In retirement, 83-year-old former school principal Barksdale Macbeth has become a model student of the simple but effective principles of a healthy lifestyle - good fuel and regular

movement.

"I exercise to try to control my blood pressure, and I eat mainly fruits and vegetables, chicken and fish - no red meat," Macbeth said during a recent visit to the Groton Senior Center, where he makes use of the fitness room, wellness clinics and other services. "I did the treadmill this morning."

He had just concluded a blood pressure check with Deb Lorick, wellness nurse with the Visiting Nurse Association of Southeastern Connecticut. Lorick runs wellness clinics at six senior centers and housing complexes in the region, catching skin cancers and symptoms of mini-strokes and offering health advice and motivation. Macbeth is one of her

regulars.

"I wouldn't miss this service," he said.

By having a relationship with a health care provider, Macbeth is following the third principle local health care providers say is essential to living as well as possible in the second half of life. For too many people, said William Kober, primary care doctor at Lawrence & Memorial Physicians Stonington, the sum of their medical care is a yearly visit with a specialist for one specific condition and trips to a walk-in clinic for treatment of an infection or injury, an approach he calls "piecemeal." Especially as people age, getting routine primary care with a trusted provider who looks at the whole person is essential, he said.

"The 20-year span from 50 to 70 is the critical period when serious diseases can manifest themselves," said Kober. "Don't ignore your body and don't try to diagnose yourself on the Internet. It's confusing. If there are any symptoms that are out of the ordinary, don't put off a visit to the doctor."

He offers this basic message to his patients: "Aging is not preventable, but becoming frail and suffering from serious illnesses and diseases can be."

By quitting smoking, getting regular exercise, eating right and getting regular medical care, older people can achieve three significant goals. And you're never too young or too old to start.

"They'll enhance their quality of life, promote longevity and preserve their independence," Kober said. "I try to give people the sense that they can take command of their health. I give them a healthy dose of empowerment."

Not only are those three principles the foundation of overall wellness as people age, but people also can reduce their risk of the big three - heart attacks, stroke and cancer - and improve their chances of survival if they do get one. These three conditions account for more than half of all deaths in New London County, according to Russell Melmed, epidemiologist with the Ledge Light Health District.

The agency, which provides public health services for New London, Groton, Ledyard, Waterford and East Lyme, was recently awarded a federal grant to reduce rates of the most prevalent diseases in the five-town region, and addressing the needs of seniors for better nutrition, more opportunities for exercise and regular health care is a key goal of the project, said Cindy Barry, senior health program

coordinator.

"Only 46 percent of people with high blood pressure have it under control," she said.

Cancer, said Dr. Stephen Lattanzi, oncologist at the New London Cancer Center in Waterford, has become one of the leading causes of death in recent decades as other vaccines and antibiotics have eliminated or reduced the potency of other diseases.

"Cancer is mainly a disease of aging," he said. "But 50 to 75 percent of serious cancers are potentially preventable."

The main ways to reduce cancer risk are quitting smoking, avoiding severe sun exposure, getting regular screenings for colon cancer and eating healthy, Lattanzi said. Other routine screenings are equally important - annual mammograms for women over 50, annual PSA (prostate-specific antigen) tests for men over 40, for example. When detected early, most cancers, he emphasized, can be treated and cured.

"It's never too late for prevention and screening," he said. "You should never stop based only on your age."

Cardiologist John Foley of Norwich, president of the Connecticut State Medical Society and medical director of the Congestive Heart Failure & Wellness Program at The William W. Backus Hospital, has witnessed first hand what can happen when people take control of their health and change their lifestyle. He recalled a recent patient who had high cholesterol and wasn't exercising and ended up with heart disease in his early 40s. Surgery to have a stent open a blockage in one of his arteries proved to be the wake-up call the man needed.

"Fear is the most effective motivation," Foley said. "People are afraid they're going to die, and they want to see their children and their grandchildren grow up."

The young man started exercising regularly, maintained a low-fat diet rich in complex carbohydrates, chicken, fish and fresh fruits and vegetables and started taking two statin medications to lower cholesterol. He has done so well, Foley said, that he was recently able to cut back to just one statin.

"He is so proud of himself," Foley said.

Of the region's leading killers, heart attacks, stroke and other cardiovascular diseases surpass all cancers, accounting for 32 percent of all deaths compared to 24 percent for cancer, according to Melmed of Ledge Light Health District. While some of a person's risk of getting heart disease is dictated by genetics, "you have control over at least half," said Mark Somers, cardiologist at L&M Physicians cardiology group in Waterford, and himself a heart attack survivor.

The single most effective way to cut both cancer and heart disease risk is to quit smoking, Dr. Somers said. After that, healthy eating, including avoiding most processed foods, which tend to be high in unhealthy fats and salt, and exercise are key. Complaining about being too tired or too busy for exercise is no excuse. It's as important as eating.

"You've got to make it a priority," Somers said. "We all find time for dinner. Make it part of your daily routine. You've got to keep in tune with what your body can do."

He recommends at least a half hour of physical activity four times a week, "but even 10 minutes is better than zero."

Beverly Helmick of Groton, 69, started her exercise routine two years ago. At the fitness center at the Groton Senior Center, she rides the stationary bicycles, works her upper body on the rowing machines and brings her heart rate up on one of the five treadmills.

"It makes me feel better," she said, pausing for a sip from her water bottle while on the treadmill. "I started this because I was tired all the time, and just didn't feel good. You've got to keep

active."

More than 300 residents are regular users of the fitness room, and a couple hundred more participate in classes ranging from Zumba Gold to tai chi to Cardio Fit and line dancing, said Connie Steffes, certified personal trainer and fitness instructor at the center.

"The demand has really grown," she said. "A lot of the people in these classes are more fit than a lot of younger people."

The benefits of regular exercise were reaffirmed in a study released in May. The Copenhagen City Heart Study, which began following 20,000 adults from ages 20 to 93 in 1976, concluded that moderate regular jogging increased life expectancy of men by 6.2 years and women by 5.6 years. The optimum benefits went to those who jogged at a slow-to-average pace for one to 2 ½ hours per week.

Mary Ann Nash, nutrition program coordinator at L&M, prefers to emphasize "having a lifestyle that's active" - that includes deliberate exercise of 30 minutes every day - but also daily, purposeful activities.

"Try to think of the things you do every day that could be movement," Nash said. She suggested activities such as pushing a lawn mower, walking the dog, washing dishes by hand instead of using the dishwasher and shrugging shoulders and tightening buttocks muscles while

driving.

In the popular "Healthier, Happier You" classes she teaches at the hospital, students learn the basics of healthy cooking and eating - whole grains, lots of fruits and vegetables, using olive, canola and peanut oils for cooking - and the difference between good fats and bad fats. Essentially, said Nash, the class promotes what's popularly known as the Mediterranean diet, but supplemented with advice about how to modify it for personal taste.

For someone who grew up eating collard greens cooked in bacon fat, she'll recommend keeping the highly nutritious greens, but instead using olive oil and some seasoning. For someone raised on beans and white rice, she'll advise keeping the beans - which are "phenomenal" heart disease fighters - but serving them over a mixture of half white and half brown rice if the person isn't ready to give up white rice altogether.

"No matter how old you are," she said, "even small changes can make an impact on every aspect of health."

One of the surest ways to reduce risk of heart disease and cancer, Nash said, is to get to a healthy weight. Being overweight, particularly around the midsection, brings on a host of problems, increasing stress on joints, the heart and metabolism. For women, the optimum waste circumference is 32 to 35 inches, and for men, it's 37 to 40 inches, Nash said.

If more Americans were within those ranges, she said, "all three of your big diseases would drop."

Thomas Manning of Mystic needs no convincing. Now 67, he lost about 20 pounds since retiring from his job as an engineer at Electric Boat, and said he feels better than he did when he was heavier.

"Having all that extra weight exacerbates the aging process," he said.

For exercise, he plays golf regularly, pushing his gear instead of riding in a cart, and decided against hiring someone to mow his lawn so he could get the benefit of doing it himself. A patient of Kober, Manning keeps his high blood pressure under control with medication and a healthy diet, something he and his wife have become more conscious of thanks to their daughter and two-year-old grandson.

"There are things people can do to make their lives more productive as they age, and not become a burden, and diet is critical," he said. "We are in control, really."