Dr Saheb Sahu, FAAP, MPH.
“Nothing surpasses regular exercise for promotion of healthy aging. It is the single most effective medical intervention”. Dr Eric Topol, Director, Scripp Research Institute, San Diego
Lifespan vs. Healthspan
Lifespan is the total length of time an individual lives, from birth to death. It measures quantity of life. Healthspan is the period of life during which a person remains healthy, functional, and free from serious disease or disability. It measures the quality of life.
Modern medicine has greatly extended lifespan, but many people spend their final years with chronic diseases and disability. By December 2023, the lifespan in USA was 79 years, but the healthspan was 66 years, a difference of 13 years (cdc.gov).
In this article I will describe how you will increase your healthspan.
How long will you live?
What researchers are discovering is that your genes interact with several other factors that influence your life and health. Your lifestyle and environment in which you live are more influential in determining your lifespan.
Genetics: Research suggests that only about 15% to 25% of your aging is dependent on your genes.
Lifestyle: Unhealthy habits-a poor diet, inactivity, obesity, high level of stress, smoking, alcohol use and lack of social support, lack of timely healthcare, generally results in poorer health and premature death.
Environment: Exposure to air pollution, chemicals and toxins can reduce your lifespan.
Life circumstances: Lack of social support, socioeconomic status and educational levels can influence your longevity.
Sex: In every country in the world, there is a general observation that female outlive male.
How to increase healthspan?
A- Regular exercise
Nothing surpasses regular exercise for promotion of healthy aging, says Dr Topol. Many of our bodily functions start to decline at a rate of about 1% to 2% a year after the age of 30. This is an undeniable fact of the aging process. But with exercise, we can slow this rate to about half a percent a year.
Good old-fashioned sweat-inducing exercise (fast walking, running, bicycling, and swimming, playing sports or other physical activities) is probably the single most important thing you can do to live better and longer.
How much exercise? – Most healthy adults need at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week or combination of both. It is also important to add muscle strengthening exercises at least twice a week.
Any amount of exercise is better than none. You are never too old, or too young, or too busy to exercise. Older adults should do muscle strengthening exercises to combat the problems of bone thinning (osteoporosis) and age-related loss of muscle mass (sarcopenia). For older adults balance training (Tai chi, standing on one foot, heel-to-toe walk) is also important to reduce the chances of fall.
B-Healthy eating
Diet is the top risk factor for disease and early death. Heart disease is the No 1 killer in the world, close behind is cancer. At least a dozen of cancers are linked to obesity. A poor diet increases the risk of diabetes, which is quite common around the world. Diabetes leads to heart disease, high blood pressure, and stroke and kidney failure.
Key components of an ideal diet are:
. Whole grains – brown rice, whole wheat, millet. Oats, quinoa
. Wide variety of fruits and vegetables of multiple colors
. Healthy fat – olive oil, minimally processed vegetable oils, nuts and seeds. Avoid trans fats,
. Dairy products – low fat milk, yogurt, kefir
.Hydration- mostly water. Limit sugary drinks.
. Do not smoke, don’t drink alcohol. No amount of alcohol is good for health and well being (not even red wine).
Keep in mind that healthy eating is much more than what you eat and how much you eat. It is also about how you eat, whom you eat with and how fast and slow you eat. Eating healthy doesn’t have to be drudgery. It can, and should be an enjoyable experience. The key is moderation.
C- Good night’s sleep – (7-9 hours)
A good night’s sleep is one of the pillars of good health. It plays a direct role in physical, mental and emotional well-being.
. Sleep helps to regulate blood pressure, heart rate and reduces risk of heart disease and stroke.
. Deep sleep supports tissue repair, muscle-recovery and growth hormone release.
. Sleep consolidates memories, and improves problem solving. Poor sleep is strongly linked to irritability, anxiety and depression.
. A good night’s sleep boosts energy and productivity. It lowers the risk of falls especially in older adults.
For most adults, 7-9 hours of quality sleep per night is ideal. There is no good data supporting popular fixes such as melatonin, magnesium, or beds that modulate temperature.
D- Social relationship
Multiple long-term studies have shown that people with good social – support; strong relationship with family, friends and partners; not only enjoy better health but live longer. The Harvard Study of Adults Development (it includes the Grant Study), one of the longest running study in the world, was started in 1938 and is still continuing. The clearest message of this study is that strong social connections with families, friends, and community are among the most important factors for happiness and health.
E- Vaccinations and Health screening
As you get older, your need for seeing your doctor will be more frequent. Your doctor will advise you what kind of vaccinations and blood tests and other screening tests you will need. Visit him at least once a year even if you feel healthy.
Vaccinations: Most vaccinations are given in childhood. But there are some recommended for adults. They are: Covid-19, Influenza, Hepatitis A, Hepatitis B, Herpes zoster (shingles), Pneumonia, Tetanus and Diphtheria. Some countries have started vaccinations for malaria and vaccination for HIV-Aids.
Screening tests for people over 50
. Hearing test
. Vision test
. Blood pressure
.Dental checkup at least once a year
. Diabetic screening- Blood sugar or A1 c
. Mammogram for breast cancer
. Pap smear for cervical cancer
. Blood cholesterol
.PSA test for prostate cancer
.Colon cancer screening- Colonoscopy, Cologuard (stool DNA), blood in the stool.
Depending on your health history, your physician may order other screening tests like- Stress test, ECG, CT scan, MRI and many other tests.
Fall risk assessment- Older adults are at much higher risk of falling and breaking their bones. I in 4 adults over the age 65 will fall. Some of the causes of fall are; hearing impairment, vision impairment, loss of muscle mass and lack of balance and coordination. The best fall prevention measure are muscle strengthening and balance exercises.
Summary
As pointed out by Dr Topol, regular exercise (aerobic, muscle strengthening and flexibility) is the single most proven way to extend your healthspan. Exercise reduces the risk of heart disease, diabetes, cancer, dementia and fall. You need to eat nutritious diet-mostly whole grains, lots of fruits and vegetables of multiple colors, fish, lean meat, legumes and beans. The diet should be low in sugar and ultra- processed foods. You should try to get 7-9 hours of quality sleep per night. Strong social-relationships promote longer, healthier and happier life. As you get older, see your family physician at least once a year and get the necessary vaccinations and screening tests done. Early detection of many diseases will lead to better treatments and better outcome. Longevity research suggests that slowing biological aging is possible, but we are not there yet. Life-style changes remain the most proven approach for now. Most important life-style change you can make is to start exercising.
Sources
1-Eric Topol. Super Agers. Simon and Schuster, New York; 2025.
2- Mayo Clinic on Healthy Aging. Mayo Clinic Press, Rochester, 2024
