Intro

TOM PARKER COULD

never be accused of being a couch potato. The Dallas lawyer is a poster boy for healthy living, maintaining a lifestyle that would leave the typical 55-year-old wheezing in the dust. Working with a coach, Parker bikes for hours at a time in a tricked-out exercise room above his garage. And on weekend mornings he swims sprints in the choppy waters of Grapevine Lake, gearing up for triathlons in Nevada and Wisconsin.

But never mind all those amphibious miles: Parker is just getting started. Like most baby boomers contemplating their mortality, he monitors his cholesterol with guard-dog zeal, fighting to get his count under 180. He bolsters his diet with high-fiber wafers and omega-3 fish oil. And once a year this son of a doctor checks himself into the Cooper Clinic across town for a physical. Not just a perfunctory workup but an all-day ordeal: Doctors scan his heart, stick a camera down his gullet, conduct dozens of tests on his blood and run him to exhaustion on a treadmill. The price: a cool $3,000 a visit. "I worry about aging badly," he says. "I really do."

If this all sounds like a bit much, it's far from extreme for the new health investor. For a growing band of affluent consumers, living a longer, healthier life is the next big challenge and often the next luxury indulgence. Vitamin-infused elixirs, 1,500-calorie-a-day diets and "executive physicals" have become routine. The most affluent Americans already live as much as four years longer than their peers, according to a recent government study. And many seem willing to spend to keep it that way. American households that earn $150,000 or more are forking over nearly $5,000 a year out of pocket for basic health care expenses almost twice as much as those who earn less. That gulf widens when you factor in other wellness investments like gym memberships, acupuncture sessions and genetic tests that claim to pinpoint health risks.

All this spending amounts to far more than just high-end hypochondria. As boomers watch their parents age, they're confident that advances in medicine and science will let them stay healthier later in life. Life expectancy itself has marched steadily higher about 25 percent longer for a 50-year-old adult since 1970 but midlifers are hoping to add quality as well as quantity. "We want to dodge a few health bullets and keep up our primary asset, the brain," says Oz Garcia, a 57-year-old nutritionist and author of books on diet and longevity. "And people will pay for that." Their role model might be Sumner Redstone, the octogenarian Viacom CEO who seems intent on proving that 90 is the new 40. Redstone recently said that he's expecting to live 50 more years. His health secret? Daily doses of antioxidant-rich fruit juices, at $40 a bottle.

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Many of these longevity seekers, of course, are taking a medical leap of faith. The benefits of many of their expensive exams aren't yet proven and can lead to false positives, heightened anxiety and invasive follow-up tests. Experts argue that some alternative treatments a giant class of medicine that includes popular remedies like dietary supplements and Reiki energy therapy lack evidentiary support and can result in people putting off necessary care. And even as the business of antiaging clinics has exploded, some techniques remain objects of skepticism.

Still, for every doubter there's a believer who's sure that science will unlock the key to longer life. We caught up with several health investors, some newly minted and some lifelong, each of whom took his own path to wellness. They've got one thing in common: They didn't blink at dropping a stack of dollars for the peace of mind that comes with potentially warding off a disease or seven and adding healthy years to their lives.

The Year Counters

As 77 million baby boomers prepare for their golden years, they're understandably attracted to fixes that might stave off the indignities of age. And health gurus are already making a fortune marketing diets, drugs and lifestyle changes that promise a longer, more vigorous life. The American Academy of Anti-Aging Medicine, which certifies doctors in this field, says antiaging will grow to a $79 billion business in 2009, up from $56 billion in 2006. Books on the topic regularly climb the bestseller list; this winter "You: Staying Young," by doctors Michael Roizen and Mehmet Oz, which was widely promoted on Oprah, sold almost a million copies in its first four months.

Jane Zentz, a semiretired farm wife in Bourbon, Ind., says that up until three years ago, she hardly focused on her health. "I like to say I was keeping Oreos in business," Zentz jokes of her old eating habits. These days following some advice from You: Staying Young like taking two baby aspirin each morning and flossing nightly comes easily. But she's also taken quite seriously the authors' contention that older people should aim to have the body they had at 18. She's slimmed down to 120 pounds by lifting weights and running on her treadmill. And with an eye to preventing the Alzheimer's disease that struck her father and his brothers, she supplements her diet with omega-3 oils and dusts her morning omelets and wheat toast with flax seeds. "I feel like there's a real chance I could live to be 116," Zentz says. "My annuity has no idea who it's dealing with."

Caloric restriction eating much less is one of the linchpins of longevity science. It takes some getting used to fatigue and loss of sexual drive are common side effects. But it has been linked to longer lives and lower incidence of age-related disease in animals: One 2006 study, from the University of Southern Illinois, showed that mice fed 30 percent fewer calories lived 20 to 30 percent longer. Bruce Jackson, a 52-year-old auto executive, thinks a similar approach could work for him. Years ago Roizen, Jackson's doctor, urged him never to eat a plate of food larger than the palm of his hand. It felt like a sacrifice, but he's stayed with it he has lost 15 pounds, and he's the only one among his siblings to dodge high blood pressure. "I'll say this," Jackson says of his monk-like discipline, "it was quite a journey."

In the meantime science is looking for shortcuts. Some researchers are studying the genes of people who live past 100, trying to develop a drug that mimics their body chemistry; others hold out hope for resveratrol, a compound in red wine that may have antiaging properties. But today's wonder drugs are controversial. Critics say that some antiaging clinics hawk a dangerous cocktail of elixirs, including drugs like human growth hormone (HGH). "I would stay as far away from these places as you can," says Jay Olshansky, a longevity researcher with the University of Illinois at Chicago, who calls many of the doctors "pure hucksters." A Stanford University analysis of HGH use in the healthy elderly found that the drug didn't extend lifespan or bolster health markers like insulin resistance or bone density. It did, however, deliver side effects, leaving 19 percent of patients with carpal tunnel syndrome.

The Lab Rats

Watching a computerized tour of your intestines live and getting dunked in a tank for an underwater weight measurement might not be most people's idea of a day at the doctor's office. But it doesn't scare Jeanne Barbet. The commercial interior designer has a lot at stake: She's haunted by her family's track record of heart disease. Heart problems plagued both her parents; one brother, she says, needed a quadruple bypass in his 50s, even though he was "so fit he was still wearing clothes from college." So about five years ago, Barbet began getting executive physicals at the Princeton Longevity Center, an hour from her home in Plainfield, N.J. The biggest draw: heart CT scans, which peek inside coronary arteries and detect signs of calcium buildup before it's severe enough to show up on other tests. The cost, $3,500 a visit, hasn't made her blink. "I think my mother could've lived a whole lot longer had she only been more proactive about her health," she says.

Executive physicals got their name from the corporate brass who first popularized them. But demand has spread, with programs popping up at famed hospitals like the Mayo Clinic and leisure spots like the Four Seasons Hotel in Westlake Village, Calif. The growth is fueled in part by a growing awareness of connections between heredity and health. Tom Parker, the Dallas attorney, is a case in point: His family history of high cholesterol and osteoporosis has helped motivate his Cooper Clinic visits if he has similar problems, he wants to catch them early.

For a wide variety of cancers, early diagnosis can drastically increase the chance of survival. According to the American Cancer Society, colon-cancer patients diagnosed during Stage I virtually, the disease's earliest phase have a 93 percent chance of being alive in five years, while fewer than half of those diagnosed late in Stage III survive that long. Breast-cancer figures are even more sobering: Just 20 percent of women diagnosed in Stage IV live for five more years. With heart tests like the ones Barbet undergoes, the advantages are less clear, but early detection is more likely than at an ordinary doctor's office. The most commonly used heart stress test can detect abnormalities only once a major cardiac artery is at least 60 percent blocked. But the coronary artery CT scan Princeton offers can detect plaque deposits much earlier, giving patients a chance to shrink them with healthy lifestyle habits.

Experts caution that earlier isn't always better. Dennis Fryback, a former member of the U.S. Preventive Services Task Force, which develops guidelines for regular physicals, says executive-physical programs often oversell what tests people need. For diseases like prostate cancer or melanoma, doctors can wind up treating tumors that would likely never develop into anything serious, and those treatments can result in side effects or even fatal complications. More tests mean more chances of false positives, which can lead to other potentially dangerous procedures. And some tests come with real health risks: Chest CT scans, for instance, deliver between 10 and 100 times as much radiation as normal X-rays, causing cell damage that can sometimes lead to cancer.

The Gene Believers

Alzheimer's disease runs in the family for Gayle Averyt. "We called it dementia when I was a kid," he notes in his molasses-soaked southern accent. And wondering whether the disease might strike him was making the retired insurance-company chairman anxious about his future. So three years ago he paid $1,225 for a full genetic assessment offered by the Lenox, Mass., branch of The Canyon Ranch spa empire. What he discovered: He had a genetic marker that indicated he has a higher-than-average risk of developing the disease.

There's no proven way to prevent the onset of Alzheimer's, but that hasn't stopped the Charleston, S.C., resident from trying. Research has suggested a connection between an active lifestyle and lower chances of dementia, so the 74-year-old now practices qi-gong (similar to tai chi) and yoga, and he and his wife have shelled out close to $30,000 on their membership at Canyon Ranch, where they spend several weeks each year hiking and taking aerobics and martial arts classes. He's also added close to 15 supplements to his diet, blazed through "brain fitness" DVD programs designed (but not proven) to keep the mind sharp and enrolled in an experimental program at the University of South Carolina that involves periodic MRI scans of his brain. "I've got a standard 74-year-old memory, and it can get spacey," he chuckles but for now, at least, that's as bad as it gets.

With almost 1,500 genetic tests on the market, more than double the number a decade ago, more people may soon be taking marching orders from a Q-tip cheek swab. There are only a handful of DNA tests that can pinpoint for certain whether someone will develop a particular disease. But the past few years have seen an explosion of discoveries about single-nucleotide polymorphisms, or SNPs (pronounced "snips"), small alterations in people's genes that can make them more likely to develop specific health problems. Researchers have isolated SNPs associated with a whole range of life-shorteners, including obesity, various cancers and a tendency toward high cholesterol. But unlocking someone's genetic code also gives doctors an opportunity to practice "personalized medicine," custom-tailoring therapeutic advice for patients.

Still, many doctors aren't comfortable incorporating SNP-based tests into their practice. A positive SNP result can be the worst kind of bad news, because there's often no proven action that consumers can take to prevent the disease they're at risk for. David Valle, head of the Institute of Genetic Medicine at Johns Hopkins University, notes that scientists continually discover new mutations that sometimes counteract ones currently associated with a given disease. A patient whose genes have been tested can get a false sense of security, Valle says, "only to find out later whoops! we were wrong." There's also a serious medical privacy issue: Although it's happened only rarely so far, patient advocates fear that health insurers could use a patient's genetic tendencies to deny them coverage.

Silicon Valley, however, is forging ahead. Startups like Navigenics, 23andMe and DNA Direct market directly to consumers over the Internet. Mari Baker, president and CEO of Navigenics, says the 17 conditions targeted by her company's $2,500 saliva test which include colon cancer and the digestive condition celiac disease have had their genetic basis confirmed by multiple studies. For a $250 yearly subscription, Navigenics will redo a customer's test profiles as new research emerges.

Seeking Alternatives

The Bright Spot for Health, a sprawling alternative-medicine mecca, is quite the eyesore from the sky, with space-age white domes sprouting from the countryside near Wichita, Kan. Dave O'Malley, a real estate investor from Chicago, knows the sight well: Every summer he and his wife, Sue, fly there in their single-engine turboprop plane for a treatment regimen that sounds like something out of The Twilight Zone. They get a full blood workup that analyzes the nutrient, mineral and toxin levels in their bodies. They sit in La-Z-Boy-style recliners for 45 minutes of vitamin C intravenous drips, followed sometimes by auricular therapy, a process similar to acupuncture that involves stimulating pressure points on the ear. Total bill: more than $2,000 per person.

O'Malley claims it has given him his life back. Some years ago he was stricken by a clanging in the ears that took 70 percent of his hearing away. As his balance deteriorated, Sue was forced to take pictures off the walls of their home he kept knocking them down and O'Malley gave up golf and considered passing along his business to a successor. After trying their luck at Chicago hospitals, the O'Malleys wound up at Bright Spot, and the center's treatments which include coaching people to eat "whole foods" without preservatives made a difference; O'Malley says he recovered most of his hearing. He also takes some of the center's branded supplements at every meal and says the benefits expand well beyond his hearing. At 61 years old, he says, "I feel like I've retained all my mental sharpness."

While only 8 percent of U.S. hospitals offered alternative medicine in 1998, a full 27 percent do today. And the most recent government study found that 36 percent of people tried some form of complementary medicine in 2002 alone. Hospitals' alternative-medicine offerings typically stick to the gold standards practices like meditation, acupuncture and therapeutic massage, which pose no serious threat to health and are sometimes backed by rigorous science. The National Institutes of Health, for instance, has concluded that acupuncture "may be useful as an adjunct treatment" for conditions as wide-ranging as asthma, addiction and tennis elbow. And all these treatments play a role in reducing stress, which in turn is linked to life-threatening conditions like hypertension and diabetes. Erin Knight, a Miami-based private banker, says she has reaped the benefits. Before she started going to Utah's Green Valley Resort and Spa, she felt "chained to a BlackBerry" and had trouble falling asleep. The spa's meditation courses and spiritual hikes changed that. "Now I lie in bed meditating," she says, "and the stress just melts away."

Some of the more spectacular claims in this field deserve serious skepticism. Vitamins and herbal supplements aren't regulated as closely as pharmaceutical products; experts caution that they often contain different ingredients than their labels suggest, including risky additives like mercury and lead. Brent Bauer, head of the integrative medicine division of The Mayo Clinic, recommends watchdog sites like consumerlab.com for safety info. Certainly, forgoing traditional medicine for an alternative-only approach can be risky. At Bright Spot, for instance, some patients have tried to treat tumors with mega-infusions of vitamin C, although Medical Director Ron Hunninghake says the official policy is to use it only as a complement to other care. "Saying vitamin C treats cancer," says Wallace Sampson, a Stanford medical professor who's studied the topic, "makes about as much sense as pointing to the bark of a tree and saying it'll treat Alzheimer's."

The $100,000 Solution

What's it worth to you to live five or 10 years longer? Research shows that some health-related extras have a real impact on longevity. Here, a look at how the costs and benefits of an unscientific sampling of indulgences could add up over a decade. Executive physicals Early detection can boost survival rates for those afflicted with heart disease and many different cancers. Comprehensive executive physicals, with their emphasis on CT scans, MRIs and batteries of blood tests that ordinary doctors don't typically do, boost the odds of catching trouble early. Patients looking for an over-the-top experience can get their yearly workup at the California Health & Longevity Institute, nestled inside a Four Seasons near Thousand Oaks, Calif. Its three-day exam includes extras like a smell test and analysis of how your DNA has aged, and for an additional $2,500, you can stay the night and have your sleep patterns monitored. Checkups every other year for 10 years: $33,500. Yoga retreats Researchers say that many people who live to age 100 are gifted at coping with stress, and one study recently concluded that adults who maintained normal blood pressure into their 50s lived five years longer than those who didn't. That's all reason enough to cultivate your inner om at places like the Como Shambhala Retreat at Parrot Cay, Turks and Caicos, where instructors teach yoga and practice Ayurveda, the ancient Indian medicine, in ocean-breeze-kissed studios. Two weeklong retreats for two: $15,300. A personal (organic) chef Healthy eating and avoidance of Cheesecake Factory-size portions is a foundation of living longer and avoiding problems like heart disease and diabetes. And diners who lack the time to shop for and cook the best foods can hire someone else to do it for them. For example, A Fresh Endeavor, a Boston-based company, will cook you four organic dinners, each feeding four people, for $475 a week, including groceries. Owner Christine Robinson says she's helped many clients lower their cholesterol and compensate for food allergies. To find a service near you, check personalchef.com . One year of healthy cooking: $24,700. A gold-plated physical trainer The Framingham Heart Study showed that regular workouts can add about three and a half years to a person's life. But for many sedentary people, those facts aren't motivation enough they need the drill-sergeant attention of a personal trainer. Shannon Powers, a 38-year-old Los Angeles casting director, works three times a week with Jason Walsh, who has trained movie actors and NFL players. They started out lifting light weights and discussing nutrition; today Powers can run around a track with the beefy Walsh strapped to a harness behind her for resistance, and she's lost almost 60 pounds. Two years of thrice-weekly training sessions at Equinox gym: $26,500.