How today's choices define tomorrow's health

This post was written by Rebecca Minser, MD, PPG - Integrative Medicine.

Longevity is currently all the rage. You can't listen to a podcast, scroll the internet or log on to Instagram or Facebook without seeing an advertisement for something related to life extension. We hear about it from very high-profile individuals like billionaire Bryan Johnson, who is currently spending $2 million per year (and every moment of his life) on his "Blueprint Protocol," to the hundreds of everyday social media influencers touting the perfect workout and ideal nutrition plan. But what is longevity, and how does one attain it?

In this post, we aim to provide clarity around the meaning of this buzzword, review what the science currently tells us and help you figure out what longevity might look like for you.

Longevity vs. healthspan

Merriam-Webster defines longevity simply as "a long duration of individual life." Is that what people actually mean when they talk about it today? Or does it now imply a longer, healthy life?

Because there is a clear difference between simply living longer and living both longer and healthier, many experts have shifted to using the term "healthspan" to refer to the number of years you spend in good health. This distinction is important, as it is already quite possible to live many years past the point of being healthy.

To understand where you fall in your own "healthspan," you have to consider what you define as healthy and when that state begins to change. Does it look like:

• Spending long hours in the garden without feeling sore and stiff the next day?

• Having the energy to keep up with your grandkids as long as possible?

• Climbing Mount Everest?

And at what point does it cease? Is it when you:

• Develop high blood pressure and need medication to manage it?

• Break a leg and can no longer ski?

• Can no longer care for yourself or perform daily tasks like cooking and bathing?

There are many definitions of being healthy, depending on your own personal views and experiences. Only you know for certain.
 

What the science says

Now that you have a clear idea of what you consider healthy and what your personal goals are, the next step is to figure out how to achieve them. Everyone wants to know what is helpful for improving how long and how well one can live.

Cruising around the internet, you will find endless options for diets, exercise plans, supplements and medications, specialty clinics, treatments and more, all with many assurances and testimonials (and very good marketing) proclaiming that their product is the thing to help you achieve your goals, regardless of what they are. Some even claim "scientific proof" that their treatment works. However, currently, there is virtually no evidence in humans that any of these interventions live up to their extraordinary claims.

Two primary drugs frequently discussed in relation to longevity are rapamycin and metformin. The initial excitement about metformin as a longevity drug has waned somewhat. There are multiple problems with the original study, which showed improved longevity in people with diabetes treated with the drug. Follow-up studies have not been able to reproduce the same results. A more recent investigation involving monkeys has re-ignited the excitement around metformin, but it also has flaws. The Targeting Aging with Metformin (TAME) trial has been approved, though not fully funded. While it may eventually offer more straightforward answers, for now, there is no evidence that metformin in people without diabetes is helpful for longevity.

Rapamycin, on the other hand, has shown some promise. Originally explored as an antifungal, it was developed as an immunosuppressant. The drug has numerous biological effects, and some data indicates it may slow aging. However, most of these studies do not include humans. Though research is ongoing on this drug and its potential anti-aging benefits, it remains unapproved for longevity use.
 

The four pillars of health

So, where does that leave us for ways to improve our lifespan and healthspan? Despite living in a fast-paced instant-gratification culture, currently, there is simply no shortcut or alternative to taking good care of yourself to improve both the length and quality of your life.

Reputable data on life-extending drugs may be scarce to non-existent. Still, decades of scientific data are absolutely clear on one thing: metabolic disease, inflammation, loss of blood sugar control and weight gain are the foundational drivers of chronic disease.

From a lifestyle medicine perspective, the most evidence-backed strategy for improving both the length and quality of your life lies in what we call the four pillars of health: sleep, movement, stress management and nutrition.

Here's a breakdown of each and why they matter:

Sleep is critical for good health, and chronic sleep deprivation is a significant issue in our culture. It is estimated that night-shift workers, after at least 5 years of exposure, have increased all-cause mortality by about 15%. Insufficient sleep can also lead to:

• Increased inflammation  

• Worsened metabolic health (insulin resistance, weight gain and high blood pressure)

• Impaired memory and heightened risk of cognitive decline

• Increased depression and anxiety

Protecting your sleep time is a good way to start improving your health right now. Replace that hour of scrolling social media to unwind before bed with a calming activity that supports quality rest. Or spend it going to bed and getting to sleep. Whatever has your attention will still be there in the morning. Your brain and your body will thank you for it.

Movement is another casualty of our current cultural lifestyle. By and large, most of us no longer work in jobs that require us to be physically active. If you've heard the phrase, "Sitting is the new smoking," that is no joke. Everyone knows that doing aerobic exercise helps the heart, but that is just one improvement. A few of the many benefits of increased movement and strength training include:

• Decreased risk of cognitive decline (dementia) by 15-20%.

• Improved bone health and reduced chance of fractures, a large risk for morbidity and mortality as we age.

• Helps manage stress, and improves mood as well

Experts recommend 150 minutes per week of moderate exercise, divided between aerobic and strength training. Moderate means you have enough breath to speak 3-4 words at a time but not enough to carry a full conversation. Otherwise, do something you enjoy and start slowly if you are new or returning to exercise. Before you know it, you will notice increased energy, better mood and better sleep.  

Stress is another issue for virtually everyone. Many of us are living under constant stress, in a never-ending "fight or flight" state. This can negatively impact sleep, mood, blood pressure and weight due to chronic hormone changes that are needed to cope with the load. Finding ways to deal with stress is critical and very individual to each of us. What you find relaxing and the thing that helps you cope may not work for your friend or neighbor. That said, some practical strategies that are known to help stress levels in everyone include:

• Regular exercise

• Meditation, spiritual or prayer practices

• Mindfulness-based stress reduction (MBSR)

• Strong social connections

• Sleep

Digital tools like the Calm app and Headspace can also be a great resource if you're looking for structure or guided practice.  

Nutrition is the last of the four pillars and can be a complex element to navigate due to the overwhelming mix of information and misinformation available online. Fad and extreme diets are everywhere, and many of us have tried at least one. These trendy eating styles involve some form of nutrient restriction, whether that means no meat, all meat, no fat, no carbs or specific eating times. The issue with this is that the vast majority of us cannot maintain this level of restriction indefinitely. When the diet is liberalized, calorie intake often increases as food choices expand. The weight that was lost tends to return, and the cycle of hope and frustration starts over.

Instead of going to extremes to reach your goals, aim for a whole foods and plant-forward approach. This can look like:

• Shopping the periphery of the store, where fresh, minimally processed foods like produce, lean proteins and dairy are located

• Eating more vegetables, fruits and legumes

• Minimizing pre-made and ultra-processed foods

• Eliminating high sugar foods and sugar-sweetened beverages of all types (including juices, even if there's "no sugar added")

Find the healthiest and balanced diet you can maintain, consume it at least 85% of the time, and attend to the other three pillars. You can fine-tune from there.
 

A brief word on supplements

Supplements are meant to be supplemental to your nutrition. There is no magic longevity bullet, despite all of the ads that tell you otherwise. Everyone is limited on time so it can be tempting to spend hundreds or thousands of dollars on these treatments, but most offer little to no known benefit. If you're looking to invest in your health, consider putting that money toward a licensed personal trainer or health coach to help you figure out how to bring these changes to your life. The knowledge you gain from these professionals will bring lasting benefits throughout the rest of your life and help you move towards your health and longevity goals, whatever they may be.

For more information about the four pillars of health or to learn more about the services offered at Parkview Physicians Group – Integrative Medicine, please visit our website here. To schedule a new patient appointment and establish care with one of our providers, call our office at 260-672-6590.