THE ULTRALONGEVITY QUIZ: HOW FAST ARE YOU AGING?

Ever wonder why people seem to age at different rates?

As you will soon learn, the speed of aging is determined by your immune system and, in fact, nearly all diseases are now thought to be caused by a breakdown in the immune system. Without a strong immune system, you will neither look healthy nor be healthy.

Take our quiz to find out if you are aging too fast.

Following are twenty questions that touch on your lifestyle and your immune system. Answer them honestly, tally up your score, and find out how fast you are aging.

1) Do you need to lose ten pounds?
a. Add 10 points if your weight is appropriate for your height
b. Add 5 points if you need to lose only ten pounds
c. Add no points if you need to lose more than ten pounds

Carrying around extra weight is stressful--not just on your back and your joints, but on your immune system too. Besides causing you to be at higher risk for diseases such as diabetes, heart disease, and cancer, extra weight also can overactivate your immune system.

One of the best ways to measure the extent of immune activation is the C-reactive protein (CRP) blood test--the higher your CRP levels, the more active your immune system is. A March 2006 article in the Journal of the American Medical Association (JAMA) showed that overweight women were eight to almost ten times more likely to have an overactive immune system, as demonstrated by high levels of CRP than women of healthy weight, even if they were physically active. Studies on men show similar results.

2) Do you smoke?
a. Add 10 points if you rarely even smell smoke
b. Add 5 points if you're exposed to some second-hand smoke every day, but you don't smoke
c. Add 2 points if you live with a smoker, but don't smoke yourself
d. Add no points if you smoke

Smoking is one guaranteed way to age your body faster. You know the effects--wrinkled skin, clogged arteries, emphysema, cancer, and impotence, to name just a few. But the most important reason to stop smoking is that it overstimulates the immune system, which in turn speeds up aging. A May 2005 study from the American Heart Journal revealed that smokers showed signs of high immune activation including elevated CRP levels, as well as higher levels of macrophage-stimulating factors, which trigger our white blood cells to multiply, proliferate, and kill. (We'll talk more about that later.)

Even second-hand smoke causes immune activation. A February 2004 study in the American Journal of Medicine showed that people exposed to second hand smoke at least three days a week had higher white blood counts, as well as higher CRP levels, than people not so exposed.

3) Do you live in one of the following cities: Birmingham (AL); Los Angeles, Fresno, Bakersfield, Hanford-Corcoran, Merced, Modesto, Sacramento, San Diego, San Jose, Visalia (CA); Bridgeport (CT);Canton-Massillon, Cincinnati, Cleveland, Columbus, Weirton (OH); Eugene-Springfield, Medford (OR); Harrisburg, Lancaster, Pittsburgh, Philadelphia (PA); Provo, Salt Lake City (UT); Charleston (WV); Huntington-Ashland (WV-KY-OH); Atlanta, Baltimore, Chicago, Detroit, Houston, Louisville, Knoxville, New York City, Newark, St. Louis, Seattle-Tacoma, or Washington DC.

a. Add 5 points if you live in the country
b. Add 2 points if you travel to the areas listed frequently (i.e.: weekly or more)
c. Add no points if you live in one of these areas

These are the forty most polluted cities in the U.S. (not necessarily in order) measured by particulate air pollution and ozone. Breathing in polluted air activates your immune system into a constant defense mode that ages your body prematurely. A February 2006 study in the American Journal of Respiratory Critical Care Medicine measured the day-to-day variations in CRP levels against the daily air pollution index. The study showed that CRP levels rose significantly approximately two days after subjects were exposed to particulate air pollution.

4) Have you broken a sweat exercising in the past twenty-four hours?
a. Add 10 points if you break a sweat exercising at least four days a week
b. Add 5 if you break a sweat at least twice a week
c. Add no points if you seldom exercise to a sweat

Exercise helps deactivate the immune system in several ways. A report in the American Journal of Cardiology in January 2004 confirmed findings from research in 2002, published in Circulation and Epidemiology, which showed an inverse relationship between exercise and CRP: Exercise lowers CRP levels. It's no surprise that exercise has been proven to prevent just about every disease and reduce the effects of aging.

5) What was your birth weight?
a. Add 4 points if you weighed more than eight and a half pounds but less than ten pounds at birth
b. Add 2 points if you weighed between seven and eight and a half pounds
c. Add zero points if you weighed less than seven pounds or more than ten pounds at birth.

Research shows that smaller babies (five and a half to six pounds) have prematurely aged immune systems, while larger babies (up to nine and a half pounds) lead longer lives with less disease. Lower birth weight has been linked to higher levels of CRP and immune activation in adult life. In the recent MIDSPAN Family Study, researchers found that CRP levels in adults were inversely proportional to their birth weight (in the range between five and a half to nine and a half pounds), and that every kg (2.2 pounds) at birth meant 11 percent lower CRP levels in adulthood.

6) Have you taken an antibiotic medication in the past year?
a. Add 4 points if you can't remember the last time you took an antibiotic
b. Add 2 points if you've taken a course of antibiotics no more than ten times in your life
c. Add no points if you generally take a course of antibiotics every year, or more often

Antibiotic use prematurely age the immune system and is linked to a number of health effects, including heart disease, allergies, asthma, and even breast cancer. Frequent antibiotic use is a sign of someone whose immune system is often in battle mode, fighting an infection but also wreaking havoc on his or her health in the process.

A study published in Chest in March 2006 showed that babies exposed to even one course of antibiotics in the first year of life faced twice as much risk of developing asthma compared with non-exposed babies, and that risk increased with each successive course of antibiotics. Another study (JAMA, February 2004) revealed that antibiotic use raised the risk of breast cancer in women-- more than fifty days of antibiotic use during a lifetime increased a woman's risk by more than 50 percent, and continued antibiotic use increased the risk further.

7) Do you have older siblings?
a. Add 4 points if you have older brothers or sisters
b. Add no points if you're an only or oldest child

Research suggests than only children, or the oldest sibling, are often more prone to allergies, eczema, asthma, and other allergic disorders, which are indicative of an overactive immune system.

A review of fifty-three existing studies, published in the Journal of Epidemiology and Community Health in 2002, showed a strong and consistent relationship between the number of siblings and allergies, asthma, wheezing, and hay fever, with the risk increasing with fewer siblings.

8) Is your belly bigger than your hips?
a. Add 10 points if your hips are bigger (yeah!)
b. Add 2 points if your belly and hip measurements are the same
c. Add no points if your belly is bigger than your hips

Your hip measurement should be at least 10 percent more than your waist measurement (for men) and 20 percent more for women. Carrying extra inches around the middle of your body is an immune system disorder, and is linked with premature aging. This rule holds true even for people who are not overweight. A study from the Brigham and Women's Hospital in Boston, published in the Journal of Epidemiology in November 2003, showed that even when weight was normal, having a waist measurement as large as one's hip measurement was linked with higher levels of immune activation.

9) Did you floss your teeth today?
a. Add 2 points if you flossed today
b. Add 1 point if you did not but often do
c. Add no points if you seldom or never floss

Yes, floss. Flossing helps reduce plaque buildup in the teeth and gums. This plaque is a thick coating of nasty bacteria that creates a constant struggle with your immune system. High levels of plaque are linked with an overactive immune system and a doubled risk of cardiovascular disease. Research from the Archives of Internal Medicine (October 2000) found that periodontal disease doubled the risk of stroke in adults over twenty-five. Also, according to a study from the Harvard Dental School and Brigham and Women's Hospital (published in the February 2001 Journal of the American College of Cardiology), higher rates of heart attacks, death from cardiovascular causes, and stroke were found in people with periodontal disease.

10) Have you made love in the past week?
a. Add 5 points if you have a good love life
b. Add 3 points if you have a fair love life
c. Add 1 point if you're frustrated with your love life (at least you know what a love life is!)

Right--just what you were waiting for: Sex is good for you. Well, actually it's not just sex; it's loving and feeling loved. Nothing quiets down a revved-up immune system better than knowing someone else loves you, and vice versa. When you're loved, not only does everything seem better in the world, it is better in your body, too.

11) Did you tell a funny joke to your friends today that made them laugh?
a. Add 2 points if you made someone laugh
b. Add 1 point if someone made you laugh
c. Add no points if you can't remember laughing

Okay, this is a bit of a trick question. If you answered yes, we know two things: You have friends, and you have a sense of humor (plus good delivery). What's important here is camaraderie and laughter. Both are rejuvenating to the immune system. "Laughter is the best medicine," is not an old chestnut. Laughter sends a signal to the immune system to chill out.

12) Did you grow up with a dog?
a. Add 2 points if you grew up with a dog
b. Add 1 points if you grew up with any pet
c. Add no points if you never had animals

Besides being a best friend, a pet plays an important role in supporting your immune system. Dogs and cats (and some other pets) create contact with most of the harmless germs our immune system needs to get to know as it develops in our childhood (however, people should be a little more careful with cats, as cats tend to cause more allergies than dogs). Without exposure to the right germs, your immune system runs amok and starts reacting to all kinds of things it shouldn't, such as pollen, grass, hay, dander, and/or mold, leading to allergies, asthma, and skin rashes.

13) Have you had a massage in the last month?
a. Add 2 points if you were massaged
b. Add 1 point if you massaged someone else
c. Add no points if you haven't done either

Talk about being relaxed. Having every tired muscle rubbed for an hour while your brain takes a holiday is good medicine. Relaxing touch combined with a release of muscle pain goes a long way toward reducing tension in your immune system, too. Massage has been shown to reduce activation of the immune system, and it feels good, besides.

14) Do you eat three meals a day? (If more than one answer applies, pick the one that applies best)
a. Add 5 points if you're a "grazer" and almost never over-eat
b. Add 3 points if you skip a meal almost every day
c. Add 2 points if you skip a meal now and then

Despite what you might think, eating three meals a day is no longer considered healthy. Meals are one of the biggest stresses on your immune system. Worse, pooling all of your day's calories into just one or two large meals is excessively stressful on our immune system. The bigger the meal, the higher the levels of CRP and interleuken-6 and the more activated your immune system--especially after a fatty meal. Grazing, or eating several smaller meals, is a better strategy than eating three large meals a day.

15) Do you take vitamins?
a. Add 4 points if you take a multivitamin an hour before your biggest meal of the day
b. Add 2 points if you take a multivitamin every day, but not before your biggest meal
c. Add no points if you don't take a multivitamin

Taking a multivitamin daily reduces stress on the immune system and slows aging. In fact, it has been shown to reduce CRP levels significantly, according to a study in the American Journal of Medicine in December 2003.

However, if you're like most people, you probably take your multivitamin first thing in the morning. Your multivitamin is actually best taken about an hour before your biggest meal of the day, when it acts to help reduce the immune activation that occurs after a meal. Research reported in Circulation in July 2003 showed that taking antioxidant vitamins A, C, E, and beta carotene before supper prevented the rise in CRP observed after a meal.

16) Have you raised your voice in anger over the past twenty-four hours?
a. Add 5 points if you can honestly say that you rarely get angry at anything
b. Add 1 point if you felt angry, but didn't yell
c. Add no points if you've raised your voice today

Be honest. Yelled at your kids? Your spouse? At the office? At the store? At anyone? How about your dog or cat?

Even when your voice gets a little edgy, it's a sign of inner hostility. Hostility or anger is a powerful emotion that tells your immune system you're geared up for a fight. Translation: Get ready to be hurt by an overactive immune system.

In a study from Duke University's Behavioral Sciences Department published in Psychosomatic Medicine in September 2004, a higher degree of anger and hostility was found to predict higher CRP levels.

17) Do you feel anxious during the day?
a. Add 2 points if you're just occasionally anxious
b. Add no points if you're anxious nearly all the time
c. If you're never anxious, add zero points because lying isn't good for your immune system, either.

Nervous? Sweaty palms? Outright scared? Or even just kind of flustered? Your immune system isn't happy when you get nervous. Anxiety sends a loud and clear message--you feel threatened. That's exactly when your defense system kicks in. Frequent anxiety ages you prematurely.

In the wake of 9/11, researchers assessed the effect of chronic anxiety on health and immune function by studying CRP levels in 721 men and 431 women. Especially in women, fear of terrorism was associated with an elevated CRP, indicating activation of the immune system.

18) Ever feel down in the dumps? Blue? Sad? Outright despairing?
a. Add 5 points if you're generally positive and optimistic
b. Add 2 points if you've felt depressed more than once in the past month
c. Add no points if you often feel depressed

Of the three most dangerous emotions (hostility, anxiety, and despair), despair is probably the worst; it tells your immune system that you are not just anxious, but also that you've given up. Despair and depression have been linked with all sorts of conditions from heart disease to brain decline to osteoporosis. If it's a frequent condition, depression clearly needs treatment. Many studies have now shown this, including a hallmark one reported in the October 1996 New England Journal of Medicine that linked depression with osteoporosis. Since then, research has also coupled depression with increased incidence of diabetes, heart disease, stroke, and cancer.

19) Did you sleep well last night?
a. Add 5 points if you almost always sleep like a baby
b. Add 3 points if you usually sleep like a baby
c. Add 1 point if you often don't get enough sleep
d. Add no points if you're always tired and you still don't seem to get enough sleep

Sleep is when your immune system can finally relax, recharge, and repair. It can't do this during the day--it's too busy defending you. It's difficult to sleep when you're sick, because your immune system is so damn busy. All kinds of repair processes occur during sleep, while sleeplessness triggers activation of the immune system.

Basic sleep deprivation is an important cause of immune overactivation as proven by many studies, including one reported in the February 2004 Journal of the American College of Cardiology showing that both short-term and chronic sleep deprivation led to elevated CRP levels.

20) Do you sing? Hum? Tap your foot much of the day? Often have a song running through your head?
a. Add 2 points if you play an instrument or sing every day
b. Add 1 point if you often listen to your home music system or portable music player
c. Add no points if you couldn't care less about music... it won't help you, but it probably won't age you either

Music soothes more than the savage beast--it also soothes your immune system; Bach, Beethoven, Mozart, or even Earl Scruggs or Eminem will do. Research on babies in a neonatal intensive care unit showed that when recorded lullabies were played, babies had better oxygen levels, fewer infections, and shorter hospital stays (Pediatric Nursing, 1998).

KEY: If your score is between:

80-100: You are aging like a Bristlecone pine tree, living in harmony with your immune system, which is calm and secure. There's no need for it to be overactive, and peace reigns in your bloodstream. But there's always room for improvement. Read on and learn how to slow the aging process even further.

60-79: You are aging like a Giant Tortoise. Your immune system is your friend and has little interest in attacking you--at the moment. It's possible to improve upon your success and make your immune system work even better. There are several steps you can take to slow down the aging process and live a longer, healthier life. Learn on!

40-59: You are aging like the average human, which isn't bad, but you could be aging so much more slowly while at the same time reducing your risk of getting sick. Knowledge is power, so here's your chance to learn how to slow the aging process and prevent disease. There are many things you can do right now to improve your immune function, starting with the right mindset: believe that you have the power to change your health and your aging speed.

20-39: You are aging like a speeding bullet, heading for a dreaded disease--if you don't already have one. This score calls for immediate action to stop this process. You probably should skip ahead to the UltraLongevity program in Section II; you can always come back and read Section I once you've taken the first steps to gain control of your immune system.

1-19: You are aging like a dinosaur (nearly extinct already). To score this low, you must be purposefully trying to hasten your own demise. But the mere fact that you're reading this book means there's still hope. Pause. Take a breath. Affirm to yourself that you are worth taking care of. And read on. This is the start of a whole new you and you are in the driver's seat. Even people who score this low can, and have, changed their lives for good.

� Dr. Mark Liponis, 2007