Humanity's Peak Health May Already Be Behind Us

In recent years there has been a consensus in medical circles that the baby-boom generation born after World War II may have already reached the peak of human health: their overall health is better than that of people born before or after them, and their life expectancy is longer.

My father is one of those born in the post-WWII baby boom; observing the physical condition of his generation, I heartily endorse this view.

On this trip back to my hometown, I noticed a low wall had been added at the exit of our courtyard, built from long stone slabs. Each slab must weigh about 50 to 100 kilograms, and they were stacked neatly. I asked my father who had carried the stones up there. He told me that he and a neighbor had done it.

The neighbor is 73; my father is 79. Our two families have been neighbors since I was born, getting along harmoniously for over 40 years without a single quarrel, always helping each other out. By age I should call him "Uncle," but by clan seniority I can only call him "Elder Brother." His son is a year younger than I; we grew up together, as close as brothers.

I weighed whether his son and I together could move those stone slabs. Probably barely, but stacking them so neatly would likely be difficult. Both of us are in our prime at forty-something or fifty, while our fathers are already past seventy; yet the combined strength of us two cannot match that of the two old men.

To save money, my father himself laid the unfinished guardrail at our door. His wall-laying technique is very amateurish and the wall is not pretty, but he is quite satisfied with it. After all, a guardrail is just a low wall for protection; as long as it serves that purpose and my father is happy, I have no objection. But I urged my father not to do such things anymore; at his age, doing such heavy physical labor makes me very anxious.

Yet I know such persuasion is useless. I can only stay with him briefly; after I leave, he will go on doing all sorts of physical chores as always, and probably as always ride his electric motorcycle out for joyrides, which often gives me a fright.

My father has eight brothers (including cousins sharing the same grandfather), the youngest now in his seventies, and seven of them are still alive. My eldest cousin-uncle is 86 this year; I do not know how to diagnose him now. His cognition has declined severely; he no longer recognizes even his own nephews, and his memory is a shambles. He still farms, but can no longer remember the correct sowing times and often makes fools of himself.

His only son, who was a doctor, died three years ago from overwork combined with long COVID; the village now looks after him as a low-income household, so basic living is no problem. But he can still both farm and fully care for himself—cooking, washing, and working are all fine. Although he often gets the farming season wrong, there are enough people in the village who correct him, so the impact is minor. His situation looks like Alzheimer's disease but is not entirely so; I really find it hard to describe and explain in medical terms.

Most likely my father, as he ages, will also experience progressively worsening memory like his cousin, but this will not stop him from continuing to work and care for himself. In earlier years he was willing to live with us; now he increasingly dislikes troubling his children. I suspect my father will likely live past 85, and not without reason: his own older brothers and sisters did so, their physical conditions are very similar, and even the state of their cognitive decline is much the same.

Yet their descendants—my cousins and me—may not be as healthy. One of my cousins has already died, at only 45. None of my father's siblings has abdominal obesity, but several of our generation already do. Our parents' generation had no hypertension, hyperlipidemia, or diabetes, but our generation has started to.

My father, though nearly eighty, has a sallow complexion, a stooped frame, and is dark and thin, looking fragile; yet he is all muscle, and his strength is on a par with mine.

These years the World Food Programme and WHO have repeatedly urged people worldwide to change their diet and reduce the proportion of meat, because the cardiovascular disease, diabetes, and cancer plaguing modern people are all related to excessive meat intake—but with little effect. For my father's generation, however, this is simply not an issue, because they ate mainly vegetarian food from childhood and still keep that habit.

Likewise, we keep urging people to exercise more and increase muscle mass to fight aging and common diseases, but such appeals have also had little effect. For my father's generation, this is not an issue either, because they keep working even in old age. Labor has given them well-developed muscles and stable blood pressure, lipids, and blood sugar.

Of my father's eight brothers and several married sisters, not one has had a stroke, not one has diabetes, and only one has had a tumor; their rate of the top fatal chronic diseases is far below the social average.

I have studied medicine for about twenty years, learning TCM, Western medicine, and psychiatry, and can discourse fluently on medical theory. Twenty years ago I did not realize that my own family carried longevity genes; today, twenty years later, I realize that my father's family is a long-lived family. The elders are all advanced in age yet still alive, and several over 85 can still work and care for themselves. They are heading toward 90, and for now I do not know where their longevity ceiling lies.

My elders' habits are not especially good: they often eat leftovers and pickled food (though not much, because they are all inveterately frugal). Their lives were never wealthy; they had constant minor ailments, and their personalities were not especially agreeable. They have made me realize that much of the medical theory I have learned and many of the popular medical articles I have written are not that reliable.

The most admirable thing about this family is precisely what used to give me a headache: their advocacy of frugality and simple living. Because they take frugality too far, they can appear stingy and stir up many conflicts. But everything has two sides, and this frugal lifestyle has also kept their bodies and minds from being overdrawn.

My burden in supporting my father is light. Starting about ten years ago, I give him tens of thousands of yuan a year in living expenses; when I checked his bank balance a few years later, most of the money I had given was still saved. My father keeps it, and it will most likely return to me in the future. After I entered college again to study Western medicine, my father refused to take any more living money from me, not wanting me to feel pressured.

Most of the time he does not even need my care. Ashamedly, when I come home to visit, he still often rushes to do my laundry and cooking, still looking after me as a child. He sleeps and rises early; the moment we take our eyes off him, he has briskly finished all the household chores, which makes us children feel quite awkward.

A few years ago, after I resolved his stubborn constipation and insomnia, the decline in his strength and memory seems to have slowed considerably. I do not know whether I am now better at dealing with the elderly, or whether his personality has grown softer, but we get along much better than before.

With such an elder in the family, of course we hope he lives even longer and stays with us a few more years. As my mentor said, parents are a wall standing between us and death; while that wall is there, we need not rush to face the Grim Reaper directly.

The family ethos of my father's side can be summed up in six characters: self-discipline, frugality, diligence. To some extent I have fully inherited this ethos, and I am the foremost adherent of it in my generation.

It is just that I did not used to approve of our family's ways, because I saw many drawbacks. The overly self-disciplined tend to be harsh on others; frugality is hard to distinguish from stinginess; both can make a person less tolerant and prone to conflict.

But I was fortunate: my mother was a generous, kind, warm, and broad-minded person, and I inherited some fine genes from her, which have helped me overcome some of the drawbacks of my father's side.

I am now nearly fifty. Confucius said that at my age one should know the mandate of heaven. But the old master spoke too tersely; he could not be bothered to explain "mandate of heaven" in detail, which has left later generations disputing the point.

My understanding of "mandate of heaven" is that it is like a combination of natural law and fate, yet slightly different. It is something mysterious, beyond our control, yet that governs our destiny; it determines our lifelong achievements, and also our health and lifespan.

The mandate of heaven is the combination of our genes, upbringing, and lifelong opportunities. To fundamentally change a person's health and life, one can only begin by changing that person's mandate of heaven. But how easy is it to change a person's mandate of heaven? If one day medicine advances to the point of being able to alter a person's mandate of heaven, then it might truly be called a science.