Healthy Aging, also known as longevity, focuses on interventions that can increase both the years of your life as well as the quality of those years. However, with all of the articles, supplements, and influencers promoting longevity, it can be difficult to try and sort through the noise in order to figure out what actually works. In this article, I will keep it simple and list the longevity techniques that are backed by science and that actually work.
As a primary care physician with a background in sports medicine my focus is on preventive care. I often see patients who ask me about new supplements, diets, or lifestyle interventions that might help them live longer. While some of this information may be helpful, many times these interventions can be experimental, unhelpful, or at worst dangerous.
Here is what has actually been shown to increase both years of life and quality of life and what does not work.
What can help
Exercise Optimization
The amount of years that you live is strongly associated with the amount of muscle mass that you have. Several studies have shown that people who live longer have a higher average muscle mass and strength.1,2,3 What this means for you is that you should try to optimize your exercise routine by focusing on resistance training. Pushing or pulling weight, whether it’s your own body weight, resistance bands, or solid weight, will help you live longer. It can also provide benefits to your overall quality of life by improving mobility, joint health, and functional independence.
Sleep Optimization
Research shows that those who live the longest sleep on average 7-8 hours per night.4,5 People who sleep less than 6 or more than 9 hours seem to have a higher mortality.4,18 The quality of your sleep is also just as important as the total amount of hours. Deep sleep with quality REM episodes helps promote cellular repair, memory formation, decreases stress hormone response, and improves cardiovascular health. Once the lights are out, your focus should be on optimizing your sleep quality. Spend the extra time on setting a calm and relaxing environment prior to falling asleep. If you can afford it, it may also be worth spending the extra money on things like a quality mattress, black out curtains, eye masks etc.
Metabolic Optimization
Optimizing your metabolic health means ensuring that certain metabolic laboratory values are in normal range. There is no single lab panel that defines your metabolic health. However, the United States Preventative Task Force (USPSTF) and World Health Organization (WHO) recommend routine screening tests that can help identify cardiometabolic risk.6,7,8 These commonly include measurement of blood glucose, lipids, liver function, kidney function, and blood counts. In fact, those who are normal weight and are metabolically unhealthy have been shown to have a higher mortality than those who are overweight but are metabolically healthy.9,10 In short, get your labs checked at least yearly or more frequently based on your discussions with your primary care doctor. Follow their advice on ways you can improve and optimize these important metabolic markers.
Mental Health Optimization
Nothing may be more important than optimizing your mental health. Feeling mentally balanced and maintaining healthy relationships with the people around you goes a long way towards helping you live longer. Your mental health sets the foundation for you to be able to focus on exercising, sleeping right, and taking care of your overall metabolic health. Studies show that people with emotional well being have a 12-20% lower risk of all cause mortality.11 Emotional stability can lead to a longer, happier life. If you’re dealing with a mental health disorder or just feeling emotionally unwell, seek professional help from your doctor or a mental health counselor. Even if you’re not dealing with mental health challenges, incorporating activities that can improve your mental health such as fostering healthy relationships, medication, yoga, or prayer can go a long way towards helping you live a longer, happier life.
What doesn’t work
“Antiaging” supplements
There are a range of supplements and products out there promoting longevity and long term health benefits. They can include such things as vitamins, minerals, compounds, and devices that have some or limited research showing how they might help you live longer. While some of these supplements might have some benefit, most supplements seem to be marginal at best and dangerous at worst.Metanalysis reviews of supplements, vitamins, and longevity formulations often show no reduction in mortality and in some cases there may be an increased risk of mortality.12,13 In fact most studies on these products lack high quality human trials that show clear benefit. Like with any supplement or product, ask your doctor before taking any supplements and be cautious of any product that promotes longevity.
“Antiaging” hormones
Hormones may improve the symptoms and signs of aging, like low libido and low energy, but evidence does not show that hormone supplementation helps you live longer.14,15 Supplementing with hormones won’t help you reverse the physiology of aging. However, optimizing such things as exercise, sleep, and a proper diet are among the best ways to support hormone regulation. If you do have to supplement with hormones, make sure that this is being done under the supervision of a qualified physician. Raising hormone levels above physiologic ranges may actually increase your mortality by increasing your risk of such things as heart disease and cancer.
Restrictive diets
Use of highly restrictive diets such as extremely low carbohydrate or protein only diets have not been shown to increase your lifespan. Certain restrictive diets can result in an increase in inflammation and stress hormones which is actually associated with aging.16,17 In addition to this, dietary patterns that restrict foods can result in deficiencies in such things as fiber and micronutrients which can result in abnormal gut health and immune function. Both of these are important in preventing the signs of aging. Avoid overly restrictive diets and focus on eating a well rounded diet with appropriate nutritional adequacy.
Stem Cells
I am seeing an increase in patients who tell me that they are looking into or have tried stem cell therapy for help with everything from chronic inflammation to reversing the signs of aging. No large clinical trials show that stem cells increase lifespan, reduce mortality, or slow aging in humans. At best, stem cells can precipitate a signaling effect that may reduce inflammation. However many of these effects have been shown in mostly orthopedic studies. Stem Cell treatments marketed to reverse aging or promote longevity are not approved by the FDA and can potentially be harmful. Risks include infection, immune reaction, or ectopic tissue growth. While stem cells may be a viable option to reduce inflammation as well as the treatment of certain cancers and immune disorders, they are not suitable for increasing lifespan at this time.
Bottom Line:
Focusing on interventions and lifestyle changes that will help you live a better quality of life is much more important than products, supplements, or interventions that will increase the years of your life. Healthy aging and longevity isn’t about just living longer but also about remaining functional. While there may be some benefit to longevity supplements and interventions, that benefit is likely marginal at best and harmful at worst. Always consult with your doctor before trying any interventions marketed for antiaging or longevity.
Sources
Basaria S, Coviello AD, Travison TG, et al. Adverse events associated with testosterone administration. New England Journal of Medicine. 2010;363(2):109–122.
Ruiz JR, Sui X, Lobelo F, et al. Association between muscular strength and mortality in men: a prospective cohort study. BMJ. 2008;337:a439.
Srikanthan P, Karlamangla AS. Muscle mass index as a predictor of longevity in older adults. American Journal of Medicine. 2014;127(6):547–553.
Leong DP, Teo KK, Rangarajan S, et al. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. The Lancet. 2015;386(9990):266–273.
Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep. 2010;33(5):585–592.
Kripke DF, Garfinkel L, Wingard DL, Klauber MR, Marler MR. Mortality associated with sleep duration and insomnia. Archives of General Psychiatry. 2002;59(2):131–136.
U.S. Preventive Services Task Force. Screening for prediabetes and type 2 diabetes. JAMA. 2021;326(8):736–743.
U.S. Preventive Services Task Force. Statin use for the primary prevention of cardiovascular disease in adults. JAMA. 2022;328(8):746–753.
World Health Organization. Prevention of cardiovascular disease: guidelines for assessment and management of cardiovascular risk. World Health Organization; 2007.
Kramer CK, Zinman B, Retnakaran R. Are metabolically healthy overweight and obesity benign conditions? A systematic review and meta-analysis. Annals of Internal Medicine. 2013;159(11):758–769.
Caleyachetty R, Thomas GN, Toulis KA, et al. Metabolically healthy obesity and the risk of cardiovascular disease and mortality: a population-based cohort study. European Heart Journal. 2017;38(9):651–659.
Chida Y, Steptoe A. Positive psychological well-being and mortality: a quantitative review of prospective observational studies. BMJ. 2008;337:a225.
Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases: systematic review and meta-analysis. JAMA. 2007;297(8):842–857.
Fortmann SP, Burda BU, Senger CA, Lin JS, Whitlock EP. Vitamin and mineral supplements in the primary prevention of cardiovascular disease and cancer: an updated systematic evidence review for the U.S. Preventive Services Task Force. Annals of Internal Medicine. 2013;159(12):824–834.
