(orchestral music) The journey to wellness is both a science and an art.

So I like to think of the body as like a musical instrument.

The musical instrument defines the capability of what is possible, what kind of music can be played, and I like to think of the art as being what you play on that instrument.

(instrumental music) - I think aging well means not only the physical part of taking care of your body, but the kind of feeling that you have that you're still interested in life, you still want to learn.

- If you have preventive maintenance in a car, just like preventative maintenance in your health that means you're trying to stay ahead and healthy and prevent other things from happening.

- I thought that while I was under treatment for my cancer that my life was going to be one of nothing but fatigue.

And then I learned that there was something called exercise that could help me.

- Your balance does indeed change.

You do become afraid of falling.

I was!

But I needed to do something about it because I didn't want it to stop my lifestyle.

Dancing for me was that thing.

- If I'm not moving, I hurt more.

If I'm not moving mentally, I'm more sluggish.

- I think it's made me feel better, move better and think better.

(dramatic orchestral music) - So The Anschutz Health and Wellness Center was built with a vision to imagine what healthcare would be like in the future.

Most of our healthcare dollars are being spent treating things that have already happened to people.

We wait for people to get sick, we figure out what's wrong, and then we try to fix them.

Prevention is really not a priority.

There's no business model for it right now.

- What it really is, we have a sick care model.

We really have to redefine the healthcare system so we don't fail, not just seniors, but everybody.

Prevention is the best medicine.

It always will be.

Most people, if you ask them if they know about the YMCA, they will say yes.

We're really an organization that serves from the cradle to the grave and everything in between and all walks of life.

The only true fountain of youth is exercise.

You want to fight like hell to have the best physical life possible in order for you to sustain those things that you love the most.

- How do you design effective programs for individuals who perhaps have some health issues.

How do we help them move better?

How do we help them eat better?

How do we help them change behaviors?

I'm currently at the University of Texas at Austin and my primary focus as a faculty member is to train students how to work with a wide range of people.

Everyone from young, healthy college age students to older adults.

And we have an organization called the Fitness Institute of Texas, where many people from the faculty, the staff, our community here in Austin come and take part in exercise classes and our students get the chance to work both one-on-one with these older adults as well as in small group classes.

The good news is it is never too late to start.

There are all kinds of success stories that I could share with you from people who thought that it was too late for me.

No matter your age, no matter your fitness level, you can start with a small change.

- Studies have shown that the average amount of time that physicians will spend talking about diet and exercise is about 30 seconds.

And that the curriculum in medical school right now has very minimal information.

I see this as a conundrum because doctors in my generation and older, we were taught to treat with pills and it really is a rethinking of the whole healthcare to introduce things that are going to be constructive for the patient, but they're not revenue generating.

Look at the reimbursement for drugs and the cost of hospitalizations and even the salaries of the CEOs and the hospital administrators and the executives.

- When I talked to people at some of the great institutions, they're still focused on chronic disease management.

And that's natural because we, through our lifestyle choices, have gotten a lot of chronic disease, a lot of diabetes, a lot of arthritis, a lot of dementia, et cetera.

And so the primary care providers, which are basically overloaded, haven't quite yet gotten to preventive gerontology, that is slowing the rate of aging, overall as a goal.

They've done studies now, where they take 70 to 80 year olds and literally by doing speed of processing games, they do physical activity, they change the food, and they get younger.

This isn't rocket science.

This is inexpensive.

This is your choices.

And it's really small choices.

This is an old flip phone.

We're now in this stage where it's not just a phone, it's a computer, it's a casino.

It's whatever you want it to be, right?

We're still at the flip phone stage in aging.

We have not moved beyond push buttons.

(gentle music) - One of the big things about changing behavior is you have to focus on what you're gonna do rather than what you're not gonna do.

And a lot of times when people make resolutions, it's often negative resolutions.

I've got to eat less, I've got to stop smoking.

And it's very hard to not do things because the motivational system doesn't learn to not do things.

It's all about action.

And so fundamentally what we have to do is to get people to think about the actions they're gonna perform and how they're going to create energy for those actions.

And exercise doesn't have to be going to the big gym and lifting huge amounts of weight.

It can be going out and taking a walk.

You've got a good comfortable pair of shoes and you step out of your house, you're exercising.

The people who stick with exercise programs are the ones who enjoy the exercise that they're doing.

There's this idea of no pain, no gain.

Maybe that works for 20 year olds, but as we get older, it's not about pain and gain.

It's about doing something that you enjoy that turns out to have a benefit in the long run.

If what you like to do is to listen to audio books, great, pop in some headphones while you're taking a walk.

- We're on a medical campus that has every kind of healthcare you can imagine, and it's fantastic healthcare, but it's largely treating sickness.

The Wellness Center was built to be a learning lab well, how could we bring this future state that we imagined to life today?

So, what we've done is we've brought the three foundational elements of wellness or well-being under one roof, nutrition, physical activity, and mental well-being.

- I am 74 years old and very proud of it.

When I came to this fitness center, the emphasis was not on weight and body, it was on health and making me feel better as a human being.

And that made all the difference in the world.

I changed the way I eat for one thing.

And I am a sweet lover from my heart.

I stick more to grains, chicken, fish, that type of thing.

I have lost about 30 pounds because of that.

And I feel probably better than I have felt in a long time.

I am a woman who did not believe in exercise, never really wanted to do it.

It was too boring.

And once I learned that the exercise took away the fatigue a lot of times and really helped with the fatigue, I was hooked!

I like to come in and do a warm-up on the bicycle.

And then I have 24 different routines that I can go through for the day.

I do things on the mat.

And I work with the machines.

And by the time I finish, and I do a 45 to a 60 minute workout, three times a week, I feel good in mind, body, and spirit.

My goal is be the healthiest that I can be with this body for as long as I have it.

- I had gotten a trainer at the age of 40 at my wife's insistence, and I did that so that I would go to the gym and I would make it a priority since I was paying someone to work out with me.

At age 52 with no health problems, I had a heart attack.

So when I arrived to the emergency room, I had no detectable blood pressure by their monitors.

But I was cognizant.

I remember everything.

And I asked them, well why did I live?

And they said, because you exercised.

(gentle music) It's amazing to me that you can leave the gym after a good workout and feel so much better.

The release of endorphins, the way you feel, even though nothing has changed about the way you look physically, mentally there's something different about it.

It's a way for us to treat all the everyday stressors in work and at home in a positive way without ever taking a medication.

I've encouraged patients to go participate in group activities.

We should be better connected as a healthcare community to think about that as a form of wellbeing and treatment of disease.

(chill music) - [Joyce] I think the balance exercises are very helpful.

The strengthening exercises are good, but she always says listen to your body, try it.

But if it's too much, go down to the next lower weight.

- Not only am I able to increase my tone, but there is a sense of accomplishment in going up in the weight groups or in the numbers of repetitions.

There's a real feeling of accomplishment that way when a new task is done and you can complete it.

- [Joyce] One example of an exercise to improve functionality, you have to carry two kettle balls around the track.

This relates directly to such gardening chores as carrying two very full pails of water out to the plants.

- [Jim] I think it's made us closer in over 50 years of marriage by having an exercise program, that is something that we can do together.

- I can't put a price tag on what it means to me to be able, at my age, to look at my children and my grandchildren and realize that barring any catastrophic illness, perhaps I'll live long enough to see them accomplish who knows what, find their life partner, graduate from college.

It's a real gift.

- The most common question is, what's the best program?

And the good news is, it's the one you'll do.

I could develop an awesome program just for you, but if that program doesn't take into account, how much time are you able to spend on this?

What do you enjoy doing?

What lights you up?

Those programs aren't gonna work.

So when we consider wellness, especially for older adults, I think what we need to think about is am I able to be functional and do the things that I care about and that I want to be able to do, whether that's playing with my grandkids or simply being able to go on a vacation with my spouse and walk everywhere that we wanna be able to walk.

- We wanna ask them open ended questions and find out what they want and then we'll help them build that roadmap to get there.

But the most important thing that we can do for people, it's not teaching them how to exercise, but invite them into a community of exercisers.

- You know, a lot of people, they look in the mirror and they figure, I gotta exercise because I want to lose weight.

And you wanna exercise to keep your body fit, but you're not going to lose weight by exercising because you don't burn enough calories just from exercise to lose weight.

You've gotta control the input side of things And one of the things I did was to start tracking my calories, and was stunned to discover that I was often eating over 3,000 calories a day, which is a lot of food.

Just one sugary drink, one helping of potato chips, that extra little bit, that's what adds up over time.

- I have focused on, a higher fiber, low carbohydrate type breakfast.

I will have berries as fruit, I have some nuts, and I've really considerably decreased consumption of meat.

The hardest part is trying to reduce stress.

In our society today, stress plays a major role in our illness.

It's just ill-defined.

It's hard to put any kind of information or studies or data to say that stress does one specific thing.

But I have no doubt that stress played a role in my disease.

(gentle music) - My name is Ed Meyers.

I'm 89 years old.

I swim three days a week when I'm not teaching.

I work out here three days a week.

I try to eat sensibly.

And I've been really blessed with a good health, but I've worked at it.

- The best day to plant a tree is 20 years ago and the second best time to plant a tree is tomorrow.

And I think we wanna live the same way.

You know, yeah, it would have been great if we'd been exercising regularly our whole lives, but even if we haven't, you know, today or tomorrow is just as good a time to start.

- [John] People might think that there's nothing I can do now.

It's too late.

But the studies have shown that, literally, the first few steps you take off the couch have the biggest impact on reducing your risk of premature death and other bad things.

So, it really isn't ever too late to start, and I think the benefits are immediate.

People talk about mental clarity.

Suddenly, they're thinking more clearly.

- Real age is the actual age of your body as opposed to your calendar age.

And so your real age is your risk of dying or disability.

So what we did was we fixed everyone's age of death to the national average, 81 for women, 78 for men, and then showed how they would vary based on their health choices and habits.

And you get to change those.

You get to slow or speed your rate of aging, hopefully, slow it so that you get to live longer, healthier.

- As you get older, physical activity has as much power in improving your brain function as it does your muscle function.

Once someone has been a committed exerciser for a period of time, rarely do they stop because they see all of those incredible benefits of long-term physical activity.

The challenge is for that person who has been sedentary and really is attempting to overcome inertia.

And what we're trying to get people to do is to move more, and perhaps eat less, but primarily to simply move their bodies more.

- I have a bad family history of heart disease.

My parents both died by the age of 60.

And so I had a heart scan that was not good and I thought, okay, I need to do more.

So on Monday, Wednesdays, and Fridays I do Get Fit in the morning and then I at noon I go over and play racquetball.

I was really scared when I first started because I had never done weights of any kind.

I didn't think I would be very good.

There's one person that I almost always pair up with and it's a woman that is like the same age as my daughter and we're always, you know, kind of keeping each other going and it's socially fun.

It wasn't as scary as I thought.

- So food is the second most important thing.

Basically the message is Mediterranean, which is if you got mostly vegetables on your plate and you can saute them in olive oil, and a few fish, wild salmon and ocean trout, and nuts and seeds.

You wanna eat things you love the taste of, but that love you back.

So you wouldn't marry someone who was trying to kill you every day.

Even if you love french fries, if they're trying to kill you, bad relationship.

Illness care is expensive and to keep people healthy, not needing illness care is the goal because they get to thrive, they get to live longer, they get to be productive longer.

The medical model, if all we're doing is illness care, is wrong.

We wanna get people so they don't need care.

You are a genetic engineer.

You may have never seen a gene, but by your lifestyle choices, you change which of your genes are on or not.

So you may not know that walking 10,000 steps a day or managing stress by doing deep breathing is changing the proteins in your body.

But it is, and that is how you're a genetic engineer that changes your family history.

- Nobody on their death bed ever said, "I wish I made that extra buck."

What they will say is that "I wish I could have hugged that person one more time.

"I wish I could have climbed that mountain "and looked at that horizon just one more time."

You get to do that longer and longer the more connected you are to a healthy It's absolutely evidence-based.

You're gonna get happier.

You're gonna feel better about yourself.

You're gonna be more productive.

Now the art form, that's a whole different story.

That picture you want to paint of what your life's going to be, you will be able to do that because you have your health.

(gentle orchestral music) - [Jim] Life is a wonderful gift, and so it's important to maintain your health and wellness.

That's really your only asset is your health.

- [Sylvia] I did not know that I could take charge of my life and not have the doctors or the medication be the ones in charge, I am the one in charge.

- In the senior program, what we try to promote, number one is activity.

Activity also involves the mind.

It involves the body.

It involves projecting who are you at this time in your life.

- Science tells us the value of having a specific set of actions, which is a crucial part of actually carrying out a plan.

And of course, science tells us a lot about healthy eating and about the kinds of exercise that are probably best for us as we age.

The thing is, what really keeps us feeling alive is the meaning that we provide for our life.

That's not about science, that is about the art of living.

It's not just about being healthy, it's about being alive.

Whether it's hanging out with family, friends, grandchildren, whether it's creating your own artwork or music, whether it's enjoying the cultural arts that are around you, that's as much a part of aging well as having a healthy body.

- When people become sedentary and inertia takes over, it's not just their physical bodies that stop moving.

Their brains stop moving, their internal organs stop moving.

We are integrated beings and we have a body, we have a spirit, we have a mind, and all of those parts are meant to work together and when one is affected negatively or positively, it's going to influence the others.

The science of aging has been around for a number of years and we have learned many, many lessons.

The art of aging well is the beauty of your own original expression of that.

And I think for most people, there's that balance between what we know and then the beauty of the expression of what we know that is most fully expressed through you as an individual.

That willingness to be challenged by new things and say, "there is so much in that big old world out there "that's left to learn and experience.

"And simply because I'm getting older "doesn't mean that I don't get to continue to do that."

- I'm really pleased with the changes I'm seeing.

Prevention has started to become something that patients are interested in, they're demanding.

Information is being disseminated that's forcing physicians to talk about it because patients are aware of it.

Patients are seeking that, looking for alternatives to traditional care and the introduction of diet and exercise falls right into that.

And there's nothing more rewarding than having a patient come back to the office and say, "I don't need a hip replacement now because I don't hurt."

- The strategic leadership for the Cleveland Clinic expects by sometime around 2022 that someplace over 50% of people will be in a value-based system rather than in a volume-based system.

Going from volume, where I get paid for the number of people I see or the number of hips or knees I replace, to getting paid for value, keeping you well and not needing care.

So that's the switch from volume to value that medicine is undergoing.

I don't know if it's going to be as fast as we expect, but when you do, then my getting you to live longer, healthier is going to be what's paid most.

And that's also what saves the system most money.

It's also what allows us to spend money on education and re-education and to keeping people healthy.

- Everybody is unique.

Everybody has a little bit different song.

Nuanced in a different way.

So when you think about it that way, it really opens up a whole panorama of possibilities.

So it's not just about eating right, exercising more, taking care of your mind, it's about well, what do you do with that?

And I think the art, it's a blank canvas.

- I'm 86.

My discs were deteriorating.

All they did was gave me pills and shots, pills and shots, kept me worse, knocked out.

My son said, "Mom, see what they can do for you, "in the pool, exercises or something."

I got in the water.

And I start moving my legs, like walking, back and forth, back and forth.

I did 30 minutes.

The next day, I did 40 minutes.

And I felt so good that I kept coming and kept coming because I didn't need any more doctors.

I didn't need no more pain pills.

I didn't need no more shots.

Like a miracle.

I come four days, and then Fridays I clean house, Saturday I go to the beauty shop and I do my nails and all that.

At 86.

(chill music)