We all know that mortality is an inevitable part of life. But what if we told you that you have more control over when – and how – you face the end than you might think?
The most common culprits for life-threatening illness are the four modern ‘horsemen of the Apocalypse’: cardiovascular disease, cancers, neurodegenerative diseases (such as Alzheimer’s and Parkinson’s), and Type 2 diabetes.
While medical technology has advanced significantly, life expectancy in Western nations has plateaued and, in some cases, even started to decline. Part of the problem is that we only deal with health problems after they arise (instead of thinking of preventative health). While this can still be effective at prolonging life, it’s often too late and there’s a swift decline, as the damage has already been done.
Much like brushing your teeth daily to prevent cavities and infections, maintaining your health should be a daily commitment. If you wait until you have an abscess and THEN start to brush, you’ve left it too late.
The quest for a fulfilling old age
Our first step is to consider what that ‘extended life’ looks like. We’ve got really good (to a point) at increasing life expectancy, but how does that translate to quality of life? We hear lots of people saying they don’t want to live ‘too long’, because they don’t want to be stuck in a nursing home for ten years, not able to enjoy the years left to them.
What if we redefine what ‘old age’ actually means?
Rather than frailty and illness, getting older can simply be a slightly toned-down version of what you were doing when much younger. Want to keep travelling around the world and climb the odd (big) hill? There’s no reason why you can’t do that.
We want to live a long, fulfilling life and then have a sharp decline to death, rather than enduring a slow, painful decline that robs us of our quality of life for decades. Think of Peter Attia’s Centenarian Olympics – the idea of preparing ourselves now to be fit, healthy and active at 100.
So how do we swap lifespan for ‘healthspan’?
When it comes to ageing well, there are some realities to contend with.
Your VO2 max decreases with age. (VO2 max is the volume of oxygen your body uses while exercising as hard as you can. It’s a common tool to understand your fitness level.) Additionally, strength typically drops by 8-17% per decade.
However we can get stronger at any age – whatever your current state, you can likely still improve.
The key to boosting health at any age? Start with the end in mind, and reverse engineer your results from there.
For example, if you want to be able to pick up your grandkids at age 70, you need to be able to squat and pick up a 12-15kg weight from the floor. Whatever your goals in later life, you can start working towards them today.
So what’s the practical takeaway here?
There’s no ‘secret sauce’ to increase lifespan AND healthspan (sorry!). It all comes down to good old exercise, nutrition, and sleep – with a healthy dose of consistency. Do you need to exercise six times a week and live like a monk? No. But you can’t expect something for nothing, so you’ll need to put in the work and build habits that serve you well for decades to come.
The power of exercise
Studies have shown that VO2max, strength, and muscle mass are better indicators of all-cause mortality than factors like BMI, weight, blood pressure, or waist-to-hip ratio. A significant finding is that going from 0 minutes of exercise per week to 90 minutes can lead to a 14% reduction in all-cause mortality. That’s more effective than ANY DRUG. The benefits of exercise are dose-dependent, so the more you do, the longer your life and health span.
Strive to be ‘below average’
Improving your VO2max can lead to substantial gains in longevity. Taking your VO2max from the lowest 25 percentile to ‘below average’ (25-50%) can result in a 50% reduction in all-cause mortality. Push it further to ‘above average’ (50-75%), and you’ll enjoy a 70% reduction. You’ll live longer, and be fitter while you’re at it.
Building and maintaining strength is beneficial on many levels. The stronger you are, the better your balance – which in turns means fewer falls and injuries.
Resistance training causes the muscles and tendons to apply tension to the bones, which stimulates the bones to produce more bone tissue. As a result, bones become stronger and more dense and the risk of osteopenia, osteoporosis, and fractures decreases.
Multiple studies have identified grip strength (and by proxy, overall body strength) as a prominent indicator of longevity – those with lower grip strength were at an increased risk for premature and all-cause mortality, cardiovascular and respiratory diseases, as well as various forms of cancer.
Finally, more muscle = better metabolic health. The more muscle you have, the more calories your body burns at rest to keep it functioning. This means that you can eat more without gaining weight. And if you do want to lose weight, adding some lean muscle can help speed up your metabolism and make dieting easier because there will be a higher energy demand.
The importance of sleep
Sleep is possibly even more critical to health than exercise, if you don’t get enough.
Not getting enough sleep can increase your risk of developing bowel, prostate or breast cancer later in life. After just one night of four to five hours of sleep, there is a 70% reduction in critical anti-cancer-fighting immune cells.
Having as little as six hours sleep a night can lead to a 200% increased risk of suffering a stroke or fatal heart attack during your lifetime.
In 2007 the World Health Organisation officially classified certain forms of late shift work as “a probable carcinogen” due to the way in which it can disrupt your circadian rhythm.
And every year after daylight saving comes into force, hospitals report a 24% spike in heart-attack visits – a trend that’s reversed in autumn when the clocks go back, giving us an extra hour of pillow time. That’s how fragile and susceptible your body is to even just one hour of lost sleep.
The role of nutrition
While nutrition is important for health and longevity, it’s not as powerful as exercise in terms of reducing all-cause mortality and addressing the risks associated with the ‘four horsemen.’ A balanced diet is the key to success. Consider incorporating:
- Adequate protein: 0.8g-1.6g of protein per kg of lean body weight per day. Ideally some of this would come from animal sources, because plant proteins are generally of lower quality, with a less favourable amino acid profile and reduced bioavailability.
- Lots of fruits and vegetables to provide essential vitamins, fibre; and to support gut health. We recommend 30 different types every week.
- Carbohydrates from grains, beans, and legumes – again, for energy and fibre.
- Moderate amounts of good fat. Remember that not all saturated fats are bad and that eating cholesterol doesn’t equal having high cholesterol levels in the body.
- A focus on natural, unprocessed foods, which are much better for gut health and overall wellbeing than processed or ‘fast’ foods.
- Fermented foods to contribute to gut health – which affects the immune system, brain health, cardiovascular health, dementia/alzheimer’s risk and T2 Diabetes. (And guess what? Exercise promotes good gut bacteria.)
Finally, avoid overeating. Three helpful ‘levers’ for moderating food intake are calorie restriction, dietary restriction (such as a keto or vegan way of eating), or time-restricted eating (like intermittent fasting).
Moderate alcohol consumption
Alcohol consumption should be approached with caution. It can harm your sleep, gut health, and contribute to weight gain. Reducing alcohol intake can help decrease the risk of all four ‘horsemen’.
We have more control over our longevity and quality of life than we might think. By addressing the four modern horsemen through exercise, adequate sleep, a balanced diet, and moderation in alcohol consumption, we can redefine what “old age” means. The goal is not just to live longer but to live better. So, set your sights on the Centenarian Olympics, and start working on your fitness, nutrition, and sleep habits today. Your future self will thank you for it.
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- Cardiovascular Health and Exercise
- Is Your Health and Fitness in Safe Hands?
- Eating Healthily but Not Losing Fat?
- Your Health Bank Account
- East London’s Health and Fitness Initiatives