last in the Boston Marathon — but I love to run," he said. "I'm terribly upset when I see runners running and I can't do it. It bothers me."

On death and dying, Bortz aligns himself with the message of surgeon and writer Atul Gawande in the book "Being Mortal": People should consider their deepest values and strive to maintain them as much as possible even in the final weeks and days of life.

"We want to die actively, not inactively," Bortz said. "My wife died here in this house after falling out of bed and hitting her head. She had advanced Alzheimer's. No pain, no tubes, no loneliness."

He was delighted to share that in the past year and a half he has found new love and companionship with Jeanne Kennedy of Palo Alto, whose photo sits among the many family images in his memento-filled home. (Kennedy, contacted separately, confirmed that she is equally delighted.)

Bortz began his career in the 1950s, practicing medicine in Philadelphia with his father, geriatrics trailblazer Edward Bortz, who chaired an early White House Conference on Aging and helped found the AARP.

"I was an only child, and I worshipped him," he said of the relationship.

At his father's death in 1970, Bortz, then 40, took up running and exercise to deal with his overwhelming grief.

"I knew exercise was the best treatment for depression, and I was devastated, clinically depressed," he said.

That same year, Bortz and wife, Ruth Anne, left Philadelphia and moved their four children to California, buying the home in Portola Valley he still occupies. Bortz began practicing at the Palo Alto Medical Clinic, a precursor to today's Palo Alto Medical Foundation.

"When I joined the clinic they said, 'You are our anointed gerontologist,' and I loved it," he recalled. He served as a physician for local senior communities Channing House, the Sequoias and Casa Olga. He made house calls and began teaching Stanford medical students, which he has continued to do.

Among his proudest achievements, he said, was chairing a board that got a senior center built in East Palo Alto. He also took on national leadership roles in the American Medical Association, the American Geriatrics Society and the Diabetes Research and Wellness Foundation.

Though he'd published extensively in medical journals, Bortz never considered writing for a general readership until he befriended Norman Cousins, then a nationally prominent writer and editor in the 1980s.

"Cousins was brilliant — he espoused the idea of attitude and wellness," Bortz said. "He told me, 'Walter, you've got to stop writing these scientific articles and write a lay book.' He wrote a wonderful blurb for my first book and got Bantam to print 75,000 copies."

That first book, "We Live Too Short and Die Too Long," came out in 1991. Over the next two decades — on top of a busy medical and teaching schedule — Bortz produced seven more.

"The writing was interspersed," he said. "When I was writing a book, I'd write a chapter a month. I was disciplined."

Recurring themes were aging, diabetes and reform of the health care system.

In "Next Medicine," published in 2011, Bortz argued that financial interests have "eroded the values of the medical profession and placed profit before human well-being."

Heart disease, for example, "is widely treated with drug interventions and invasive surgery — both of which are extravagantly profitable for pharmaceutical giants and hospitals. But daily exercise and a healthy diet can help prevent heart disease and can be obtained by patients essentially for free."

Until the "medical-industrial complex" drops its "vested interest in keeping Americans sick ... medicine will fail to effectively address the leading cause of disability and mortality today: chronic diseases like diabetes that are largely preventable," he said.

Bortz advocates reforming health care by boosting incentives for healthy lifestyle choices throughout the system.

"I went to talk to health insurers in Minneapolis about five years ago, and I said, 'Why don't you preach health? Give everybody who registers for AARP a step-counter. For every 25 steps you take, you can save a penny on health care costs,'" he said.

As he approaches his 89th birthday, Bortz said he's sticking to his eight tips to age "successfully" laid out in his first book, including: "Set goals and accept challenges that force you to be as alive and creative as possible."

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Comments

14 people like this
Posted by neighbor
a resident of another community
on Dec 9, 2018 at 5:22 pm

Dr. Bortz is an eloquent spokesperson for exercise, and certainly everyone should get moving a whole lot more. However, genetic predisposition for heart disease is a huge factor in outcomes.

Remember Jim Fixx? He's credited with being the father of the running craze (he wrote "The Complete Book of Running in 1977), but suddenly died in 1984 at age 52 while jogging. It turns out that heart disease was prevalent throughout his family.

Eating right and exercising clearly help -- but, unfortunately, there is more to the story when it comes to heart disease.


22 people like this
Posted by Bob Smith
a resident of Mountain View
on Dec 9, 2018 at 6:16 pm

Among a population you can always find exceptions, and by highlighting exceptions like Mr. Fixx (?), you dilute Dr. Bortz's point. Dr. Bortz's point is that with proper diet and exercise you have a significantly improved statistical chance of becoming a centenarian. It is by no means a guarantee, but your odds have improved. When studying cardio diseases, yes, predispositions are a factor, but statistically diet and exercise is more significant. So, time to get up and out. Cheers -


13 people like this
Posted by Old Mtn View
a resident of Old Palo Alto
on Dec 9, 2018 at 6:28 pm

True enough.

Exercise is essential in old age, but it's not the only factor for long life and genetics plays a big part as well. One mistake I think Bortz is making is to not switch up his exercise. The answer isn't to run or do nothing. Strength training, swim, bike (stationary, or traditional), etc.


17 people like this
Posted by Stanford Resident MD
a resident of Stanford
on Dec 9, 2018 at 6:43 pm

> However, genetic predisposition for heart disease is a huge factor in outcomes.
> Eating right and exercising clearly help -- but, unfortunately, there is more to the story when it comes to heart disease.

Absolutely. Professional athletes on the average, live to about the same age as non-athletes (including couch potatos).

The key is to watch your weight as obesity leads to other damaging health issues.
Reducing the use of alcohol and tobacco is also beneficial although for some individuals, it doesn't seem to have much of an impact...again, the genetic factor.

Some say we are born with X amount of heartbeats...you can use them up now through heavy excercise and rigorous sports activities or save them for later on. Your choice.


3 people like this
Posted by Anonymous
a resident of Duveneck/St. Francis
on Dec 9, 2018 at 7:30 pm

I believe I’ve read there will be a great need for gerontologists. I hope Dr. Bortz is able to influence many current med students to go this route. Thank you.


13 people like this
Posted by Stanford Resident MD
a resident of Stanford
on Dec 9, 2018 at 7:45 pm

> I believe I’ve read there will be a great need for gerontologists.

Absolutely. The Baby Boomer population (ages 54-72) now comprises roughly 26% of the American population but will drop to approximately 19% by 2030.

Meanwhile the Gen Xers and Millennials will be growing older as well.





2 people like this
Posted by Anon
a resident of Another Palo Alto neighborhood
on Dec 10, 2018 at 10:18 am

Posted by Stanford Resident MD, a resident of Stanford

>> The key is to watch your weight as obesity leads to other damaging health issues.
>> Reducing the use of alcohol and tobacco is also beneficial although for some individuals, it doesn't seem to have much of an impact...again, the genetic factor.

If your point is that statistics are averages, and, that anything can happen to -you-, sure, of course. A sleepy truck driver could crush your car like a bug any day. But, smoking has an enormous impact on both life expectancy and fitness later in life-- on average. Look at Figure 3 in this web-version paper which compares impact of smoking, exercise, and diet on longevity. Don't smoke:

Web Link

Beyond that, physical activity and diet are both significant factors. See the article. Fig. 3 sums it up in an easy-to-understand presentation.

>> Some say we are born with X amount of heartbeats...you can use them up now through heavy excercise and rigorous sports activities or save them for later on. Your choice.

Some may say that, but, the statistics say that physical activity will help you live longer, and, be more fit to enjoy it. Not to mention that exercise will lower your resting heartbeat as well, lowering the number of heartbeats that you are using up. :-)


1 person likes this
Posted by great advice but....
a resident of another community
on Dec 10, 2018 at 10:25 am

Great advice, but you just have to hope that you do not draw the short straw resulting in a debilitating long term illness such as Alzheimers which cannot be prevented by exercise or healthy living. Still no cure and Medicare does not cover custodial care. It's a heartbreaking disease with huge impact on finances.


2 people like this
Posted by MF
a resident of Professorville
on Dec 10, 2018 at 11:48 am

Great Advice But- exercise and diet do help slow down Alzheimers. Vigorous exercise and 12 hours between your 1st and last meal are what the latest research has proven- and of course eating a low inflammation diet.

Web Link
Web Link

Get moving, cut the sugar and saturated fats, healthy sleep habits, no heavy drinking and you will live your healthiest life- whatever the number shall be.


3 people like this
Posted by Bottom Line
a resident of Menlo Park
on Dec 10, 2018 at 12:04 pm

> ...Alzheimers which cannot be prevented by exercise or healthy living.

Excellent point as there are no health-related preventative measures regarding Alzheimers Disease.

>> ...exercise and diet do help slow down Alzheimers.

Slowing down VS preventing Alzheimers = two different stories. On the other hand, exercise and diet can slow down the effects of dementia which is a SYMPTOM of Alzheimers but not an actual disease of its own.

>>>...exercise will lower your resting heartbeat as well, lowering the number of heartbeats that you are using up. :-)

Heavy cardio-vascular work-outs will reduce one's remaining heartbeats regardless of any rest periods. You cannot have your cake and eat it too. Moderation, as in anything is the key to living longer exclusive of family genetics and accidental deaths.

Best bet...watch your weight and don't get fat.


1 person likes this
Posted by Anon
a resident of Another Palo Alto neighborhood
on Dec 10, 2018 at 12:16 pm

Posted by Bottom Line, a resident of Menlo Park


>> >>>...exercise will lower your resting heartbeat as well, lowering the number of heartbeats that you are using up. :-)

>> Heavy cardio-vascular work-outs will reduce one's remaining heartbeats regardless of any rest periods.

Where can I find the evidence supporting your hypothesis? Google Scholar? Web Link


2 people like this
Posted by Bottom Line
a resident of Menlo Park
on Dec 10, 2018 at 12:58 pm

Where can I find the evidence supporting your hypothesis? Google Scholar? Web Link

Elementary my Dear Watson...if you have say, 200 heartbeats and expend 150 during a moderate workout (using one minute as a scaled-down time frame), you will only have 50 heartbeats remaining projected over a remaining lifetime.

On the other hand...if you were to forego the workout and instead opt to watch TV or dabble on the computer while enjoying a cold beer, you will still have 200+.

Excuse me while I go grab a Heineken.


2 people like this
Posted by MP
a resident of another community
on Dec 10, 2018 at 1:10 pm

"Move or Die" - John Adams


1 person likes this
Posted by Anon
a resident of Another Palo Alto neighborhood
on Dec 10, 2018 at 2:30 pm

Posted by MP, a resident of another community

>> "Move or Die" - John Adams

I've wondered about the context of this. Found it in the online archives.gov:

Web Link

More context: it is in a letter from Adams to his son, Charles:

"One of the most essential Things for a Lawyer is to study his Constitution and take Care of his Health.— Exercise is indispensible— No Regimen without it, will do. No Abstinence no Medicine, No Diet will Supply its Place. Move or die, is the Language of our Maker in the Constitution of our Bodies. Your Constitution is a very good one, and it will be unpardonable in you not to preserve it."

Web Link)


Like this comment
Posted by kathy kastner
a resident of Evergreen Park
on Dec 18, 2018 at 6:33 pm

I totally and heartily subscribe and ascribe to the regime the good doctor recommends: eating well, exercise, good 'tude. I do this not to live longer but because I feel so much better on a day to day basis.
Sounds simple - just requires a little discipline and self-control. Right? Family history aside, what about the many many many who are not in my position: I have access and means, knowledge to eat well, my 'hood is safe enough to get out and run; I am in a wonderful relationship and my kids are launched. Why is it that these basic, social determinants of health are rarely - if ever - part of the 'live long and prosper' equation


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